During a laser vocal cord nodule ablation, if an airway fire occurs, what is the MOST likely cause of the fire?

The occurrence of an airway fire during a laser vocal cord nodule ablation is most commonly associated with the improper use of an endotracheal tube. Specifically, if a laser-specific endotracheal tube is not utilized, this can increase the risk of ignition due to the materials from conventional endotracheal tubes that are not designed to withstand laser energy.

Laser-specific endotracheal tubes are constructed from materials that minimize the risk of fire, as they are typically made of non-combustible or fire-resistant materials. When lasers are employed in procedures involving delicate structures like the vocal cords, the intense energy they emit can ignite flammable materials. Substituting a laser-specific tube with a standard tube, which may contain materials that are more likely to catch fire, significantly raises the risk of an airway fire during surgery.

While issues such as compromised draping or inadequate management of wet sponges can contribute to the overall safety practice during surgical procedures, the specific link between the use of a laser-specific endotracheal tube and the risk of fire underscores the importance of using the right equipment in laser surgery environments.