ELECTROCAUTERY-INDUCED IGNITION OF TONSILLAR PACKING

A recent case of ignition of a bismuth-subgallate pack during routine tonsillectomy prompted this investigation of local oxygen levels. Simi lar conditions were reproduced in the laboratory to determine their in fluence on the flammability of materials commonly used to aid in haemo stasis. Cotton tonsil packs soaked in saline, adrenalin, or adrenalin and bismuth were compared. During spontaneous ventilation through an a ge-appropriate uncuffed endotracheal tube, an air leak rarely occurred . However, when assisted ventilation was used, an airway leak produced an elevated oxygen concentration in 8 of 10 children. This was associ ated with increased combustibility of the packs, regardless of solutio n mixture. The addition of bismuth further increased combustibility. P artially saturated packs appeared to be more combustible than fully sa turated packs.