if a fire occurs in the airway immediate actions by the anesthesia provider can limit airway tissue damage and provide a secure Payton airway the operating room fire crisis checklist contains important actions for the anesthesia provider and operating room team that helps improve communication and establish team situational awareness if this crisis occurs in the event of an airway fire the first action should be to extinguish the fire by eliminating the accelerant and fuel this is done by turning off the oxygen disconnecting the circuit from the patient and removing the airway device any additional flammable material should be removed and saline should be poured into the airway to decrease any further burning after the fire is extinguished ventilation should be re-established using a bag and mask with room air an endotracheal tube should be considered in a timely manner to prevent hypoxia and provide a secure airway in the event of Airways swelling after placement of an ED to tracheal tube an assessment of the airway should be completed to determine the extent of damage as well as to retrieve any residual debris after extinguishing the airway fire and initiating ventilation confirm that no secondary fire exists on the surgical field drapes and towels if the fire cannot be extinguished the use of a fire extinguisher may be warranted if the fire still persists evacuate the patient close the operating room door and turn off all gas supply it to the O are a discussion about the patient's condition and subsequent plan of action should occur with the operating room team to best devise a course of action and treatment plan any materials that were involved in the fire should be saved for evaluation finally a debriefing with the operating room team and any other providers present for this critical event is important to address the factors that led to the fire and the emotional toll it may have had on those involved