Typical surgical fire involves oxidizers, fuel

Consider this true example, taken from the December 2003 issue of ECRI’s Health Devices, of how a fire can occur during surgery:

During a tonsillectomy, the surgeon had packed the space around the uncuffed tracheal tube with dampened gauze pledgets. The patient was receiving a mixture of O₂ and N₂O. Some time into the surgery, electrosurgery was used to cauterize the tonsil bed.

The pledgets either had been insufficiently wetted or had been allowed to dry somewhat from the gases leaking through them from the patient’s lungs. One of the tissue embers landed on a dry pledget and ignited it in the oxidizer-enriched atmosphere in the airway. The burning pledgets ignited the outside of the tracheal tube and the red rubber catheter used for retraction of the soft palate.

The fire was extinguished with saline solution, but not before the patient sustained burns in the upper oropharynx.