Hello,
I wonder if I could ask people for their opinions on the safety of using nasal cannulae for ventilation when treating port wine stains on the face/Head.
We have a paediatric patient with a PWS that extends into hair-bearing scalp (the treated area will also come very close to the nose). The consultants would like to anaesthetize the patient with a propofol/remifentanil infusion whilst spontaneously ventilating on nasal cannulae in order to avoid having to manipulate the airway because the patient has previously subluxed.
Although the child's parents have shaved the affected area of scalp in the past there is always some short stubble present during treatment.
In addition to the possible risk of igniting hair I'm also aware of the possibility of igniting remote pools of oxygen from cases reported in the literature (e.g. Remote fire with the pulsed dye laser: Risk and prevention - Heidi A. Waldorf et al) and the laser's own manual.
Should the use of nasal cannulae be avoided at all costs in the light of these potential risks and an LMA with a member of the spinal team holding the head, to reduce the risk of neck movement be used?
Regards
Perways
Perways Akram
Laser Protection Advisor
Medical Physics and Clinical Engineering
Nottingham University Hospitals NHS Trust
Queen’s Medical Centre Campus
Derby Road
Nottingham NG7 2UH
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