Please refer to Figure 100-1 for the ASA airway fire algorithm. Recognition is the first step in managing an OR fire. Early signs may include a flame or flash, unusual smells or sounds, smoke, heat, and unexpected movement of drapes or the patient. If one of these signs is noted, the surgeon should stop the procedure, and the anesthesiologist should initiate a thorough evaluation for a fire. If a fire is present, the entire OR team should be notified, followed by initiation of the OR fire protocol. Each member should perform his/her task without delay and subsequently assist others. For fires outside the breathing circuit or airway, the flow of airway gases should be stopped, and all drapes and flammable materials removed from the patient. All burning materials must be extinguished with saline, water, or by smothering. A carbon dioxide fire extinguisher may be necessary if the fire is refractory to these measures. If the fire still persists, activate the fire alarm and evacuate the patient and OR team from the room. Ensure that the OR door is closed and the medical gas supply has been turned off. After extinguishing the fire, assess the patient’s respiratory status and potential for smoke inhalation injury.