Jet ventilation has been used extensively for laryngeal surgery. When the trachea is not intubated, a metal needle mounted in the operating laryngoscope or passed through the cords can be used for jet ventilation. Jet ventilation may be performed manually using a simple hand valve attached to an appropriate oxygen source or with the use of various mechanical devices that allow for adjustment of rate and oxygen concentration. Because oxygen can support combustion, the anesthesia provider should consider as low a concentration of oxygen as is possible. Many patients will tolerate an Fio₂ of 30% or less; however, oxygen requirements for each patient should be considered for their individual needs. Also, using lower levels of oxygen will minimize the risk of fire.