To get the blue key on level 18, Spawned Fear:

First, go into the room where the blue key is and take a
look at the key.  If there are three short vertical bars in
front of the key, blocking access to it, then see REMOVING
THE BARS, below.  Otherwise:

Just outside the door to the blue-key room is another room.
One wall of this room is lined with what appear to be five
switches in a horizontal row.  The switch closest to the
blue-key door will drop the pedestal that the blue key sits
upon.  You can activate this switch one of two ways: 1) You
can stand on the raised platform next to the blue-key door,
and shoot the switch with your pistol, shotgun (either one)
or chaingun; or 2) Simply walk up to the switch and punch
it, or buzz it once with your chainsaw.
This causes the blue-key pedestal to drop down to floor
level for a few seconds; then it will rise back up again.
In the meantime, you can grab it.
Before you activate the switch, it's advisable to have the
door to the blue-key room already open.

REMOVING THE BARS
-----------------
If the blue key is blocked by vertical bars, you'll have to
lower them by activating a switch, and/or killing one or
more (varies by Skill level) Barons of Hell.  The Baron(s)
and switch are a few rooms away from the blue-key room.
First, from the blue-key room, walk out the door (into the
room with the 5 switches on the wall), and step through the
next door.  As you step through, turn right and follow the
right-hand wall, passing the first door you come to, then
look for the next door.  It'll have a switch just outside
it, to the left.
Open that door and you'll see a chamber ahead of you, with
another door on the far side, across a square pool of green
slime.  Activate the switch next to you (next to the door
you just opened), and this will open the door on the far
side of the slime pool.
Kill the Baron(s) that you released from the far chamber,
and a floor grate will rise out of the slime pool, allowing
you to cross unharmed.
In the far chamber, you'll see a switch ahead of you.  If
you killed every Baron in that chamber, the vertical bars
in the blue-key room should have lowered, and you can
ignore the switch.  Otherwise, you can activate this switch
to drop the bars that were blocking access to the blue key.

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