Inhalational Injury
Considerations
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Emergency/full stomach
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Airway swelling & potential for airway obstruction
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Tracheobronchial thermal & chemical injury resulting in pulmonary complications:
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Alveolar collapse/atelectasis & airway plugging
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Bronchospasm
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Pneumonia
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ALI/ARDS
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Carbon monoxide & cyanide poisoning
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General burn considerations:
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Hypovolemic shock
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Hypo or hyperthermia
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Rhabdomyolysis
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Cardiac depression
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DIC, consumptive coagulopathy
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Management
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Secure airway early if compromised
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Bronchoscopy to document degree of tracheobronchial injury
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Use lung protective ventilation strategies:
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Tidal volume ≤ 6cc/kg
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Plateau pressure < 30cm H2O
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PEEP & FiO2 to achieve adequate oxygenation (PaO2 ≥55 to 80 mmHg)
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Start burn resuscitation
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Rule out & treat carbon monoxide & cyanide poisoning
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ICU admission & monitoring