Inhalation Injury

• significant cause of death in burned patients

• Causes: closed space exposure to chemicals, carbon monoxide, toxins in smoke (ammonia, sulfur dioxide, etc.), and steam; direct thermal injury is rare due to glottic reflex closure to heat)

• SSx: facial burns (amount of facial surface burn does not correlate with severity of inhalation injury), singed nasal hairs, soot in mouth or nose, hoarseness, wheezing, carbonaceous sputum

• Dx: direct laryngoscopy and bronchoscopy, may consider radionu-cleotide xenon scans

• Complications: upper airway obstruction, pulmonary edema, chemical tracheobronchitis, carbon monoxide poisoning

• Rx: monitoring, supplementary oxygen (may require intubation), aggressive pulmonary toilet, serial arterial blood gasses, bronchodila-tors, corticosteroids are contraindicated (increases mortality)

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