SMOKE INHALATION/BURNS (RESPIRATORY MANAGEMENT (Airway Management,…
Dependent on stage- Early, Intermediate and Late stages
Direct thermal damage to the upper airway from inhaling hot gases.
Chemical injury to the lungs due to inhalation of toxic by-products of combustion found in smoke.
Damage to O2 delivery and cellular O2 utilization through exposure to CO or hydrogen cyanide.
Flame Exposure, Hot Liquids, Electrical/Chemical:
Indirectly affect the lungs causing bronchconstriction,
non-cardiogenic pulmonary edema and in worse cases ARDS.
Severity dependent on BSA affected and burn depth: First, Second and Third degree
headache, confusion seizures or coma, chest tightness, nausea/vomiting, mydriasis, dyspnea, hypernea, hypertension (early), Hypotension (late)
facial/neck burns, singed nose hairs, sooty sputum, cyanosis,hoarseness, coughing, stridor
Mechanical Ventilation Protocol
Oxygen Therapy Protocol
Resuscitation, Resurfacing, Rehabilitation, and Reconstruction
Exposure to the following:
Thermal injuries, Flame exposure,
Hot liquids, Electrical/Chemical
Acute Ventilatory Failure:
Inc COHb, Dec pH, Inc PaCO2, Dec HCO3-, Dec PaO2, Dec SaO2
Used to assess more severe burns - ARDS and PNA
Assessment of airway damage
Sats > 90%, Co-oximetry needed
Humification, allow mild/moderate resp acidosis to prevent pulmonary injury
CBC, electrolytes, lactate, ABG, Co-oximetry, coagulation profile
ARDS- If P/F ratio < 300, B/L diffuse infiltrates
Inc pH, Dec PaCO2, Dec HCO3-, Dec PaO2, Dec SaO2
: Inc COHb, Dec pH (lactic acidemia) , Dec PaCO2, Dec HCO3-, Dec PaO2, Dec SaO2
Severe cases of ARDS, PaCO2 may be elevated and combined respiratory and metabolic acidosis may be present
If vocal cords are damaged or the patient is likely o require MV > 10-12 days ---> recommend tracheostomy