Acute inhalation injury in burn patients: A case report

Background: A burn on the face leads to a high possibility of a concomitant smoke inhalation injury being present. Inhalation injury is associated with a difficult airway and early intubation is critical. Airflow may be... [ view full abstract ]

Background: A burn on the face leads to a high possibility of a concomitant smoke inhalation injury being present. Inhalation injury is associated with a difficult airway and early intubation is critical. Airflow may be obstructed secondary to upper airway edema caused by thermal injury. Oxygen delivery may also be reduced in the setting of lower airway and lung parenchyma injury. Lastly, carbon monoxide poisoning prevents appropriate oxygen delivery to tissues.

Case description: We describe the case of a healthy, non-smoking 30-year-old male with no past medical history who suffered an inhalation injury and facial burn due to an apartment fire. Endotracheal intubation was performed immediately on arrival and confirmed by portable chest film. Bronchoscopy was performed to diagnose inhalation injury and to assess the severity. Treatment consisted of supportive care, mechanical ventilation, and appropriate transfer to a burn center.

Discussion: We conclude with advice on the optimal airway management in patients with inhalation injury, the role of bronchoscopy and objective grading of inhalation injury, and lastly guidelines in treatment in this population.