Case of the Month #46 A Major Burn Injury: Taming the Flames

Published 13/02/2024

Your team set up for intubation. You continue with your assessment. What considerations for breathing are immediately relevant?

What considerations for breathing are immediately relevant? 

  • Inhalational injury 

    • May impair gas-exchange 
    • Will require bronchoscopy to evaluate in due course 
  • Carbon monoxide poisoning 

    • Check carboxyhaemoglobin levels 
    • Check blood gas co-oximetry, as pulse oximeters will over-read 
    • Washout is hastened by 100% oxygen 
  • Torso eschars may restrict ventilation 

You secure the airway using a videolaryngoscope and a size 9.0 uncut ETT. The upper airway is covered in soot and appears erythematous, but is not overtly swollen or ulcerated.