Inhalation injury occurs when noxious stimuli such as heat, gases, or particulate matter come into contact with the respiratory system.
Residential fires and workplace accidents are common events that lead to inhalation injury.
Pathophysiology includes thermal injury, systemic absorption of toxic compounds, and direct cellular injury.
Clinical manifestations include upper airway obstruction, carbon monoxide poisoning, airflow obstruction, and acute respiratory distress syndrome.
Therapy is largely supportive, although targeted therapies are the subject of active investigation.
Long-term sequelae and complications are common.
Inhalation injury is a spectrum of clinical disease that occurs when the respiratory system is exposed to extreme heat or toxic substances. These exposures occur most commonly in the setting of occupational chemical accidents and residential fires. The severity and pathogenesis of clinical disease depends upon the toxins present and the level of exposure. Acute disease severity can range from mild to fatal. Chronic consequences of inhalation injury are common.
History and exam
Key diagnostic factors
- presence of risk factors
- similarity of symptoms to those of others at site of exposure
- hoarseness or dysphonia
- facial burns
- upper airway oedema
- loss of consciousness
Other diagnostic factors
- known inhalation exposure
1st investigations to order
- pulse oximetry
- arterial blood gas
- carboxyhaemoglobin (CO-Hb) level
- chest x-ray
- cardiac telemetry monitoring
- urine toxicology screen
- serum ethanol level
Investigations to consider
- pulmonary function tests (PFT)
- laryngoscopy and bronchoscopy
- serum lactate
- cyanide level
- Cardiogenic oedema
- Guideline for inhalation injury in burns patients. Adult guideline
- Management of airway burns and inhalation injury. Paediatric guideline
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