Inhalation / Non-thermal Burns Flashcards
How does inhalation injury affect
Damages airway due to inhalation of hot gas or combustion causing irritation
Systemic affects of absorption of CO
Mortality
Increased by 40%
How long for symptoms to present
Can take up to 5 days
When should you suspect
Closed space / house fired Any burn to head and neck Facial injury Singed nasal hair Soot in respiratory or pharyngeal secretion Wheeze Hoarse voice Brassy cough SOB Tachypneoa Stridor Altered consciousness Can obstruct due to swelling of vocal cord
How do you classify
Supraglottic - above larynx
Subglottic - below larynx
What causes supraglottic
Primary thermal due to inhalation of gas
What happens
Inflammatory mediators
Cause oedema and obstruction
What causes subglottic
Chemical injury
Damages alveoli resulting in interfere in gas exchange
Heat wouldn’t travel that far
What happens
Systemic absorption
CO and cyanide = most important
Shifts shifts oxyhaemoglobin curve to the left
leads to LOC, neurotoxicity and convulsion
Mortality
Unlikely to survive
How do you investigate
ABG - CO level / carboxyHb
CXR
Bronchoscopy to exclude pulmonary injury - anaesthesist can do if suspect
What will ABG show
Metabolic acidosis due to CO
How do you manage
Humidified O2 at 15l non-rebreath Large bore IV access Monitor sats Senior help - anaesthetist Greater fluid requirement Analgesia
What may be needed and when
Hyperbaric O2 if CO >30%
What can cause electrical burns
Low voltage
High voltage
Lightening
What is amount of heat proportional to
Current
Resistance
Duration
What has most resistance and least
Bone = most Fat Tendon Skin Muscle Vessel Nerve = least
How do you manage
Turn of power
Same as above
What is required within 24 hours
ECG
What can cause chemical burn
Acid
Alkali = more dangerous
What does extend depend on
Toxicity Quantitiy Concentration Temperature of chemical SA exposed Duration of contact Systemic effects
What are common acid
HCL = extremely corrosive
Nitric
Sulphuric
What happens with HCL
H = skin injury
Fluroide binds Ca = hypocalcaemia
How do you manage
Irrigation until pH back to neutral
Do not apply neutralisation as further damage
What suggests NAI
Multiple demarcated
Unusual body area - back, shoulder, buttock
Implement
