Lecture 33 - Disaster Medicine (Inhalation Lung Injury)

Question 1

Thermal inhalation injury affects the ______ airway (supraglottic structures). It is rare because there is efficient _____ _____ in the upper airways. Prolonged effects can include damaged _____ function of more distal airways (which increases risk of infection via decreased clearance of pathogens), and thick ____ secretions leading to obstruction, atelectasis, and poor gas exchange.

Answer 1

Upper

Heat exchange

Cilliary function

Mucous

Question 2

Inhalation of chemicals or noxious gasses results more in ______ injury initially, and progress to parenchymal injury.

Answer 2

Thrachobronchial injury

Question 3

The best indicator of Parenchymal injury is a decrease in the ____:____ ratio. The more severe the injury, the more the ratio decreases (and more rapidly as well).

Parenchymal injury leads to a decrease in _____ production in the alveoli, risk of atelectasis, V/Q mismatch, and increased risk of ______.

Answer 3

PaO2 : FiO2

Surfactant

Pneumonia

Question 4

How does water solubility of inhaled chemicals affect where they end up in the airways and how irritative they are?

Answer 4

Less water soluble = more capable of getting into the lower airways.

More water soluble = more irritative.

Question 5

_____ ______ is the gold standard for assessing airway damage from smoke inhalation injuries. Though it has obvious difficulty producing clear images of the more distal airways.

Answer 5

Fiberoptic Bronchoscopy

Question 6

One of the main differences in the way chemical attacks vs biological attacks affect populations is the progression.

_______ attacks result in unusually large numbers of patients to seek help for similar symptoms all at the same time. ______ attacks result in a progressive increase in the number of patients seeking help for similar symptoms.

Answer 6

Chemical attack –> patients all at the same time

Biological –> progress increase in number of patients.

Question 7

Forced oscillation technique (FOT) is better than Spirometry at providing information about ______ airways (larger/proximal or smaller/distal?). How do patients have to breathe when using it?

Answer 7

Smaller/distal

They just have to breathe normally (it uses tidal volume).