Smoke inhalation injuries

[medicsb]

While intubation success is important. I think the biggest issue is what is going to be your treatment plan pre, during, and post airway management.

If your treatment plan revolves around just an E.T. tube you probably shouldnt RSI. But if you have a plan in place ie: peep levels, inhaled epi, etc. Then carry out your plan

Pre and post intubation management is a given, no? Are people intubating and not ventilating? For the short duration in the prehospital setting, PEEP is not an absolute necessity. Post ETI sedation is. Inhaled epi probably won't do t anything, so NBD if it's not done.

In the ICU, mucolytics and beta agonists are part and parcel, but in the prehospital setting I don't think it's an absolute must.

 

[Carlos Danger]

Possibly silly question, but might video laryngoscopy help?

Not a silly question. But the problem with these patients isn't usually the ability to visualize the glottis, it's that the tissues inside the airway and/or pharynx are swollen.

Of course they can still have other factors (obesity, reduced cervical ROM for whatever reason) that make visualization difficult, and VL therefore helpful.

 

[NomadicMedic]

I could see VL being advantageous because it would reduce the trauma that is inflicted on an airway from multiple DL attempts. Looking and atttempting to pass a tube more than once might very well turn that airway into hamburger.

 

[NPO]

What about nebulized epi? Or racemic epi? Does it have any merit with smoke and heat inhalation injuries?

I gave nebulized epi yesterday for croup and it made me think, it's a similar process, so would it be feasible?

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