Failure to clear casts and secretions following inhalation injury
can be dangerous: report of a case.
Although only 3.3% of over 1 200 patients had assault burns, they were associated with a higher frequency of inhalation injury
, a larger size of third-degree burns and a longer intubation period, indicating a more severe clinical course than accidental burns.
In our study, 16 burn patients without NI received prophylactic antimicrobial agents because of poor immunostatus and inhalation injury
. Antimicrobial usage in our BCU could be further reduced if only prophylaxis was given to patients with poor immunostatus and an open burn wound that did not close within a few days.
* inhalation injury
with/or face, neck and chest wounds
The diagnosis of smoke inhalation injury
is based on clinical findings such as singed nasal hairs, intraoral soot, and signs of respiratory distress, including stridor, hoarseness, drooling, and dysphagia.
Patient description Peak Patient # Age Sex Diagnosis IAP mmHg 1 14 y/o M 60% TBSA burn and inhalation injury
, ARDS 39 2 6 w/o M GI obstruction with dysmotility Septic shock, MSOF 17 3 2 m/o M Kwashiorkor, zinc deficiency Septic Shock 27 4 5 m/o F BPD; NEC, Septic Shock 20 5 2 y/o M Neuroblastoma s/p nephrectomy.
Presenting with symptoms of dyspnea and exhibiting carbonaceous material in his nares and mouth, the patient was intubated shortly after arrival for concern of inhalation injury
and was placed on a ventilator.
On arrival at the hospital on October 14, 1992, the child was in "critical condition" from an inhalation injury
and third degree burns.
From an inhalation injury
, he suffered pneumonia, a collapsed lung, and adult respiratory distress syndrome.
The PMCs shown in this example are PMC 0508, Burn: Smoke Inhalation with Inhalation Injury
, and PMC 0509, Burn: Smoke Inhalation without Inhalation Injury
They cover pathophysiology; evaluation, resuscitation, and treatment; wound care, use of antibiotics, and control of burn wound sepsis; nutrition; inhalation injury
; general (nonburn) inpatient wound care; toxic epidermal necrolysis syndrome and Stevens-Johnson syndrome; chemical burns; and pediatric burn management.
Survival is greatly dependent on adequate therapeutic measures, including resuscitation, infection control, early wound closure, management of inhalation injury
, adequate nutrition, pain control and acute rehabilitation.