Chemical And Thermal Injuries Flashcards Preview

Airways > Chemical And Thermal Injuries > Flashcards

Flashcards in Chemical And Thermal Injuries Deck (9)
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0
Q

What are some causes of inhalational injury

A

Hot, dry gases

Steam

toxic/chemical/irritating gases

smoke

1
Q

What is the major concern with chemical and thermal injury in regards to the airway

A

Airway patency and oxygenation

Early airway control is key to maintaining the airway patency and oxygenation

2
Q

What are some pathophysiologies related to thermal injury

A

Carbon monoxide (CO) poisoning

cyanide (CN) poisoning

aspiration

3
Q

If the airway is directly involved in a thermal injury what causes a rapid loss of airway patency

A

Laryngeal edema

4
Q

If the airway is not directly involved what are some possible cardio respiratory effects that can impact oxygenation

A

Increased lung water

Lung injury causes increased lung water

also major burns with or without lung injury are usually resuscitated Vigorously with fluids, so this can increase the water in the lungs as well i.e. 3rd spacing

5
Q

What is the route of choice for airway maintenance in thermal injury

A

Oral ETT, if nasal is used to convert to OETT as soon as possible

Note: nasal And tracheal airways have risk of infection

6
Q

In order to evaluate the patient for discontinuing airway support, what should be done

A

A simple cuff leak test to confirm that there is no airway edema

7
Q

Suppose there is airway edema, How should you evaluate the patient prior to discontinuing airway support

A

DL under general anesthesia

Explain the procedure to the patient
make the patient NPO (Including parental) for 8 hours
induce with general anesthesia via ETT using Sevo and oxygen
maintain spontaneous ventilation
introduce laryngoscope & observe upper airway edema
decision point: if Airway okay then extubate, if not leave intubated And reevaluate 24 hours later

8
Q

What types of chemicals may have produced chemical injury in the airway

A

Acrolein - Released by cellulosic conflagration (Extensive fire ), can produce pulmonary edema

Ammonia

Cyanide – polyurethane conflagration

carbon monoxide – fires and incomplete combustion

HCL – PVC Confederation; severe mucosal burns in airway

Phosgene

Lye ingestion