Patients with severe thermal injuries may die not of the cutaneous burns but of asphyxiation (most often due to low ambient oxygen levels at the fire scene or carbon monoxide poisoning) or of injury to the upper airway or pulmonary parenchyma. Admission cooximetry should be performed in all burn patients to rule out carbon monoxide poisoning. Pulse oximetry may overestimate hemoglobin saturation, and arterial oxygen tension may remain normal - despite high concentrations of carboxyhemoglobin. Flexible bronchoscopy can confirm supraglottic or subglottic injury. Later, flexible or rigid bronchoscopy facilitates pulmonary toilet in patients in whom obstructing airway casts develop; nebulized heparin may reduce cast formation. Prophylactic high-frequency percussive ventilation is recommended when intubation is required.
|Original language||English (US)|
|Number of pages||13|
|Journal||Journal of Critical Illness|
|State||Published - Dec 1 1997|
ASJC Scopus subject areas
- Critical Care and Intensive Care Medicine