What is included in the prehospital care for smoke inhalation injury?

Updated: Oct 15, 2021
  • Author: Keith A Lafferty, MD; Chief Editor: Joe Alcock, MD, MS  more...
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Answer

As always, prehospital care providers must do everything in their power to remove the patient from ongoing exposure without becoming casualties themselves. Although emergency department (ED) care is mostly supportive, prompt delivery to the ED should be a priority.

Secure the airway as needed, deliver high-flow oxygen by mask, and obtain IV access. Cardiac monitoring also is important for any patient with respiratory distress. Beta-agonists such as albuterol may be given as a nebulized treatment to those who demonstrate signs of bronchoconstriction.

If respiratory failure is present, the patient should have assisted ventilation and/or endotracheal intubation. Perform cricothyrotomy if airway obstruction is present or impending and an airway cannot be secured orally.

Obtain a CO level at the scene if possible. In a consecutive case series of 18 patients, cardiac arrest complicating CO toxicity was uniformly fatal, despite administration of hyperbaric oxygen (HBO) therapy after the initial resuscitation. The prognosis of this condition should be considered when making triage decisions for these patients. [41]


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