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Acute Management of the Upper Airway in Facial Burns and Smoke Inhalation

Acute Management of the Upper Airway in Facial Burns and Smoke Inhalation Abstract • Among 740 patients with acute burns who were admitted to our burn center from 1972 through 1975, thirty-six required upper airway access within the first 24 hours after burn for oral and facial burns or smoke inhalation. Nasotracheal intubation was initially used. Twelve survived; 11 were successfully extubated and one required a tracheostomy. If the patient had not sustained major smoke inhalation, extubation was usually possible without tracheostomy when edema subsided between one and six days after the burn. It is concluded that endotracheal intubation is a satisfactory method of gaining airway control in severe oral and facial burns and in smoke inhalation. The mortality associated with orofacial burns or smoke inhalation is related to the degree of lung damage, patient's age, and the extent of the burn; it is not related to the method of upper airway control. (Arch Surg 111:744-749, 1976) References 1. Achauer BM, Allyn P, Furnas DW, et al: Pulmonary complications of burns: The major threat to the burned patient . Ann Surg 177:311-319, 1973.Crossref 2. Furnas DW, Bartlett RH, Achauer BM: Management of the respiratory tract , in Lynch JB, Lewis SD (eds): Symposium in the Treatment of Burns . St Louis, CV Mosby Co, 1973. 3. Bartlett RH: Post traumatic pulmonary insufficiency , in Cooper P, Nyhus L (eds): Surgery Annual 1971 . New York, Appleton-Century-Crofts Inc, 1971. 4. Allyn PA, Bartlett RH: Pulmonary management of the burn patient . Heart Lung 2:714-719, 1973. 5. German JC, Allyn PA, Bartlett RH: Pulmonary artery pressure monitoring in acute burn management . Arch Surg 106:788-791, 1973.Crossref 6. Allyn PA, Bartlett RH: Management of the critically ill burn patient, in Zschoche DA (ed): Comprehensive Review of Critical Care. St Louis, CV Mosby Co, to be published. 7. Zikria BA, Weston GG, Chodoff M, et al: Smoke and carbon monoxide poisoning in fire victims . J Trauma 12:641-649, 1972.Crossref 8. Zawacki BE: Pulmonary complications of burns. Read before the American Burn Association, Denver, 1975. 9. Bartlett RH, Gentile DE, Allyn PA, et al: Hemodialysis in the management of massive burns . Trans Am Soc Artif Intern Organs 19:269-276, 1973.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Acute Management of the Upper Airway in Facial Burns and Smoke Inhalation

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Publisher
American Medical Association
Copyright
Copyright © 1976 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1976.01360250020003
Publisher site
See Article on Publisher Site

Abstract

Abstract • Among 740 patients with acute burns who were admitted to our burn center from 1972 through 1975, thirty-six required upper airway access within the first 24 hours after burn for oral and facial burns or smoke inhalation. Nasotracheal intubation was initially used. Twelve survived; 11 were successfully extubated and one required a tracheostomy. If the patient had not sustained major smoke inhalation, extubation was usually possible without tracheostomy when edema subsided between one and six days after the burn. It is concluded that endotracheal intubation is a satisfactory method of gaining airway control in severe oral and facial burns and in smoke inhalation. The mortality associated with orofacial burns or smoke inhalation is related to the degree of lung damage, patient's age, and the extent of the burn; it is not related to the method of upper airway control. (Arch Surg 111:744-749, 1976) References 1. Achauer BM, Allyn P, Furnas DW, et al: Pulmonary complications of burns: The major threat to the burned patient . Ann Surg 177:311-319, 1973.Crossref 2. Furnas DW, Bartlett RH, Achauer BM: Management of the respiratory tract , in Lynch JB, Lewis SD (eds): Symposium in the Treatment of Burns . St Louis, CV Mosby Co, 1973. 3. Bartlett RH: Post traumatic pulmonary insufficiency , in Cooper P, Nyhus L (eds): Surgery Annual 1971 . New York, Appleton-Century-Crofts Inc, 1971. 4. Allyn PA, Bartlett RH: Pulmonary management of the burn patient . Heart Lung 2:714-719, 1973. 5. German JC, Allyn PA, Bartlett RH: Pulmonary artery pressure monitoring in acute burn management . Arch Surg 106:788-791, 1973.Crossref 6. Allyn PA, Bartlett RH: Management of the critically ill burn patient, in Zschoche DA (ed): Comprehensive Review of Critical Care. St Louis, CV Mosby Co, to be published. 7. Zikria BA, Weston GG, Chodoff M, et al: Smoke and carbon monoxide poisoning in fire victims . J Trauma 12:641-649, 1972.Crossref 8. Zawacki BE: Pulmonary complications of burns. Read before the American Burn Association, Denver, 1975. 9. Bartlett RH, Gentile DE, Allyn PA, et al: Hemodialysis in the management of massive burns . Trans Am Soc Artif Intern Organs 19:269-276, 1973.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: Jul 1, 1976

References