Inhalation injury - Revision history

Danbot: Add verified PubMed references (PMIDs 29461292, 37149380)

2026-03-22T10:53:36Z

Add verified PubMed references (PMIDs 29461292, 37149380)

← Older revision		Revision as of 10:53, 22 March 2026
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	==Background==		==Background==
	* Inhalational injury a concern with history of being trapped in enclosed space for some time with toxic gases / fumes		* Inhalational injury a concern with history of being trapped in enclosed space for some time with toxic gases / fumes <ref>Foncerrada G, et al. Inhalation Injury in the Burned Patient. Ann Plast Surg. 2018 Mar;80(3 Suppl 2):S98-S105. PMID 29461292</ref>

	==Clinical Features==		==Clinical Features==
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	===Irritant Gases===		===Irritant Gases===
	* Irritant gases ([[ammonia toxicity\|ammonia]], formaldehyde, [[chlorine gas\|chlorine]], nitrogen dioxide) when dissolved in water lining respiratory tract produce a [[chemical burns\|chemical burn]] and inflammatory response		* Irritant gases ([[ammonia toxicity\|ammonia]], formaldehyde, [[chlorine gas\|chlorine]], nitrogen dioxide) when dissolved in water lining respiratory tract produce a [[chemical burns\|chemical burn]] and inflammatory response
	* More soluble the gas produces more upper airway burns/irritation symptoms		* More soluble the gas produces more upper airway burns/irritation symptoms<ref>Bittner E, Sheridan R. Acute Respiratory Distress Syndrome, Mechanical Ventilation, and Inhalation Injury in Burn Patients. Surg Clin North Am. 2023 Jun;103(3):439-451. PMID 37149380</ref>
	* Less soluble gases produce more pulmonary injury and [[respiratory distress]]		* Less soluble gases produce more pulmonary injury and [[respiratory distress]]

Rossdonaldson1: /* See Also */

2025-11-26T19:10:59Z

Rossdonaldson1: /* Differential Diagnosis */

2025-11-26T19:09:08Z

Differential Diagnosis

← Older revision		Revision as of 19:09, 26 November 2025
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	{{Inhalation exposure}}		{{Inhalation exposure}}
	{{Burn DDX}}		{{Burn DDX}}
			{{Toxic gas exposure DDX}}

	==Evaluation==		==Evaluation==

Rossdonaldson1: /* Video */

2024-04-17T20:14:28Z

Video

← Older revision		Revision as of 20:14, 17 April 2024
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	==External Links==		==External Links==

	~~==Video==~~
	~~{{#widget:YouTube\|id=CB10airH5Sg}}~~

	==References==		==References==

ClaireLewis at 04:18, 21 April 2021

2021-04-21T04:18:16Z

← Older revision		Revision as of 04:18, 21 April 2021
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	* Hyperacute - severe [[wheezing]], [[bronchoconstriction]], significant [[hypoxemia]]		* Hyperacute - severe [[wheezing]], [[bronchoconstriction]], significant [[hypoxemia]]
	* Acute [[pulmonary edema]] - onset at 48-72 hours post injury in a previously asymptomatic patient		* Acute [[pulmonary edema]] - onset at 48-72 hours post injury in a previously asymptomatic patient
	* Broncho[[pneumonia]] often at 10 days post-~~inury~~		* Broncho[[pneumonia]] often at 10 days post-injury

	==Differential Diagnosis==		==Differential Diagnosis==
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	: Examples - smoke inhalation from burning building, leak of a solvent, chemical fumes		: Examples - smoke inhalation from burning building, leak of a solvent, chemical fumes
	* Physical examination with focus on airway and pulmonary system		* Physical examination with focus on airway and pulmonary system
	* Observe of evidence of airway compromise or respiratory distress		* Observe for evidence of airway compromise or respiratory distress
			* [[Chest x-ray]], pulse oximetry, [[ABG\|arterial blood gas]]
			* Consider [[carbon monoxide toxicity\|carboxyhemoglobin]] and/or [[cyanide]] level if any suspicion based on history

	==Management==		==Management==
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	* Separate patient from fumes/toxic agent		* Separate patient from fumes/toxic agent
	* Decontaminate if not done on scene		* Decontaminate if not done on scene
	* Secure airway if necessary and ventilate		* Secure airway if necessary and ventilate, observe for respiratory distress and airway compromise
	* [[Oxygen]] at 6-12 liters per minute via mask		* [[Oxygen]] at 6-12 liters per minute via mask
	* [[Chest x-ray]], pulse oximetry, arterial blood gases
	* Consider carboxyhemoglobin level or [[cyanide]] level if any suspicion based on history
	* Observe for respiratory distress and airway compromise

	===Inert Gases===		===Inert Gases===
	* Remove victim from the gas		* Remove victim from the gas
	* Fresh air or oxygen		* Fresh air or oxygen
	* Observe for sequelae from hypoxia ([[myocardial infarction]], cerebral injury)		* Observe for sequelae from [[hypoxia]] ([[myocardial infarction]], cerebral injury)

	===Allergic===		===Allergic===
	* Aerosolized [[bronchodilators]]		* Aerosolized [[bronchodilators]]
	* [[Corticosteroids]] in patients with history of reactive airway disease		* [[Corticosteroids]] in patients with history of reactive airway disease

	===Smoke Inhalation / Thermals===		===Smoke Inhalation / Thermals===
	* Ensure adequate oxygenation, ventilation, pulmonary toilet and fluid resuscitation		* Ensure adequate oxygenation, ventilation, pulmonary toilet and [[IVF\|fluid resuscitation]]

	==Disposition==		==Disposition==

Elcatracho: /* Inert Gases */

2021-04-19T09:51:20Z

Inert Gases

← Older revision		Revision as of 09:51, 19 April 2021
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	* Remove victim from the gas		* Remove victim from the gas
	* Fresh air or oxygen		* Fresh air or oxygen
	* Observe for sequelae from hypoxia (myocardial infarction, cerebral injury)		* Observe for sequelae from hypoxia ([[myocardial infarction]], cerebral injury)

	===Allergic===		===Allergic===
	* Aerosolized [[bronchodilators]]		* Aerosolized [[bronchodilators]]

Elcatracho: /* General */

2021-04-19T09:50:49Z

General

← Older revision		Revision as of 09:50, 19 April 2021
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	* [[Oxygen]] at 6-12 liters per minute via mask		* [[Oxygen]] at 6-12 liters per minute via mask
	* [[Chest x-ray]], pulse oximetry, arterial blood gases		* [[Chest x-ray]], pulse oximetry, arterial blood gases
	* Consider carboxyhemoglobin level or cyanide level if any suspicion based on history		* Consider carboxyhemoglobin level or [[cyanide]] level if any suspicion based on history
	* Observe for respiratory distress and airway compromise		* Observe for respiratory distress and airway compromise

ClaireLewis: /* General */

2019-09-28T19:26:49Z

General

← Older revision		Revision as of 19:26, 28 September 2019
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	* Decontaminate if not done on scene		* Decontaminate if not done on scene
	* Secure airway if necessary and ventilate		* Secure airway if necessary and ventilate
	* [[Oxygen at]] 6-12 liters per minute via mask		* [[Oxygen]] at 6-12 liters per minute via mask
	* [[Chest x-ray]], pulse oximetry, arterial blood gases		* [[Chest x-ray]], pulse oximetry, arterial blood gases
	* Consider carboxyhemoglobin level or cyanide level if any suspicion based on history		* Consider carboxyhemoglobin level or cyanide level if any suspicion based on history
	* Observe for respiratory distress and airway compromise		* Observe for respiratory distress and airway compromise

	===Inert Gases===		===Inert Gases===
	* Remove victim from the gas		* Remove victim from the gas

ClaireLewis: /* Irritant Gases */

2019-09-28T19:26:34Z

Irritant Gases

← Older revision		Revision as of 19:26, 28 September 2019
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	* Present with severe [[hypoxia]]		* Present with severe [[hypoxia]]
	===Irritant Gases===		===Irritant Gases===
	* Irritant gases ([[ammonia toxicity\|ammonia]], formaldehyde, [[chlorine gas\|chlorine]], nitrogen dioxide) when dissolved in water lining respiratory tract produce a [[chemical burn]] and inflammatory response		* Irritant gases ([[ammonia toxicity\|ammonia]], formaldehyde, [[chlorine gas\|chlorine]], nitrogen dioxide) when dissolved in water lining respiratory tract produce a [[chemical burns\|chemical burn]] and inflammatory response
	* More soluble the gas produces more upper airway burns/irritation symptoms		* More soluble the gas produces more upper airway burns/irritation symptoms
	* Less soluble gases produce more pulmonary injury and [[respiratory distress]]		* Less soluble gases produce more pulmonary injury and [[respiratory distress]]

	===Systemic Toxins===		===Systemic Toxins===
	* Includes [[carbon monoxide]], hydrogen [[cyanide]], [[hydrogen sulfide]]		* Includes [[carbon monoxide]], hydrogen [[cyanide]], [[hydrogen sulfide]]

ClaireLewis at 19:26, 28 September 2019

2019-09-28T19:26:17Z

← Older revision		Revision as of 19:26, 28 September 2019
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	==Clinical Features==		==Clinical Features==
	===General===		===General===
	* Initial signs/symptoms - ~~coughing~~, wheezing, dyspnea, irritated mucous members (runny eyes/nose), chest pain, hypoxia		* Initial signs/symptoms - [[cough]], [[wheezing]], [[dyspnea]], irritated mucous members (runny eyes/nose), [[chest pain]], [[hypoxia]]
	* Specific features dependent on type of exposure		* Specific features dependent on type of exposure
	===Inert Gases===		===Inert Gases===
	* Inert gases (carbon ~~dioxise~~, fuel gases) displace air and oxygen producing asphyxia		* Inert gases (carbon dioxide, fuel gases) displace air and oxygen producing asphyxia
	* Present with severe hypoxia		* Present with severe [[hypoxia]]
	===Irritant Gases===		===Irritant Gases===
	* Irritant gases (ammonia, formaldehyde, chlorine, nitrogen dioxide) when dissolved in water lining respiratory tract produce a chemical burn and inflammatory response		* Irritant gases ([[ammonia toxicity\|ammonia]], formaldehyde, [[chlorine gas\|chlorine]], nitrogen dioxide) when dissolved in water lining respiratory tract produce a [[chemical burn]] and inflammatory response
	* More soluble the gas produces more upper airway burns/irritation symptoms		* More soluble the gas produces more upper airway burns/irritation symptoms
	* Less soluble gases produce more pulmonary injury and respiratory distress		* Less soluble gases produce more pulmonary injury and [[respiratory distress]]
	===Systemic Toxins===		===Systemic Toxins===
	* Includes carbon monoxide, hydrogen cyanide, hydrogen sulfide		* Includes [[carbon monoxide]], hydrogen [[cyanide]], [[hydrogen sulfide]]
	* Interfere with delivery of oxygen for use in cellular energy production		* Interfere with delivery of oxygen for use in cellular energy production
	* Liver, kidney, brain, lung and other organ damage		* Liver, kidney, brain, lung and other organ damage
	===Allergic===		===Allergic===
	* Inhaled gases, particles, aerosols		* Inhaled gases, particles, aerosols
	* Produce bronchospasms and edema similar to asthma		* Produce bronchospasms and edema similar to [[asthma]]
	===[[Smoke inhalation injury\|Smoke Inhalation / Thermal]]===		===[[Smoke inhalation injury\|Smoke Inhalation / Thermal]]===
	* Most fatalities from burn injuries are attributed to smoke inhalation		* Most fatalities from burn injuries are attributed to smoke inhalation
	* Soot in posterior pharynx, singed nasal hair		* Soot in posterior pharynx, singed nasal hair
	* Hyperacute - severe wheezing, bronchoconstriction, significant hypoxemia		* Hyperacute - severe [[wheezing]], [[bronchoconstriction]], significant [[hypoxemia]]
	* Acute pulmonary edema - onset at 48-72 hours post injury in a previously asymptomatic patient		* Acute [[pulmonary edema]] - onset at 48-72 hours post injury in a previously asymptomatic patient
	* ~~Bronchopneumonia~~ often at 10 days post-inury		* Broncho[[pneumonia]] often at 10 days post-inury

	==Differential Diagnosis==		==Differential Diagnosis==
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	* Decontaminate if not done on scene		* Decontaminate if not done on scene
	* Secure airway if necessary and ventilate		* Secure airway if necessary and ventilate
	* Oxygen at 6-12 liters per minute via mask		* [[Oxygen at]] 6-12 liters per minute via mask
	* Chest x-ray, pulse oximetry, arterial blood gases		* [[Chest x-ray]], pulse oximetry, arterial blood gases
	* Consider carboxyhemoglobin level or cyanide level if any suspicion based on history		* Consider carboxyhemoglobin level or cyanide level if any suspicion based on history
	* Observe for respiratory distress and airway compromise		* Observe for respiratory distress and airway compromise
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	* Observe for sequelae from hypoxia (myocardial infarction, cerebral injury)		* Observe for sequelae from hypoxia (myocardial infarction, cerebral injury)
	===Allergic===		===Allergic===
	* Aerosolized bronchodilators		* Aerosolized [[bronchodilators]]
	* Corticosteroids in patients with history of reactive airway disease		* [[Corticosteroids]] in patients with history of reactive airway disease
	===Smoke Inhalation / Thermals===		===Smoke Inhalation / Thermals===
	* Ensure adequate oxygenation, ventilation, pulmonary toilet and fluid resuscitation		* Ensure adequate oxygenation, ventilation, pulmonary toilet and fluid resuscitation

← Older revision		Revision as of 19:10, 26 November 2025
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	==See Also==		==See Also==
	*[[Smoke inhalation injury]]		*[[Smoke inhalation injury]]
			*[[Inhalant abuse]]
	*[[Burns]]		*[[Burns]]