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SMOKE INHALATION
These pages are excerpted from the Trauma
Resident Handbook, Rhode Island Hospital Department of Surgery,
Division of Trauma - updated 2001. The policies herein are intended
to serve as guidelines only. Individual circumstances need to
be considered as there may be times when it is appropriate or
desirable to deviate from these guidelines. These educational
guidelines will be reviewed and updated routinely.
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All patients with suspected smoke inhalation
injury should be evaluated by the Trauma Service.
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Smoke Inhalation
* |
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Manage life-threatening
and urgent injuries |
COHgb > 25% +/- symptoms,
or
COHgb > 15% in pregnancy, or
One
of the following
(and no obvious explanation other
than CO):
1. History of loss of consciousness
2. Disorientation/altered MS in ED
3. ECG c/w ischemia or infarction |
Yes:
Patient unstable or has
associated injuries - inhalation injury, thermal or mechanical
trauma? |
No:
HBO not indicated **
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No: |
Yes: |
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Consult
- Toxicology
- Medical/Pulmonary
- Neuropsychiatry
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Admit to trauma
Consult
- Toxicology
- Neuropsychiatry
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Consider HBO |
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* To confirm diagnosis of inhalation injury, consider
bronchoscopy.
** If stabilized within 72 hours, may still qualify for delayed
HBO
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