EMRA Simulation Guide

Pulmonary - Smoke Inhalation Injury

CASE: 55-year-old male presents with shortness of breath following a house fire

Learning Objectives

1. Recognize a critically ill patient and potential for impending conditions
2. Understand the potential medical complications in caring for patients in fires
3. Airway escalation and management in burn victims
4. Fluid resuscitation in burn victims
5. Indications for transfer to a burn center

Critical Actions

• IV access x2 large-bore peripheral IVs
• Place patient on monitors with continuous oxygen saturation monitoring
• Place patient on continuous end-tidal capnography
• Ask for a full set of vital signs including HR, BP, oxygen saturation, and temperature
• Early intubation for impending respiratory compromise
• Ask for and interpret appropriate labs (VBG/ABG, co-oximetry)
• Order a CXR
• Must examine skin and airway
• Administration of IV fluids with use of Parkland formula
• Tdap administration
• Initiation of transfer to burn center
• Closed-loop communication
• Synthesis of the case
• Disclose appropriate information to the patient/family

Download the case here.