Acute management of the upper airway in facial burns and smoke inhalation
R. H. Barlett, M. Niccole, M. J. Tavis, P. A. Allyn and D. W. Furnas
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, patients' s age, and
the extent of the burn; it is not related to the method of upper airway
control.
