caa a22 4500 465772595 CHVBK 20180323111933.0 cr unu---uuuuu 170327e19900801xx s 000 0 eng 10.1007/BF00177097 doi (NATIONALLICENCE)springer-10.1007/BF00177097 Successful early management of adolescent inhalation injuries [Elektronische Daten] [Mary Fallat, Sarah Longmire-Cook] We recently cared for 12 adolescents with inhalation injuries who were involved in a bus accident and subsequent fire. These patients arrived at our trauma center between 2 and 8 h following injury. Need for early intubation was mandated by hoarseness, stridor, and respiratory distress. There were 27 scene deaths attributed to smoke inhalation and thermal burns by postmortem examination in combination with carboxyhemoglobin values of 18% to 69%. There were no deaths among our 12 patients, whose carboxyhemoglobin values ranged from 3.2% to 18.8%. Seven patients required emergency endotracheal intubation, and 5 others were electively intubated in the operating room due to signs and symptoms of respiratory injury. All 12 patients were subsequently bronchoscoped. One patient who underwent bronchoscopy did not require continued intubation, but the other 11 all had dense soot lining the entire visible tracheobronchial tree. One patient developed clinical pneumonia while intubated. Patients require intubation for from 2 to 10 days and pre-extubation bronchoscopic examination was performed in 8 patients, documenting improvement. Five patients with severe facial burns underwent laryngoscopy, and vocal cord edema in 4 delayed extubation despite an improved lower airway. Two patients required late tracheotomy for glottic and interarytenoid scarring. One patient who required reintubation due to cord edema and 1 other who had been intubated emergently in the field required late tracheostomies for glottic and interarytenoid scarring. We had no mortality and low morbidity in a group of young patients with severe inhalation injuries. Rather than the more common complications of pneumonia and adult respiratory distress syndrome, glottic and supraglottic injuries caused the most disability. Periodic evaluation with bronchoscopy and laryngoscopy prior to extubation may have helped to minimize further airway trauma and contributed to our early good results. Springer-Verlag, 1990 Pulmonary burns nationallicence Smoke inhalation nationallicence Fallat Mary Department of Surgery and Division of Pediatric Surgery, University of Louisville School of Medicine, 550 South Jackson Street, 40292, Louisville, KY, USA aut Longmire-Cook Sarah Department of Surgery and Division of Pediatric Surgery, University of Louisville School of Medicine, 550 South Jackson Street, 40292, Louisville, KY, USA aut Pediatric Surgery International Springer-Verlag 5/5(1990-08-01), 322-326 0179-0358 5:5<322 1990 5 383 https://doi.org/10.1007/BF00177097 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/BF00177097 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Fallat Mary Department of Surgery and Division of Pediatric Surgery, University of Louisville School of Medicine, 550 South Jackson Street, 40292, Louisville, KY, USA aut NATIONALLICENCE 700 1- Longmire-Cook Sarah Department of Surgery and Division of Pediatric Surgery, University of Louisville School of Medicine, 550 South Jackson Street, 40292, Louisville, KY, USA aut NATIONALLICENCE 773 0- Pediatric Surgery International Springer-Verlag 5/5(1990-08-01), 322-326 0179-0358 5:5<322 1990 5 383 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer