Discuss the possible damage with short term and long term complications of a firefighter inhaling heated air and in respiratory distress. Prioritize the necessary interventions to stabilize the patient. Then discuss an in-depth plan of care for recovery.
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Lung injuries, also known as inhalation injuries, can occur in a firefighter who has inhaled hot air. Pulmonary damage caused by inhalation of thermal or chemical irritants is known as inhalation injury.
Heat damage, which is limited to upper airway structures, chemical irritation in the respiratory tract, and systemic poisoning, which may occur with carbon monoxide or cyanide inhalation, are the three forms of injuries.
Carbon Monoxide (CO) and Cyanide gas (HCN) poisoning and lung discomfort should be tested on a firefighter who has been injured by smoke inhalation. A decline of cognitive capacity, hypotension, cyanosis, CNS depression, lethargy, irritability, extreme temporal headache, generalized muscle fatigue, and coma are all signs of toxic exposure (nearly always from CO poisoning).
When a patient has smoke inhalation, it is important to assess the patient’s airway, breathing, and circulation right away. Bronchospasm occurs in some patients, who may benefit from the use of bronchodilators. Elective intubation should be considered when upper airway damage is suspected.
After 2-3 days of smoke inhalation, bacterial colonization and invasion peaks. Antibiotics for prophylaxis should not be used because they are ineffective and raise the risk of the emergence of resistant species. Any patient who has been exposed to toxic smokes for more than 24 hours should be monitored and imaged with serial chest radiographs.
If antibiotic treatment is required, the most common species in secondary pneumonia after smoke inhalation injury are Staphylococcus aureus and Pseudomonas aeruginosa.
Ware, L. B., & Matthay, M. A. (2010). The acute respiratory distress syndrome. New England Journal of Medicine, 342(18), 1334-1349.