Clinical Challenges in Burn Surgery: Inhalation Injury

Behind The Knife: The Surgery Podcast

A nearby house fire has brought several patients to your hospital via ambulance, where you are the sole provider on duty. These patients require urgent triage and stabilization before transfer to the regional burn center. You are very concerned about inhalation injury and are tasked with making complex clinical decisions in a high-pressure situation. What are the next steps? Join Drs. Kevin Foster, Tina Palmeri, Ryan Rihani, Tommy Tran, and Kiran Dyamenahalli as they explore the intricacies of managing smoke inhalation injury and more!
Hosts:
Tommy Tran, Tristar Skyline Medical Center
Kiran Dyamenahalli, MGH Sumner Redstone Burn Center
Kevin Foster, Arizona Burn Center
Tina Palmeri, UC Davis Firefighters Burn Institute Regional Burn Center
Ryan Rihani, UT Health Dunn Burn Center
Tam Pham, Harborview Medical Center (Editor)
Learning Objectives:

1. Understand the etiology and common scenarios associated with inhalation injury
2. Understand the effect of inhalation injury on morbidity and mortality
3. Describe indications for invasive airway management (intubation, bronchoscopy, and mechanical ventilation).
4. Describe complications of inhalation injury and their management.

References:
Fournier, M., Turgeon, A. F., Doucette, S., Morrisette, M., Archambault, P., & Bouchard, N. (2016). Nebulized heparin for inhalation injury in burn patients: A systematic review and meta-analysis. Critical Care, 20(1), 1-10. https://doi.org/10.1186/s13054-016-1285-8
Norris, C., LaLonde, C., Slater, H., & Purser, D. (2005). Survival from inhalation injury. Burns, 31(7), 803-815. https://doi.org/10.1016/j.burns.2005.04.003
Li, W., Tang, X., Chen, Y., & Zhao, Z. (2021). Update on smoke inhalation injury: Pathogenesis, diagnosis, and treatment. Journal of Thoracic Disease, 13(4), 1797-1808. https://doi.org/10.21037/jtd-20-3328
Hahn, S. M., Kim, Y. H., Kim, K. H., & Lee, S. U. (2020). Advances in the diagnosis and treatment of smoke inhalation injury in burn patients. Acute and Critical Care, 35(1), 1-10. https://doi.org/10.4266/acc.2020.00175
Bittner, E. A., Shank, E., Woodson, L., & Martyn, J. A. (2015). Acute and long-term outcomes of burn injuries: A focus on inhalation injury. Clinics in Chest Medicine, 36(4), 549-560. https://doi.org/10.1016/j.ccm.2015.08.007
Romanowski, K. S., & Palmieri, T. L. (2019). Inhalation injury in burns: Pathophysiology, diagnosis, and treatment. Journal of Burn Care & Research, 40(5), 517-523. https://doi.org/10.1093/jbcr/irz123
Dyamenahalli, K., Garg, G., Shupp, J. W., Kuprys, P. V., Choudhry, M. A., & Kovacs, E. J. (2019). Inhalation injury: Unmet clinical needs and future research. Journal of Burn Care & Research, 40(5), 570-584. https://doi.org/10.1093/jbcr/irz055

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