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SMOKE INHALATION

These pages are excerpted from the Trauma Resident Handbook, Rhode Island Hospital Department of Surgery, Division of Trauma - updated 2001. The policies herein are intended to serve as guidelines only. Individual circumstances need to be considered as there may be times when it is appropriate or desirable to deviate from these guidelines. These educational guidelines will be reviewed and updated routinely.

All patients with suspected smoke inhalation injury should be evaluated by the Trauma Service.

Smoke Inhalation *

Manage life-threatening and urgent injuries

COHgb > 25% +/- symptoms, or
COHgb > 15% in pregnancy, or
One of the following
(and no obvious explanation other than CO):
1. History of loss of consciousness
2. Disorientation/altered MS in ED
3. ECG c/w ischemia or infarction

Yes:
Patient unstable or has associated injuries - inhalation injury, thermal or mechanical trauma?

No:

HBO not indicated **

 No:

 Yes:
 

Consult

  • Toxicology
  • Medical/Pulmonary
  • Neuropsychiatry

Admit to trauma

Consult

  • Toxicology
  • Neuropsychiatry
 

Consider HBO
 


* To confirm diagnosis of inhalation injury, consider bronchoscopy.
** If stabilized within 72 hours, may still qualify for delayed HBO

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