Education  |   October 2017
Images in Anesthesiology: Video Laryngoscopy for Intubation after Smoke Inhalation
Author Notes
  • From the Department of Anesthesiology, R. Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland.
  • Supplemental Digital Content is available for this article. Direct URL citations appear in the printed text and are available in both the HTML and PDF versions of this article. Links to the digital files are provided in the HTML text of this article on the Journal’s Web site (www.anesthesiology.org).
    Supplemental Digital Content is available for this article. Direct URL citations appear in the printed text and are available in both the HTML and PDF versions of this article. Links to the digital files are provided in the HTML text of this article on the Journal’s Web site (www.anesthesiology.org).×
  • Address correspondence to Dr. Grissom: tgrissom@umm.edu
Article Information
Education / Images in Anesthesiology / Airway Management / Respiratory System / Trauma / Burn Care
Education   |   October 2017
Images in Anesthesiology: Video Laryngoscopy for Intubation after Smoke Inhalation
Anesthesiology 10 2017, Vol.127, 709. doi:10.1097/ALN.0000000000001655
Anesthesiology 10 2017, Vol.127, 709. doi:10.1097/ALN.0000000000001655
SMOKE inhalation (Supplemental Digital Content, http://links.lww.com/ALN/B432, video of the entire procedure with commentary) produces injury through direct thermal injury, chemical injury from soot and other irritant compounds, and systemic toxicity. In addition to direct thermal trauma, airway edema occurs as a result of exposure to inhaled components such as aldehydes, ammonia, and phosgene, as well as fluid resuscitation. This can rapidly lead to airway obstruction and hypoxia, making early evaluation and frequent reassessment essential. Obvious signs of injury include facial burns, soot at the nose and mouth, singed facial hair, and carbonaceous sputum. Patient characteristics such as stridor, hoarseness, and inability to tolerate secretions also suggest upper airway injury.
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