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Inhalation Injury — RACP Adult Medicine MCQ

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EasyRespiratoryInhalation InjuryRACP Adult Medicine

A 30-year-old man rescued from a house fire presents with hoarse voice, stridor, soot in the nares and oropharynx, and singed nasal hairs. He has facial burns. SpO₂ is 97% on room air. Carboxyhaemoglobin (COHb) is 25%. What is the most important immediate management?

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Correct answer: B — Intubation for airway protection

Stridor, hoarseness, and soot in the airway with facial burns indicate impending upper airway compromise from inhalation injury. Early intubation is critical as airway oedema progresses rapidly and can make delayed intubation impossible. COHb 25% indicates significant CO exposure requiring 100% O₂. The airway takes priority over everything else.

Reference: ANZBA – 2024 – Burns Guidelines; eTG Emergency 2024