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Circumferential full-thickness chest burn restricting ventilation — RCPSC EM MCQ

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HardTraumaCircumferential full-thickness chest burn restricting ventilationRCPSC EM

CTAS 1: A 52-year-old has 35% TBSA flame burns including circumferential full-thickness chest burns. He is intubated. Ventilator peak pressures rise and tidal volumes fall despite correct tube position and no pneumothorax on ultrasound. Chest wall is leathery and tight. What is the most appropriate next step?

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Correct answer: B — Perform chest escharotomy with burn centre consultation

Circumferential chest eschar can mechanically restrict ventilation. Escharotomy relieves constriction while burn centre transfer is arranged.

Reference: ATLS burn care; Canadian burn centre practice