A 40-year-old is intubated after facial burns from a house fire. Soot is present in the oropharynx, carboxyhaemoglobin is 18%, lactate is 9 mmol/L,

Question

A 40-year-old is intubated after facial burns from a house fire. Soot is present in the oropharynx, carboxyhaemoglobin is 18%, lactate is 9 mmol/L, and he remains hypotensive after fluids. What is the most appropriate next step?

Accepted Answer

Treat carbon monoxide exposure, consider cyanide antidote for severe lactic acidosis, and transfer to a burn centre

Answer

Use pulse oximetry alone to exclude inhalation toxicity

Answer

Give prophylactic antibiotics for inhalation injury as definitive care

Answer

Delay burn centre discussion until wounds are debrided

Answer

Extubate early because facial swelling is not yet marked

Inhalation injury and toxic smoke exposure — RCPSC EM MCQ

A 40-year-old is intubated after facial burns from a house fire. Soot is present in the oropharynx, carboxyhaemoglobin is 18%, lactate is 9 mmol/L, and he remains hypotensive after fluids. What is the most appropriate next step?