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Smoke inhalation injury — SCE Respiratory MCQ

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HardRare/MiscellaneousSmoke inhalation injurySCE Respiratory

A 33-year-old firefighter is rescued from an enclosed-space fire with confusion, soot around the mouth and hoarse voice. SpO2 reads 99% on pulse oximetry while ABG co-oximetry shows carboxyhaemoglobin 28% and lactate 8 mmol/L. What is the most appropriate management?

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Correct answer: D — High-flow oxygen with urgent airway and cyanide-toxicity assessment

Pulse oximetry is falsely reassuring in carbon monoxide poisoning, and hoarseness with soot raises airway-injury risk; high-flow oxygen and urgent airway assessment are required, with cyanide considered when lactate is high after smoke inhalation. Nebulisers do not treat CO poisoning. Delayed outpatient review is unsafe given potential airway oedema and toxic inhalation.

Reference: Resuscitation Council UK; TOXBASE smoke inhalation guidance