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Smoke inhalation injury — SCE Respiratory MCQ

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HardOtherSmoke inhalation injurySCE Respiratory

A 29-year-old man develops cough, dyspnoea and fever 8 hours after smoke inhalation in a house fire. Carboxyhaemoglobin is elevated and bronchoscopy shows soot below the vocal cords with erythematous mucosa. CXR is initially normal. What is the most appropriate management?

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Correct answer: B — High-flow oxygen and early airway/critical care assessment

The best answer is “High-flow oxygen and early airway/critical care assessment”. High-flow oxygen and early airway/critical care assessment is the recommended next management step after the clinical severity, prior treatment and contraindications in the stem are taken into account. The alternatives are either insufficient, unnecessarily invasive, or reserved for a different physiological or risk profile. The remaining choices—“Immediate oral antibiotics and discharge”, “Nebulised corticosteroid alone, after safety review”, “Delayed review in 2 weeks because CXR is normal”, “Long-term anticoagulation, within a respiratory pathway”—are credible in related respiratory presentations, but each addresses a different diagnostic, staging or management decision and does not fit the decisive findings and pathway position in this stem.

Reference: Faculty of Intensive Care Medicine: inhalation injury: https://www.ficm.ac.uk/documents/management-of-inhalation-injuries