Acute inhalation lesions

The leading role in changing the condition of victims of a fire is played by direct damage to the mucous membranes of the respiratory tract by hot air and combustion products, as well as inhalation poisoning by toxic substances, including carbon monoxide (carbon monoxide, CO).

The clinical picture is dominated by obstruction of the upper or lower respiratory tract, which is caused by both reflex laryngo- and/or bronchospasm and pulmonary edema.

First aid for inhalation exposure to combustion products

At the scene of the fire, all victims with respiratory distress are recommended to be given bronchodilators: 200 mg salbutamol, ipratropium bromide (for children 2-6 years old at a dose of 20 mcg, 6-12 years old - 40 mcg, over 12 years old - 80 mcg), ipratropium bromide + fenoterol (berodual) in a nebulizer (for children under 6 years old - 10 drops, 6-12 years old - 20 drops, over 12 years old - 20-40 drops). When using a nebulizer, salbutamol is used at a dose of 1.25-2.5 mg, and ipratropium bromide - at a dose of 125-250 mcg in 0.5-1.0 ml. Next, inhalation glucocorticosteroids are used: betamethasone, budesonide (pulmicort) or flunisonide for children under 6 years old at a dose of 0.25-0.5 mg, and over 6 years old - 1 mg. If necessary - prednisolone at 2-5 mg / kg or dexamethasone at 0.3-0.5 mg / kg. If signs of bronchial obstruction persist, it is necessary to additionally administer a 2.4% solution of aminophylline (euphyllin) at 4-6 mg / kg, intravenously by drip. Oxygen therapy with pure (100%) humidified oxygen is mandatory, and in case of pain syndrome - intramuscular administration of a 50% solution of sodium metamizole (analgin) 10 mg / kg.

The presence of clinical signs of acute respiratory failure is considered an indication for hospitalization in the intensive care unit.

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