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Acute inhalation

Alexey Portnov, medical expert
Last reviewed: 23.04.2024

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Leading importance in changing the condition of victims in a fire is directly damaged by hot air and combustion products of the mucous membranes of the respiratory tract, as well as inhalation poisoning with toxic substances, including carbon monoxide (CO) carbon monoxide.

In the clinical picture, obstruction of the upper or lower respiratory tract predominates, which is due to reflex laryngo- and / or bronchospasm as well as pulmonary edema.

Emergency care for inhalation lesions by combustion products

At the site of the fire, all affected with respiratory disorders are shown the administration of bronchodilators: 200 mg of salbutamol. Ipratropium bromide (children 2-6 years in a dose of 20 mcg, 6-12 years - 40 mcg, over 12 years - 80 mcg), ipratropium bromide + fenoterol (beroduala) in a nebulizer (children under 6 years - 10 drops, 6- 12 years - 20 drops, over 12 years - 20-40 drops). When using a nebulizer, salbutamol is used in a dose of 1.25-2.5 mg. And ipratropium bromide - in a dose of 125-250 μg in 0,5-1,0 ml. Further inhalation glucocorticosteroids are used: betamethasone, budesonide (pulmicort) or flunisonide for children under 6 years in a dose of 0.25-0.5 mg, and over 6 years - 1 mg. In necessary cases - prednisolone 2-5 mg / kg or dexamethasone at 0.3-0.5 mg / kg. With preservation of signs of bronchial obstruction, it is necessary to additionally introduce a 2.4% solution of aminophylline (euphyllin) at 4-6 mg / kg, intravenously drip. It is obligatory to carry out oxygen therapy with pure (100%) moistened oxygen, and with pain syndrome - intramuscular injection of 50% solution of metamizole sodium (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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