Extensive burns in an elderly man found in a brush fire

Area of Science:

• Emergency Medicine
• Trauma Care
• Burn Management

Background:

• A rural advanced life support (ALS) ground service activated a flight team for an 80-year-old male found in a brush fire.
• The patient sustained 100% burns of varying severity, necessitating emergent transport to a specialized burn center.

Observation:

• Upon arrival, the flight crew observed the patient being ventilated with a bag valve mask and immobilized on a spine board.
• The patient presented with a low Glasgow Coma Score (E1, V1, M4 = 6) and signs of airway compromise, including soot in the nares and oropharynx, and neck swelling.
• Difficulty ventilating and noted trismus precluded the placement of an oral airway, with stridor indicating significant upper airway obstruction.

Findings:

• The patient exhibited signs of severe airway compromise secondary to extensive burns and environmental factors.
• Advanced airway management was urgently required due to the inability to secure the airway with basic maneuvers.

Implications:

• This case highlights the critical need for rapid assessment and intervention for airway management in patients with severe burns and potential inhalation injuries.
• Early activation of air medical services is crucial for timely transport and advanced care in complex trauma scenarios.
• Effective inter-facility communication and coordination between ground and air medical teams are vital for optimal patient outcomes.