Inhalation Injury: Which Providers Can Assess the Need for Intubation?

Area of Science:

• Trauma Surgery
• Burn Care
• Airway Management

Background:

• Unnecessary intubation in burn patients is a concern, often driven by fears of inhalation injury.
• Acute care surgeons (ACSs) manage airways in emergent settings.

Purpose of the Study:

• To compare intubation rates between burn surgeons and non-burn ACSs in emergent burn injury cases.
• To evaluate if specialized burn care impacts airway management decisions.

Main Methods:

• Retrospective cohort study of burn patients admitted to a verified burn center (June 2015-December 2021).
• Compared intubation rates, bronchoscopy findings, and extubation times between burn and non-burn ACS evaluations.
• Excluded polytrauma, friction burns, and pre-intubated patients.

Main Results:

• No significant difference in emergent intubation rates between burn (62%) and non-burn (38%) ACS groups.
• Similar rates of inhalation injury diagnosis, time to extubation, and early extubation (within 48 hours).

Conclusions:

• Burn and non-burn ACSs demonstrate comparable airway evaluation and management skills for burn patients.
• Surgeons with acute care surgery backgrounds and ATLS training are capable of managing burn patient airways effectively.
• Further research should explore other provider groups to identify educational interventions for preventing unnecessary intubations.