Trauma

Burns / inhalation injury

Before / During / After / Pitfalls

Before

• Look for facial burns, soot, hoarseness, stridor, enclosed-space exposure, CO/cyanide risk.
• Early airway may be safer before edema progresses.
• Prepare smaller tubes if swelling; call burn/ICU/anesthesia/ENT as appropriate.

During

• Avoid delay if airway edema is progressing.
• Use gentle technique; swollen tissue bleeds and distorts easily.
• Confirm tube and secure well; facial burns complicate fixation.

After

• Treat CO/cyanide exposure when indicated.
• Anticipate edema progression and difficult tube exchanges.
• Communicate airway findings to burn/ICU team.

Pitfalls

• False reassurance from initial normal exam.
• Poor tube securement on burned face.
• Forgetting toxic inhalation physiology.