Predictors of Inhalation Injury in Burn‐Injured Patients Before Arrival At
Emergency Medicine Australasia (2020) doi: 10.1111/1742-6723.13604 ORIGINAL RESEARCH To intubate or not to intubate? Predictors of inhalation injury in burn-injured patients before arrival at the burn centre Kylie DYSON ,1,2 Paul BAKER,3 Nicole GARCIA,3 Anna BRAUN,3 Myat AUNG,4 David PILCHER,4 Karen SMITH,2 Heather CLELAND3,5 and Belinda GABBE1,6 1Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia, 2Centre for Research and Evaluation, Ambulance Victoria, Melbourne, Victoria, Australia, 3Victorian Adult Burns Service, Alfred Hospital, Melbourne, Victoria, Australia, 4Intensive Care Unit, Alfred Hospital, Melbourne, Victoria, Australia, 5Central Clinical School, Monash University, Melbourne, Victoria, Australia, and 6Health Data Research UK, Swansea University Medical School, Swansea, UK Abstract injury was 11%. Increasing %TBSA Key findings burned, flame, enclosed space, face Objective: Inhalation injury occurs burns, hoarse voice, soot in mouth and • Eleven percent of burn-injured in approximately 10–20% of burn shortness of breath were predictive of patients in our study had con- patients and is associated with inhalation injury. The model provided firmed inhalation injury. increased mortality. There is no clear excellent discrimination (area under • The mortality rate of patients method of identifying patients at risk fi curve 0.87, 95% con dence interval with inhalation injury was of inhalation injury or requiring – 0.84 0.91). A lower proportion of 16%. intubation in the pre-hospital setting. patients intubated at a non-burn centre • Increasing percentage of total Our objective was to identify pre- had an inhalation injury (33%) com- burn centre factors associated with pared to patients intubated by emer- body surface area burned, fl inhalation injury confirmed on bron- gency medical services (54%) and in the ame, enclosed space, face choscopy, and to develop a prognos- burn centre (58%).
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