Thermal and chemical burns of the upper respiratory tract.

A burn of the upper respiratory tract is a lesion of the mucous surface of the respiratory system that occurs as a result of exposure to chemicals, fumes, high temperatures, hot steam or smoke. Clinical characteristics depend on the area and depth of the lesion, the well-being of the victim, as well as the quality of first aid provided.

The causes of burn damage to the respiratory tract are very diverse. For example, injury can be caused by hot metals, flames, boiling water, steam, hot air or toxic chemicals.

Symptoms

A burn to the respiratory tract is accompanied by damage to the face, neck and head.

Symptoms of such lesions are:

burn of the skin of the face or neck;
burnt hairs in the nasal cavity;
soot on the tongue or palate;
necrosis in the form of spots on the oral mucosa;
swelling of the nasopharynx;
hoarse voice;
manifestation of pain when swallowing;
difficulty breathing;
the appearance of a dry cough.

These are only external signs of a burn. To establish a complete clinical picture, it is necessary to conduct additional medical studies:

bronchoscopy;
laryngoscopy;
bronchofibroscopy.

Varieties

Burns of the upper respiratory tract occur:

chemical;
thermal.

Chemical burn. The depth and severity of such injury depend on the concentration, characteristics and temperature of the hazardous substance, as well as the duration of its effect on the respiratory system. Chemical reagents can be:

acid;
alkali;
chlorine;
hot metal alloy;
concentrated salt.

Such damage may be accompanied by necrosis of respiratory tract tissue and the appearance of a scab.. Paroxysmal shortness of breath and cough, burning sensation and redness in the mouth are also observed.

Thermal damage occurs when hot liquids and steam are swallowed. Such an injury destroys lung tissue, disrupts blood circulation in the respiratory tract, and leads to swelling and inflammation. Victims often experience shock and develop bronchospasm.

Classification Features

Burn injuries to the respiratory tract are classified into certain groups:

Burn of the lungs and bronchi. Occurs after inhaling hot air, steam or smoke. Hyperemia develops, the bronchi cannot retain internal moisture, and mucus accumulates in the lungs. This provokes respiratory failure, severe swelling and burn shock. Inhaled acrid smoke can cause not only thermal, but also serious chemical burns, which pose a great danger to the body.
Burn of the larynx. Occurs after swallowing boiling liquids, food or under the influence of hot vapors. Such injuries are much more severe when compared with burn injuries of the pharynx, since the epiglottis, its folds and cartilages are affected. There is a swallowing disorder, each sip is accompanied by pain. Purulent sputum mixed with blood may appear.
Throat burn. It also occurs (like a laryngeal injury) after swallowing boiling liquids, food or hot vapors. With mild damage, swelling of the pharyngeal mucosa and painful swallowing are observed. In more complex situations, blisters and a white coating appear, which disappear after 5-7 days, leaving behind erosion. Swallowing disorder in such cases lasts up to 2 weeks.
In most cases it occurs during fires. Respiratory failure, cyanosis, difficulty swallowing, shortness of breath and cough are observed. However, the thermal type of such injury is rarely observed, since the human body has the ability to involuntarily contract the muscles of the larynx, causing a tight closure of the glottis.

First aid

In case of burn injury to the respiratory tract, it is important to provide first aid to the victim as quickly as possible. Such events are carried out in a certain sequence:

The victim is transferred from the room with the active damaging agent in order to fully provide him with access to fresh air.
If the patient is conscious, it is necessary to give him a reclining position, raising his head.
In case of loss of consciousness, the victim should lie on his side to avoid choking while vomiting.
The mouth and throat are rinsed with water, adding a small amount of novocaine or another agent that has an anesthetic effect.
If the burn is caused by an acid, dilute a small amount of baking soda in water.
If the acting reagent is alkali, rinse is carried out with water with the addition of acid (acetic or citric acid is suitable).
After providing such emergency care, you should call an ambulance or take the patient yourself to the nearest medical facility.
During transportation, it is important to check the breathing status of the victim. If it stops, artificial respiration must be performed immediately.

Treatment

Treatment of burn injuries of a chemical or thermal nature is carried out using a similar technique.

The purpose of such therapeutic actions is:

eliminate swelling of the larynx, ensure normal functioning of the respiratory tract;
prevent or eliminate shock and pain;
relieve bronchial spasms;
facilitate the release of accumulated mucus from the bronchi;
prevent the development of pneumonia;
prevent pulmonary respiration problems.

During treatment, in most cases, the following groups of drugs are prescribed:

Painkillers:

Promedol;
Bupranal;
Prosidol.

Anti-inflammatory:

Ketorolac;
Ibuprofen;

Decongestants:

Lasix;
Trifas;
Diacarb.

Desensitizing:

Diphenhydramine;
Diazolin;
Diprazine.

Additional methods of the treatment process are:

complete silence of the victim for 10-14 days, so as not to injure the ligaments;
carrying out inhalations.

A burn of the respiratory tract is a complex injury that requires timely provision of first aid and further prescription of a restorative treatment process. Such measures will help speed up recovery and prevent respiratory problems.

A burn of the respiratory tract is damage to body tissues that occurs under the influence of high temperatures, alkalis, acids, salts of heavy metals, radiation, etc. Depending on the reasons that caused the burn injury, chemical, thermal and radiation burns are distinguished. To alleviate the condition of the victim, it is necessary to be able to provide first aid, which helps prevent the development of complications.

An upper respiratory tract burn is dangerous due to complications

Clinical picture

Often the respiratory tract affects the tissues of the face, head, neck and even the chest. The symptoms are as follows:

severe pain in the nasopharynx and sternum;
increased pain when inhaling;
labored breathing
increased body temperature;
swelling of the nasopharynx;
necrotic spots on the mucous membranes;
skin burns in the neck and face
damaged skin around the lips;
swelling of the mucous membranes;
damage to the outer laryngeal ring, which causes laryngeal stenosis and suffocation.
painful swallowing;
nasality, hoarseness, hoarseness.

Medical diagnostics, including laboratory tests, laryngoscopy and bronchoscopy, allow you to fully assess the nature and extent of the lesions.

In the first twelve hours, the patient experiences swelling of the respiratory tract and bronchospastic syndrome. The inflammatory process can affect the lower respiratory tract and lungs.

The symptom of a burn is pain.

Burn therapy

Timely and correct first aid and long-term rehabilitation are a guarantee of a favorable prognosis. For a burn of the respiratory tract, emergency care consists of several stages:

until the ambulance team arrives, the person is transferred to fresh air;
the body should be in a reclining position. It is advisable to slightly raise the upper part of the body. If the victim has lost consciousness, then lay him on his side so that he does not suffocate from the vomit;
The oral cavity and nasopharynx should be rinsed with water at room temperature. Procaine or another anesthetic with moderate activity can be added to the water;
for burns with acids, sodium bicarbonate (baking soda) is added to the water, and for alkali - citric or acetic acid;
During transportation to a medical facility and until the ambulance arrives, monitor the victim’s breathing. In the absence of rhythmic respiratory movements, artificial ventilation of the lungs cannot be avoided.

Treatment for chemical and thermal burns of the respiratory tract is aimed at relieving swelling of the larynx and pain, ensuring normal access of oxygen to the body, preventing the development of bronchospastic syndrome, ensuring the outflow of fluid secreted by the affected tissues from the bronchi and lungs, and preventing collapse of the lung lobe.

First aid for burns of the upper respiratory tract

The patient is prescribed analgesics, anti-inflammatory, decongestant and antibiotic drugs. It is advisable not to strain the vocal cords for half a month and carry out regular inhalations.

Chemical burns from acids and chlorine

Acids, alkalis, and salts of heavy metals are destructive to the delicate mucous membrane of the respiratory tract. Sulfuric acid (H2SO4) and hydrogen chloride (HCl) are dangerous. often accompanied by necrotic lesions that threaten the life of the victim. Dead tissue becomes dark blue when exposed to hydrochloric acid, and greenish when exposed to acetic acid. The victim needs to rinse and clean the nasopharynx under running water. The rinsing continues for twenty minutes.

Toxic chlorine causes burns

Chlorine is no less toxic; when working with it, you should use a gas mask. Chlorine is an asphyxiating gas; if it enters the lungs, it causes burns of lung tissue and suffocation. The victim must be immediately removed from the room in which there are high concentrations of the toxic substance. In the first minutes, the mucous membrane swells and a strong burning sensation and hyperemia occurs. The painful condition is accompanied by a cough, rapid and difficult breathing.

Before emergency medical services arrive, rinse your nasopharynx and mouth with a two percent baking soda solution.

In case of severe pain, injection of painkillers is allowed. Do not forget about your own protection: when providing emergency care, you must wear rubber gloves and a cotton-gauze bandage.

Thermal burn of the respiratory tract

Thermal burns of the upper respiratory tract occur as a result of inhalation of hot air, steam or hot liquid entering the body. The victim is diagnosed with a state of shock and severe constriction of the bronchi caused by muscle contraction. Thermal burns damage the lung tissue. Swelling and inflammation occur, the skin is damaged, and circulatory disorders are noted.

Thermal damage to the respiratory system often occurs with complications. To alleviate the condition of the victim, first aid for a burn of the upper respiratory tract is carried out as follows:

transfer the patient from the heat exposure zone;
rinse your mouth with clean water at room temperature;
give the patient a sufficient amount of cool, still water to drink;
To prevent hypoxia, put an oxygen mask on the patient.
For minor burns, transport the victim yourself to the nearest hospital.

Degrees of VDP burns

Preventive actions

Strengthen your immune system, beware of drafts, dress for the weather and avoid visiting crowded places during epidemics. Acute respiratory diseases are dangerous for a weakened body;
regularly visit an otolaryngologist and pulmonologist;
stop smoking cigarettes and do not inhale steam and combustion products;
wear a gauze bandage when using household chemicals;
ventilate the premises;
Spend as much time as possible outdoors.

Chemical burns of the respiratory tract

Chemical burns occur due to ingestion or inhalation of concentrated chemical solutions (acids, alkalis, etc.). Most often, the vestibular part of the larynx (epiglottis, aryepiglottic and vestibular folds, arytenoid cartilages) is affected. At the site of contact of the chemical agent with the mucous membrane, a local burn reaction occurs in the form of hyperemia, edema, and the formation of fibrous plaque. In severe cases, damage to the laryngeal skeleton may occur.

Clinic.

Functional disorders come to the fore: difficulty breathing and changes in voice up to aphonia. Laryngoscopy data indicate the location and size of the lesion in the larynx, changes in the glottis, the nature of edema and infiltration, fibrous plaque and its prevalence. In each specific case, it is necessary to exclude the possibility of diphtheria.

Treatment.

In the first 1-2 hours after a burn, inhalation with a weak (0.5%) solution of alkali (for acid burns) or acid (for alkali burns) is advisable. It is necessary to rinse the throat and mouth with the same substances. An indispensable condition is maintaining silence for 10-14 days. To relieve pain, rinse with warm decoctions of chamomile and sage 2 times a day for 2-3 weeks. If there is bad breath and fibrinous films on the mucous membrane of the mouth and pharynx, rinsing with a weak solution of potassium permanganate is prescribed. Inhalation therapy has a good effect. Inhalations of menthol, peach, and apricot oils and antibiotics are used in combination with a hydrocortisone suspension (15-20 procedures per course). Active anti-inflammatory and hyposensitizing therapy is carried out.

Chemical burns of the gastrointestinal tract.

Chemical burns of the pharynx and esophagus occur when ingesting corrosive liquid poisons, most often concentrated solutions of acids and alkalis, taken accidentally or for suicidal purposes. When exposed to acid, a dense scab is formed, when exposed to alkalis, a soft, loose scab is formed. Clinically, three degrees of pathological changes in tissues are distinguished:

I degree - erythema;

II degree - formation of bubbles;

III degree - necrosis. Clinic.

In the first hours and days after a burn, acute pain in the throat and along the esophagus is characteristic, aggravated by swallowing and coughing. Extensive scabs form on the mucous membrane of the lips, mouth and pharynx. If toxic substances enter the larynx or trachea, attacks of coughing and suffocation occur. In some cases, a toxic substance can be recognized by its smell.

With first degree burns, only the superficial epithelial layer is damaged, which is torn off on days 3-4, exposing the hyperemic mucous membrane. The general condition of the patient suffers little. Second degree burns cause intoxication, which is most pronounced on days 6-7 during the period of rejection of necrotic plaques that leave erosion. Since the thickness of the mucous membrane is damaged, healing is granulation resulting in a superficial scar. With a third degree burn, the mucous membrane and underlying tissue are damaged to varying depths, and severe intoxication occurs. The scabs are rejected by the end of the 2nd week, deep ulcers are formed, the healing of which is delayed for several weeks and sometimes months. In this case, rough deforming scars are formed, usually causing a narrowing of the esophagus.

Burns of the esophagus are often accompanied by complications such as laryngitis, tracheobronchitis, esophageal perforation, periesophagitis, mediastenitis, pneumonia, sepsis, and exhaustion. In childhood, I and U degree burns cause swelling of the pharynx and larynx, an abundance of sputum, which causes significant breathing difficulties due to stenosis in the pharynx and larynx.

Treatment for burns of the pharynx and esophagus should begin as early as possible, preferably at the scene of the incident. In case of chemical burns, the toxic substance must be neutralized within the first 6 hours. If there is no antidote, water should be used with half the volume of milk or raw egg whites added. It is permissible to rinse the stomach with boiled warm water. If it is impossible to insert a gastric tube, give 5-6 glasses of washing liquid to drink, then induce vomiting by pressing on the root of the tongue. Washing should be repeated using 3-4 liters of washing liquid.

Along with the neutralization and washing out of the toxic substance for second and third degree burns, anti-shock and detoxification measures are indicated: pantopon or morphine solution is administered subcutaneously - 5% glucose solution, plasma, freshly citrated blood. Cardiovascular and antibacterial drugs are used. If the patient can swallow, a gentle diet is prescribed, plenty of fluids to drink, and vegetable oil is given to swallow; if swallowing is impossible, vegetable and parenteral nutrition is indicated.

In many cases, with burns of the pharynx, the entrance of the larynx is involved in the process; The swelling that occurs here can sharply narrow the lumen of the larynx and cause asphyxia. Therefore, the presence of laryngeal edema is an indication for the use of pipolfen, prednisolone, calcium chloride (drug destenosis). In some cases, tracheostomy is necessary. It is advisable to administer antibiotics throughout the healing period of ulcers (1-2 months), which prevents pneumonia and tracheobronchitis, prevents the development of infection on the wound surface and reduces subsequent scarring.

The most common method of reducing cicatricial stenosis of the esophagus during the recovery process is early bougienage or leaving a nasoesophageal tube in the esophagus for a long time.

In this article:

A lung burn refers to damage to internal organs, which, unlike superficial burn injuries, occurs in a more severe form and can lead to quite serious, sometimes irreversible, consequences. Such a burn can occur when inhaling hot air, combustion products or chemical vapors. Inhalation damage to the lungs does not occur in isolation, but is always combined with other burns of the respiratory tract: the mucous membrane of the nose, larynx and trachea. Such injuries are diagnosed in 15-18% of burn patients admitted to the hospital.

An injured person who has suffered a burn to the lungs should be immediately taken to the hospital for first aid and surgical treatment. Often a burn to the respiratory system, combined with significant damage to the skin, leads to death. Despite timely medical care, many patients, whose body cannot cope with the injuries caused, die within the first three days after receiving the injury. The resulting necrosis and pulmonary edema leads to cessation of respiratory function.

Difficult diagnosis of lung burns aggravates the situation. In some cases, inhalation lesions are completely asymptomatic while maintaining high laboratory values. Such damage can be suspected after collecting a complete medical history and clarifying all the circumstances of the injury. Clinical examination data can be used as an indirect diagnostic method. Damage to the lungs may be indicated by the localization of burns on the surface of the chest, neck and face, as well as traces of soot on the tongue and in the nasopharynx. The victim often begins to choke, there may be a change in voice, vomiting blood, coughing with sputum containing soot particles.

All these symptoms will not allow us to determine the extent and depth of the lesion. However, they are the ones who will help doctors make a preliminary diagnosis and provide the necessary medical care in a timely manner. Treatment of such burns begins at the scene with careful lavage of the airway and provision of oxygen. If edema, hypoxemia, obstruction occurs, as well as if it is impossible to clear the airways from mucus and increased intracranial pressure resulting from cerebral hypoxia, ventilation support and intubation are prescribed. Burn injury to the lungs increases the victim's fluid requirement by 50%. With inadequate infusion therapy, the severity of the burn injury can worsen, causing the development of various complications. Antibiotic treatment is used only in rare cases where there are clear signs of infection.

Thermal lesions

Thermal inhalation lesions of the lungs, as a rule, occur during a fire that occurs in a confined space, for example, in a vehicle, small living or working space. Such injuries are often combined with severe skin burns, cause acute respiratory failure and can lead to the death of the victim. In the first few hours, the clinical picture is characterized by uncertainty.

Defeat can be assumed based on several signs and manifestations:

Impaired consciousness;
Dyspnea;
Hoarseness of voice;
Cough with black sputum;
Cyanosis;
Traces of soot on the mucous membrane of the throat and tongue;
Burnt back of the throat.

Victims are hospitalized in a specialized burn center or intensive care unit of the nearest multidisciplinary hospital. A thermal burn can lead to complications such as the development of respiratory failure or the occurrence of acute lung injury syndrome. In this case, in addition to the main treatment, respiratory support such as artificial ventilation, nebulizer therapy and an innovative technique of extracorporeal membrane oxygenation may be required.

Chemical lesions

The main substances whose vapors can cause a chemical burn to the respiratory tract include various acids, alkalis, volatile oils and salts of heavy metals. Cyanide and carbon monoxide are the most toxic to the human body. When oil products, rubber, nylon, silk and other materials are burned, ammonia and polyvinyl chloride are released, which are a source of chlorine, hydrochloric acid and aldehyde. All these toxic substances can cause burns to the respiratory tract and lungs.

The severity of the lesions can vary and depends on several factors:

Duration of exposure;
Degrees of concentration;
Temperatures;
The nature of chemicals.

The harmful effects of aggressive agents will be more pronounced at high concentrations of solutions. However, even weakly concentrated substances with prolonged exposure to humans can cause lung burns.

Unlike thermal damage, a chemical burn has a less pronounced clinical picture. Characteristic symptoms include severe pain immediately after the injury, difficulty breathing, nausea, dizziness and loss of consciousness. A burn disrupts the normal functioning of the lungs and without timely treatment can lead to the development of respiratory distress syndrome, acute burn toxemia and burn shock. The last of these conditions is life-threatening.

Chemical burns of the respiratory tract rarely lead to death in patients. However, if any characteristic symptoms appear, you should call an ambulance. Doctors will quickly relieve pain and restore breathing and blood circulation. All these actions will help prevent the development of burn shock.

In the first hours after injury, it is advisable to carry out inhalations. For these purposes, in case of an acid burn, a weak alkali solution is used, respectively, in case of an alkali burn, a weak acid solution is used. In addition to inhalation therapy, anti-inflammatory and hyposensitizing therapy are actively used. Since damage to the respiratory tract leads to injury to the vocal cords, all victims are advised to remain silent for the first two weeks.

Thermal and chemical burns of the lungs can occur from inhalation of flame, smoke, hot air and vapors saturated with aggressive chemical elements. Such injuries are often life-threatening and often fatal. To identify all possible internal injuries and prompt treatment, victims are immediately taken to specialized medical institutions.