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 resulting from exposure to chemicals, fumes, high temperatures, hot steam or smoke. Clinical characteristics depend on the area and depth of the lesion, the victim's well-being, as well as the quality of the first aid provided.

The causes of burn damage to the respiratory tract are very diverse. For example, hot metals, flames, boiling water, steam, hot air, or pesticides can cause injury.

Symptoms

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

Symptoms of such lesions are:

burns to 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;
appearance of dry cough.

These are just 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 are:

chemical;
thermal.

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

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

Such damage may be accompanied by necrosis of the tissues of the respiratory tract and the appearance of a scab.. There is also paroxysmal shortness of breath and cough, burning sensation and redness in the mouth.

The defeat of the thermal nature occurs when hot liquids and steam are swallowed. Such an injury destroys lung tissue, disrupts the blood circulation in the respiratory tract, leads to their swelling and inflammation. The victims often experience a state of shock, bronchospasm develops.

Features of the classification

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

Burns of the lungs and bronchi. Occur after inhalation of 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 caustic smoke can cause not only thermal, but also serious chemical burns, which pose a great danger to the body.
Larynx burn. 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 cartilage are affected. There is a swallowing disorder, each sip is accompanied by pain. Purulent sputum with blood impurities may appear.
Throat burn. It also occurs (like trauma to the larynx) after swallowing boiling liquids, food or hot vapors. With mild damage, swelling of the pharyngeal mucosa and painful swallowing are observed. In more difficult situations, blisters and white plaque 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, swallowing disorder, dyspnea and cough are observed. At the same time, the thermal appearance of such an 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 a burn injury to the respiratory tract, it is important to provide first aid to the victim as soon as possible. These activities are carried out in a certain sequence:

The victim is transferred from a room with an 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 so as not to choke during 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 acid, a small amount of baking soda is diluted in water.
If the acting reagent is alkali, rinsing 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 respiratory status of the victim. If it stops, artificial respiration should be performed immediately.

Treatment

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

The purpose of such therapeutic actions is:

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

During treatment, in most cases, drugs of the following groups 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 first aid and further appointment of a restorative treatment process. Such measures will help speed up recovery and prevent respiratory problems.

A respiratory tract burn is damage to body tissues that occurs under the influence of high temperatures, alkalis, acids, salts of heavy metals, radiation, etc. Depending on the causes 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.

VRT burn - dangerous complications

Clinical picture

Often, the respiratory tract affects the tissues of the face, head, neck, and even the chest. The symptoms look like this:

severe pain in the nasopharynx and in the sternum;
increased pain during inhalation;
labored breathing
increase in 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 stenosis of the larynx and suffocation.
painful swallowing;
nasality, hoarseness, hoarseness.

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

In the first twelve hours, the patient has edema of the respiratory tract and bronchospastic syndrome. The inflammatory process can cover the lower respiratory tract and lungs.

Burn symptom - pain

Burn therapy

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

before the arrival of the ambulance, the person is transferred to fresh air;
the body should be in a semi-lying position. It is advisable to slightly raise the upper part of the case. If the victim has lost consciousness, then lay him on his side so that he does not suffocate from vomit;
the mouth and nasopharynx should be rinsed with water at room temperature. Procaine or another moderately active anesthetic can be added to the water;
for acid burns, 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 dispensed with.

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

First aid for a burn 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 during the crescent and carry out regular inhalations.

Chemical burns with acids and chlorine

Acids, alkalis, salts of heavy metals are detrimental to the delicate mucous membrane of the respiratory tract. Hazards are sulfuric acid (H2SO4) and hydrogen chloride (HCl). often accompanied by necrotic lesions that threaten the life of the victim. Dead tissues under the influence of hydrochloric acid acquire a dark blue hue, and under the influence of acetic acid - a greenish color. The victim must rinse and clean the nasopharynx under running water. Washing continues for twenty minutes.

Toxic chlorine causes burns

Chlorine is no less toxic, when working with which you should use a gas mask. Chlorine is an asphyxiant gas, when it enters the lungs, it causes burns to the lung tissue and asphyxiation. The victim must be immediately taken out of the room in which there are high concentrations of poisonous poisonous substances. In the first minutes, the mucous membrane swells and there is a strong burning sensation and hyperemia. The painful condition is accompanied by a cough, rapid and difficult breathing is observed.

Before the arrival of the emergency medical service, rinse the nasopharynx and oral cavity with a 2% solution of baking soda.

With a strong pain syndrome, injection of painkillers is allowed. Do not forget about your own protection: during 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 ingestion. 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. There are edemas, inflammatory processes, the skin is damaged, 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 affected zone;
rinse your mouth with clean water at room temperature;
let the patient drink a sufficient amount of cool non-carbonated water;
Wear an oxygen mask to prevent hypoxia.
in case of minor burns, transport the victim to the nearest hospital yourself.

Degrees of burns of the upper respiratory tract

Preventive actions

strengthen immunity, beware of drafts, dress according to the weather and refuse to visit 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 outdoors as possible.

Chemical burns of the respiratory tract

Chemical burns are caused by swallowing or inhaling concentrated chemical solutions (acids, alkalis, etc.). Most often, the vestibular part of the larynx is affected (epiglottis, scoop-epiglottic and vestibular folds, arytenoid cartilages). 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 skeleton of the larynx is possible.

Clinic.

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

Treatment.

In the first 1-2 hours after the burn, inhalations with a weak (0.5%) solution of alkali (for acid burns) or acids (for alkali burns) are advisable. The same substances should be used to rinse the pharynx and oral cavity. An indispensable condition is the observance of silence for 10-14 days. To relieve pain, rinse with warm decoctions of chamomile, sage 2 times a day for 2-3 weeks. In the presence of bad breath and fibrinous films on the mucous membrane of the oral cavity and pharynx, rinsing with a weak solution of potassium permanganate is prescribed. Good effect gives inhalation therapy. Apply inhalations of menthol, peach, apricot oils, antibiotics in combination with hydrocortisone suspension (15-20 procedures per course). Conduct active anti-inflammatory and hyposensitizing therapy.

Chemical burns of the esophagus.

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

I degree - erythema;

II degree - the formation of bubbles;

III degree - necrosis. Clinic.

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

With first-degree burns, only the superficial epithelial layer is damaged, which is torn off on days 3-4, exposing the hyperemic mucosa. The general condition of the patient suffers little. Burns of the II degree cause intoxication, which is most pronounced on the 6th-7th day during the period of rejection of necrotic deposits that leave erosion. Since the thickness of the mucous membrane is damaged, healing is granulation with an outcome in a superficial scar. With a III degree burn, the mucous membrane and underlying tissue are damaged to different depths, severe intoxication occurs. Scab rejection occurs 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, as a rule, causing a narrowing of the esophagus.

Esophageal burns are often accompanied by complications such as laryngitis, tracheobronchitis, esophageal perforation, periesophagitis, mediastinitis, pneumonia, sepsis, exhaustion. In childhood, I and U degree burns cause swelling of the pharynx and larynx, an abundance of sputum, which causes significant respiratory failure 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. In case of chemical burns, it is necessary to neutralize the toxic substance in the first 6 hours. In the absence of an antidote, water should be used with the addition of half the amount of milk or raw egg whites by volume. It is permissible to wash the stomach with boiled warm water. If it is impossible to insert a gastric tube, give 5-6 cups 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 in burns of the II and III degrees, anti-shock and detoxification measures are indicated: pantopon or morphine solution is injected subcutaneously - 5% glucose solution, plasma, freshly citrated blood. Cardiovascular and antibacterial drugs are used. If the patient can swallow, a sparing diet is prescribed, plenty of fluids, vegetable oil is allowed to be swallowed: 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 edema 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 dystenosis). In some cases, a tracheostomy is needed. It is advisable to administer antibiotics during the entire period of ulcer healing (1-2 months), which is the prevention of pneumonia and tracheobronchitis, prevents the development of infection on the wound surface and reduces subsequent scarring.

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

In this article:

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

An injured person who has received a lung burn should be immediately taken to a hospital for first aid and prompt treatment. Often, a burn of the respiratory system, combined with significant damage to the skin, leads to death. Despite the timely medical care provided, many patients whose body has not coped with the injuries caused die in the first three days after the injury. The resulting necrosis and pulmonary edema leads to the cessation of respiratory function.

Difficult diagnosis of lung burns exacerbates the situation. In some cases, inhalation lesions are completely asymptomatic with high laboratory values maintained. It is possible to suspect such damage after collecting a complete anamnesis and finding out all the circumstances of the injury. Clinical examination data can be used as an indirect diagnostic method. 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, may indicate lung damage. The victim often begins to suffocate, there may be a change in voice, vomiting with blood, coughing up sputum containing particles of soot.

All these symptoms will not allow to determine the extent and depth of the lesion. However, it is they who will help doctors to make a preliminary diagnosis and provide the necessary medical care in time. Treatment of such burns begins at the scene with careful airway toileting and oxygen supply. In the event of edema, hypoxemia, obstruction, as well as in the impossibility of freeing the airways from sputum and increased intracranial pressure resulting from cerebral hypoxia, ventilation support and intubation are prescribed. A burn injury to the lungs increases the victim's need for fluid by 50%. With inadequate infusion therapy, the severity of the burn injury can worsen, provoking the development of various complications. Antibiotic treatment is used only in those rare cases where clear signs of infection are observed.

Thermal damage

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

It is possible to assume a lesion by several signs and manifestations:

Violation of consciousness;
Dyspnea;
Hoarseness of voice;
Cough with black sputum;
Cyanosis;
Traces of soot on the mucous membrane of the pharynx and tongue;
Burned posterior pharyngeal wall.

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

Chemical lesions

The main substances, the vapors of which can cause a chemical burn of the respiratory tract, include various acids, alkalis, volatile oils and salts of heavy metals. Cyanides and carbon monoxide are the most toxic to the human body. During the combustion of petroleum products, rubber, nylon, silk and other materials, ammonia and polyvinyl chloride are released, which is 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 be different and depends on several factors:

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

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

Unlike thermal injury, a chemical burn has a less pronounced clinical picture. Characteristic signs include severe pain that occurs immediately after 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 are rarely fatal in patients. However, if any characteristic symptoms appear, an ambulance should be called. Doctors will quickly relieve pain, 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, when burned with acid, a weak solution of alkali is used, respectively, when burned with alkali, a weak solution of acid is used. In addition to inhalation, anti-inflammatory and hyposensitizing therapy is actively used. Since airway involvement leads to vocal cord injury, all victims are advised to remain silent for the first two weeks.

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