First aid treatment and airway management for chemical burns combined with inhalation injury: A case report

Abstract

Chemical burns account for a small percentage of burn patients, and there are even fewer burn patients suffering from chemical burns combined with inhalation injury. As chemical substances corrode the airway, which leads to persistent necrotic shedding of the respiratory mucosa and scarring contracture as the airway heals, a proportion of patients develop airway stenosis, requiring more aggressive treatment or even surgery. A 38-year-old female chemical factory worker sustained an inhalation injury due to exposure to reactive substances (liquid and smoke) during production. She developed third- to fourth-grade airway stenosis and dyspnoea 2 months postinjury. Interhospital consultation led to referral to the Second Affiliated Hospital of Xi'an Jiaotong University for tracheotomy and endotracheal stent implantation. Postoperative dyspnoea improved, and regular follow-up was performed. The treatment process of this patient has provided us with valuable experience in the initial management and respiratory tract care of chemical burn patients.

Keywords: airway management; airway obstruction; burns; case report; inhalation; tracheotomy.

FIGURE 1

The laryngoscopy showed severe oedema of the epiglottis and glottis.

FIGURE 2

Second day after injury. Long strips of yellow‐white tissue were discharged from the patient's nasal cavity.

FIGURE 3

Montgomery safe‐T‐tube.

FIGURE 4

Three‐dimensional airway reconstruction computed tomography (CT) image from September 2023. (A) The dumbbell‐shaped trachea was observed below the vocal cords and above the apex of the heart. (B) Airway stenosis was observed where the tracheal T‐tube was placed.