Injuries above the tracheal carina

Introduction Moderate inhalation injury refers to more than tracheal carina, including damage to the throat and trachea. Moderate inhalation injury refers to more than tracheal carina, including damage to the throat and trachea. The clinical manifestations are irritating cough, hoarseness, difficulty in breathing, sputum in the sputum, and sputum of the tracheal mucosa, edema of the throat leading to airway obstruction, and inspiratory wheezing. The auscultation of the lungs is weakened or rough, and can be heard and wheezing and dry rales. Patients often have bronchitis and aspiration pneumonia.

Cause

The main cause of inhalation injury is thermal action, but at the same time, a large amount of unburned smog, carbon particles, and irritating chemicals are also inhaled, which also damages the respiratory tract and alveoli. Therefore, inhalation damage is a mixed damage of heat and chemicals.

Inhalation injury is related to the environment in which the injury occurs. It often occurs in an environment that is not ventilated or sealed, especially in explosive combustion. In this environment, the concentration of hot flame is high, the temperature is high, and it is not easy to spread rapidly. The patient cannot leave the fire immediately; in addition, in a confined space, the combustion is incomplete, resulting in a large amount. Carbon monoxide and other toxic gases cause the patient to become toxic and stunned, and suffocate to death. When combined with explosive combustion, high temperature, high pressure, high flow rate of air and thick toxic gases can cause damage to the deep respiratory tract and lung parenchyma. In addition, the patient stands or rushes to shout, causing the heat to inhale, which is also one of the causes of injury.

an examination

Moderate inhalation injury refers to more than tracheal carina, including damage to the throat and trachea. The clinical manifestations are irritating cough, hoarseness, difficulty in breathing, sputum in the sputum, and sputum of the tracheal mucosa. The edema of the throat causes airway obstruction and inspiratory wheezing. The auscultation of the lungs is weakened or rough, and can be heard and wheezing and dry rales. Patients often have bronchitis and aspiration pneumonia.

Differential diagnosis

Differential diagnosis of damage above the tracheal carina:

1. Mild inhalation injury:

Above the glottis, including damage to the nose, throat, and glottis. Clinical manifestations of nasopharynx pain, cough, increased saliva, dysphagia; local mucosal congestion, swelling or formation of blisters, or mucosal erosion, necrosis. The patient had no hoarseness and difficulty breathing, and there was no abnormality in the auscultation of the lungs.

2. Severe inhalation injury:

Refers to the area below the bronchus, including damage to the bronchus and muscle parenchyma. Clinical manifestations of severe dyspnea immediately or within a few hours after injury, incision of tracheal deduction can not be alleviated; progressive hypoxia, lip cyanosis, increased heart rate, agitation, paralysis or coma; cough and phlegm, early pulmonary edema, Hemorrhagic foamy sputum; necrotic endometrial shedding, can cause atelectasis or suffocation. The auscultation of the lungs is low, rough, and can be heard and wheezing, followed by dry and wet rales. Patients with severe lung parenchymal injury may die of acute respiratory failure due to extensive alveolar damage and severe bronchospasm within a few hours after injury.

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