Inhalation of toxic chemicals, hot vapors of liquids and gases cause injury to the mucosa and lead to a burn of the respiratory tract. As a rule, such damage is difficult to treat and treat, and organs must constantly perform vital functions. Serious complications often develop, leading to disability, and sometimes death. In the article, we consider the degree of the disease, how first aid is provided and what are the treatment methods.
Classification
Airway burns are divided as follows:
- Thermal - arising under the influence of high temperatures.
- Chemical - when chemical substances or their vapors get on the mucous membranes of the respiratory system.
In its pure form, such damage is rare, more often they are combined. During fires, ignition often provokes the explosion and evaporation of chemicals or, conversely, the contact of particularly active compounds with air causes ignition.
At the location of the burns of the respiratory tract are upper and lower. The first arise:
- in the nasal cavity - atrophy of the mucous membrane occurs, which leads to rhinitis and pharyngitis;
- pharynx - vocal cords are affected, laryngospasm, voice loss and asphyxia are possible;
- larynx - the epithelium is damaged, in severe cases, muscles, ligaments and cartilage; high probability of severe consequences.
Bottom observed:
- In the trachea - respiratory failure, cyanosis, shortness of breath, suffocation and cough occur. Damage to the trachea, as a rule, occurs simultaneously with the larynx, which significantly exacerbates the condition of the victim.
- In the bronchi - damage is accompanied by hyperemia, accumulation of fluid in the lungs, respiratory failure. Burns of lung tissue are usually not fixed.
It is noted that in itself a burn of the upper respiratory tract occurs rarely, only with a shallow and single inhalation of toxic fumes or hot air. More often, damage to the upper and lower respiratory tract occurs simultaneously.
Severity
When toxic substances evaporate, inhale hot air, water vapor or swallow boiling water, the mucous membranes of the mouth, nose and throat are injured. The patient's condition and treatment tactics depend on the depth and area of the mucosal lesion. Depending on this, four degrees of burns of the respiratory tract are distinguished:
- The outer layers of the mucous membrane are affected: from the nasal cavity to the larynx. Hyperemia of the mucosa, slight wheezing in the lungs is noted. In the later stages, pneumonia may occur.
- The middle layers of tissues are damaged, swelling occurs, the voice becomes hoarse, breathing is difficult, wheezing and shortness of breath are possible. Fibrous films form in the trachea. The patient's condition is characterized as severe.
- The soft tissues of the deep layers are broken. The mucous membranes strongly swell, the voice often disappears, necrosis of the mucosal areas occurs, laryngo- and bronchospasm are possible. The patient's condition worsens gradually, speech is often absent.
- Extensive tissue necrosis and respiratory arrest are observed, leading to death.
Chemical burn of the respiratory tract
Such a burn can be obtained at the workplace by inhaling vapors of various toxic compounds, if the safety rules are not followed:
- if personal protective equipment is not used;
- the ventilation system does not work;
- improperly stored chemicals.
And also in emergency situations:
- due to a violation of the tightness of the container in which toxic substances are stored;
- evaporation of chemicals under the influence of high temperatures.
Most often, chemical burns to the respiratory tract affect workers in the chemical industry and personnel who, on duty, have to deal with detergents and disinfectants. These include employees from various laboratories, paramedical personnel and water treatment plants.
Damage to the respiratory system with chemicals occurs simultaneously with damage to the skin of the face, neck and oral cavity. In practice, it is very difficult to determine from the effects of vapors of which substances (alkalis or acids) damage occurred until a blood test was done.
Thermal Burns
Thermal damage occurs when inhaling hot air, steam, or swallowing hot liquid. In this case, shortness of breath occurs, the skin of the skin turns blue, a change in voice occurs. On examination, damage to the upper palate and pharynx is noticeable. The patient behaves uneasily due to severe pain and shortness of breath. In especially severe cases, he loses consciousness.
A very characteristic burn in case of fire. The victim's neck, lips, mouth and mucous membrane of the nostrils are damaged, which are filled with soot. And with a burn of the respiratory tract, laryngospasm occurs with steam. When inhaling hot steam, the muscles of the larynx involuntarily contract, so there is no obvious damage to the trachea, bronchi and lungs. This type of burn does not lead to serious injury.
Burn symptoms
The following general signs of burns of the respiratory tract are noted:
- hoarseness of voice;
- dry coughing;
- severe pain, asthma attacks;
- heavy and intermittent breathing;
- external defects of the dermis of the face and mucous membranes of the nasal cavity and throat.
These symptoms are noted with burns of both the upper and lower respiratory tract. For a severe stage, it is characteristic:
- Excessive salivation and serous nasal discharge.
- Vomiting with blood streaks and dead particles of the epithelium.
- Respiratory failure or its complete disappearance.
- Loss of consciousness.
The first symptoms of a burn of the respiratory tract occur immediately after exposure to a damaging factor. Strong soreness in the throat, which increases with inhalation, is necessarily noted. The surface of the lips and the mucous membrane of the oral cavity are swollen and highly hyperemic. The victim has an increase in heart rate, body temperature rises, headache, drowsiness and general malaise occur.
First aid
Having found the victim, it is necessary to immediately call the doctors, and before their arrival to provide quick and competent first aid for a burn of the respiratory tract. Purposeful and clear-cut actions help reduce the number of possible complications that will save the victim not only health but also life. To do this, you must:
- Secure the victim - remove him from the lesion.
- Arrange fresh air.
- To give the victim a half-sitting position, if he is conscious, otherwise put him on one side, and place his head above the body so that vomit does not get into the respiratory tract.
- Make artificial respiration in case of loss of consciousness.
- During self transportation or waiting for an ambulance, monitor the state of breathing.
In the event of a thermal burn, the patient should rinse his mouth and nasopharynx with water at room temperature, in which Novocaine solution can be added to reduce pain. If the burn has occurred from acid ingress on the mucosa, then a little baking soda should be dissolved in the water, and the alkali is neutralized with acetic or citric acid.
First aid
Upon arrival of the team, medical workers provide assistance to a victim of a burn of the respiratory tract as follows:
- Analgesics are administered intramuscularly using metamizole sodium or Ketorolac and sedatives, for example, Diphenhydramine, Relanium.
- They wash their face and neck with clean cold water, rinse their mouth thoroughly.
- Provide breathing using an oxygen mask.
- In the absence of breathing, Ephedrine or Adrenaline is administered intravenously, and in the absence of effect, a tracheostomy is performed.
Having completed all the activities, the patient is immediately taken to a medical institution for further medical care.
Therapeutic tactics
After the victim is taken to the hospital with a thermal or chemical burn of the upper respiratory tract, the doctor conducts a thorough examination, reveals its cause, nature and severity. After the results obtained during the diagnostic examination, the doctor prescribes therapy for each patient individually, taking into account the characteristics of the body. All treatment measures are aimed at the following:
- elimination of pain shock;
- normalization of breathing;
- reduction of swelling of the larynx;
- the exception of bronchospasm;
- facilitating the withdrawal of accumulated epithelial cells, mucus;
- prevention of pneumonia;
- warnings against lung atelectasis, which occurs when the bronchial lumen is obstructed due to the accumulation of viscous secretions.
All these problems are eliminated with the conservative treatment of burns.
Determination of severity
When a person with burns damages the surface of the skin, then the specialist can immediately see the severity of this pathology. With the respiratory system, everything is much more complicated, an external examination gives far from complete information. It is very difficult to assess the depth and scale of internal tissue damage. When conducting diagnostic measures, a burn of the respiratory tract is equivalent to deep burn damage to the skin. The stage is determined after laryngoscopy and bronchoscopy. These procedures allow you to check the condition of the trachea and bronchi in a short period. In stationary conditions, the treatment regimen for thermal and chemical burns does not differ.
Drug therapy
Treatment of burns of the respiratory tract is standardly carried out according to the following scheme:
- The doctor prescribes the patient bed rest and complete rest. It is forbidden to talk for at least two weeks so as not to harm the vocal cords.
- Conducting anti-shock therapy. Humidified oxygen is provided to eliminate oxygen deprivation. Agonists of morphine drugs are used for pain relief, a solution of glucose and a blood substitute is poured, support is provided by “Dopamine” - the hormone of happiness, “Dobutamine”, stimulating myocardial receptors, “Heparin” to reduce blood clots and maintain cardiac activity.
- Cervical vagosympathetic block. Used for prolonged pain relief, which reduces the use of narcotic drugs.
- To weaken the pathological process, the administration of diuretics, glucocorticosteroids, ascorbic acid, a polarizing mixture, which includes glucose, potassium, magnesium, insulin, is prescribed.
After the volume of blood and urine is restored and there is a partial removal of inflammation of the mucous membranes, treatment of burns of the respiratory tract continues:
- antibacterial drugs so that a secondary infection does not join;
- "Succinic acid" to prevent changes in acid-base balance;
- Vitamin B12 and Neurovitan - to support the body and restore tissue.
In addition, therapy is carried out using aerosol inhalations, if breathing is disturbed, trachea or bronchi are intubated, as well as a tracheotomy with the introduction of a special tube to resume breathing function.
Physiotherapeutic treatment
Burn disease in addition to the respiratory system is accompanied by disorders of the heart system and central nervous system. For burns of the upper respiratory tract, physiotherapeutic procedures are prescribed to help the main treatment. They help to rehabilitate faster, prevent infection of the damaged surface, accelerate and facilitate the passage of dead tissue, and stimulate the formation of the epithelium. The following procedures are used:
- UHF and UHF - to prevent inflammatory processes and improve the passage of lymph.
- Ultraviolet radiation, drug electrophoresis - help relieve pain.
- High-frequency magnetotherapy, infrared laser therapy - to prevent the formation of keloid scars.
In addition, physiotherapy methods are often used to restore the balance of the nervous and cardiac systems. To do this, apply electrosonotherapy, aerotherapy, electrophoresis with drugs.
Alternative methods of treatment
To treat an injured mucosa of the respiratory tract, you can use at home:
- Cold treatment. Apply a cold compress to the surface of the neck. Break the ice into small pieces and use to swallow.
- Butter. Apply to lubricate the damaged mucosa several times a day. Sea buckthorn, rosehip, peach and olive oil, as well as fish oil, are suitable for this purpose.
- Herbal decoctions. They are prepared from chamomile grass, yarrow, calendula, oak bark. 200 ml of boiling water take a tablespoon of dry raw materials. Rinse a solution of room temperature several times a day.
- Dairy products. You can drink milk, kefir and whey, eat sour cream. All this will help the healing of the mucosa.
As a rule, all these methods are used only for mild burns, but in any case, before treatment with folk remedies, be sure to consult your doctor. In addition, the patient must follow a diet due to pain in the larynx. Food should be consumed in pureed form and moderate temperature.
Effects
With a burn of the upper respiratory tract, narrowing of the bronchi is possible, which is caused by muscle contraction. A severe tracheal lesion literally within a few minutes causes suffocation. The occurrence of early consequences associated with respiratory failure is life threatening to the individual.
Help the victim can only immediate resuscitation. With a burn of the respiratory system from late complications, the most common are:
- Secondary infection of damaged tissues and the formation of purulent processes.
- Structural voice disorders.
- The occurrence of chronic diseases of the trachea.
- The development of pneumonia - occurs in all individuals who receive a chemical or thermal burn of the second or third degree.
- Emphysema - there is an excessive accumulation of air in the lungs due to destruction of the structure of the alveoli.
- Chronic respiratory, renal and heart failure.
- The death of tracheal and bronchial tissues, the development of sepsis is an inflammatory reaction with the development of a local infectious process.
Forecast
Damage to the respiratory tract, as well as a skin burn, cause serious disorders of all vital processes. The prognosis depends directly on the severity of the damage received, competent and timely first aid provided, the age of the individual and his physical condition, as well as existing chronic ailments.
Damage to the first degree of severity with a small percentage of burns to the airways does not pose a serious health threat. They are easily treated with medications, especially in young and middle-aged people. In older people, therapy is longer and complications may develop.
Even severe burns of the respiratory organs located before the trachea do not pose a threat to the life of the victim. But damage to the second and third degree of the respiratory system is always associated with complications. When the bronchi and lungs are affected, significant tissue death occurs, which often leads to death.
A burn of the respiratory system is a serious injury and can occur even after cure several years later. Therefore, it is necessary to systematically undergo preventive examinations and carry out all doctor's prescriptions.
Preventative measures
Basic preventive measures to prevent burns of respiratory organs and their consequences include the following:
- Full rehabilitation. After careful treatment, the patient must perform physiotherapeutic procedures, physiotherapy exercises, take walks in the fresh air, observe a sparing diet, providing the body with enough minerals and vitamins.
- Rejection of bad habits.
- Compliance with safety regulations when handling toxic liquids, hot air and water.
Conclusion
It is very important to know how to provide first aid after a burn, because the condition of the victim in many respects depends on its proper organization. After the event, it is necessary to show the patient to a qualified specialist, even if it seems that the burn is not dangerous. After all, it is very difficult to assess on your own what condition the mucous membranes are inside.
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