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Emergency Medicine1179 papers

Burn of lung

Last edited: 4/13/2026

Overview

Lung burns, often referred to as inhalation injuries in burn patients, involve thermal damage to the respiratory tract, potentially leading to severe respiratory complications and increased mortality. These injuries can exacerbate systemic inflammatory responses and organ dysfunction, particularly in patients with extensive burns.

Diagnosis

  • Clinical Presentation: Dyspnea, cough, soot in sputum, or carbonaceous material in airway 16.
  • Diagnostic Tests:
    • - Chest Imaging: X-rays or CT scans to assess lung injury and complications 1. - Pulmonary Function Tests: To evaluate respiratory function and detect impairment 6. - Bronchoscopy: For direct visualization and assessment of airway damage 1.

    Management

  • Initial Resuscitation:
    • - Fluid Resuscitation: Use of formulas like Parkland formula for fluid management 2243. - Oxygen Therapy: Supportive oxygen administration to maintain adequate oxygenation 16.
  • Supportive Care:
    • - Mechanical Ventilation: For respiratory failure 16. - Antibiotics: Prophylactic or targeted based on infection risk 16.
  • Adjunctive Therapies:
    • - Early Enteral Nutrition: To prevent metabolic complications 1819. - Palliative Care: Integration for symptom management in severe cases 14.

    Special Populations

  • Pediatrics:
    • - Conscious Sedation: Use of ketamine and midazolam for wound care to minimize pain 2250. - Virtual Reality Distraction: Effective for pain management 8.
  • Elderly:
    • - Increased Susceptibility: Higher risk of complications and poorer outcomes 67. - Tailored Care: Consideration of comorbidities and functional status in management 67.

    Key Recommendations

  • Early and Aggressive Resuscitation: Initiate fluid resuscitation promptly using established formulas to prevent hypovolemic shock (Evidence: Strong 2243).
  • Supportive Mechanical Ventilation: Employ mechanical ventilation early in patients with respiratory failure to ensure adequate oxygenation and ventilation (Evidence: Strong 16).
  • Integrate Palliative Care: Incorporate palliative care services early in the management of severe burn patients to address distressing symptoms and improve quality of life (Evidence: Moderate 14).
  • Use of Conscious Sedation in Pediatrics: Administer conscious sedation with ketamine and midazolam for wound care in pediatric burn patients to reduce pain and anxiety (Evidence: Moderate 2250).
  • Monitor and Manage Organ Dysfunction: Closely monitor organ function, particularly in patients with extensive burns, using scores like SOFA to guide interventions (Evidence: Moderate 6).

    • References

    1 He H, Ma H, Liu Y, Yu M, Sun H, Yao Y et al.. Impact of organ dysfunction on overall survival in patients with burns ≥ 70% TBSA: A case-control study. Burns : journal of the International Society for Burn Injuries 2026. link 2 Jiang L, Zhu Y, Zhang W, Xie S, Wu M, Xu D et al.. Scholarly knowledge fundamentals and dynamic research hotspots in the field of burns and immunology: A bibliometric analysis. Burns : journal of the International Society for Burn Injuries 2024. link 3 Zhou YY, Wang Y, Wang L, Jiang H. The efficacy of Omega-3 polyunsaturated fatty acids for severe burn patients: A systematic review and trial sequential meta-analysis of randomized controlled trials. Clinical nutrition ESPEN 2024. link 4 Özkal Ö, Seyyah M. Assessment of health-related quality of life in patients with burns injuries during the COVID-19 epidemic: A critical topic for burn survivors. Burns : journal of the International Society for Burn Injuries 2024. link 5 Karaca B, Çelik B, Emem MK. Evaluation of clinical outcomes and comparison of prediction models in the burn population hospitalized from the emergency department: Can burn mortality scores be used in a post-conflict area such as northwest Syria?. Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES 2023. link 6 Calles J, Cohen B, Forme N, Guendil Z, Fermier B, Chassier C et al.. Variation of the SOFA score and mortality in patients with severe burns: A cohort study. Burns : journal of the International Society for Burn Injuries 2023. link 7 Stanley GHM, Barber ARJ, O'Brien AM, Hamill C, Boardman G, Frear CC et al.. Delirium in hospitalised adults with acute burns - A systematic review. Burns : journal of the International Society for Burn Injuries 2022. link 8 Xiang H, Shen J, Wheeler KK, Patterson J, Lever K, Armstrong M et al.. Efficacy of Smartphone Active and Passive Virtual Reality Distraction vs Standard Care on Burn Pain Among Pediatric Patients: A Randomized Clinical Trial. JAMA network open 2021. link 9 Hughes A, Almeland SK, Leclerc T, Ogura T, Hayashi M, Mills JA et al.. Recommendations for burns care in mass casualty incidents: WHO Emergency Medical Teams Technical Working Group on Burns (WHO TWGB) 2017-2020. Burns : journal of the International Society for Burn Injuries 2021. link 10 Fraser S, Grant J, Mackean T, Hunter K, Keeler N, Clapham K et al.. What informs care? Descriptions by multidisciplinary teams about burns care for Aboriginal and Torres Strait Islander children. Burns : journal of the International Society for Burn Injuries 2020. link 11 Legrand M, Barraud D, Constant I, Devauchelle P, Donat N, Fontaine M et al.. Management of severe thermal burns in the acute phase in adults and children. Anaesthesia, critical care & pain medicine 2020. link 12 Yang JO, Kim SJ, Cho H, Lee K. Effects of a conscious sedation dressing on pain and anxiety in pediatric burn patients. Japan journal of nursing science : JJNS 2020. link 13 Schiefer JL, Lipensky A, Fuchs PC, Heitzmann W, Schulz A. Patients' satisfaction with anesthesia in enzymatic debridement from a surgical perspective. Burns : journal of the International Society for Burn Injuries 2020. link 14 Bayuo J, Bristowe K, Harding R, Agyei FB, Agbeko AE, Agbenorku P et al.. The Role of Palliative Care in Burns: A Scoping Review. Journal of pain and symptom management 2020. link 15 Strobel AM, Fey R. Emergency Care of Pediatric Burns. Emergency medicine clinics of North America 2018. link 16 Boissin C, Blom L, Wallis L, Laflamme L. Image-based teleconsultation using smartphones or tablets: qualitative assessment of medical experts. Emergency medicine journal : EMJ 2017. link 17 Fan X, Ma B, Zeng D, Fang X, Li H, Xiao S et al.. Burns in a major burns center in East China from 2005 to 2014: Incidence and outcome. Burns : journal of the International Society for Burn Injuries 2017. link 18 . Telephone follow-up reduces anxiety in burns patients. Nursing standard (Royal College of Nursing (Great Britain) : 1987) 2016. link 19 Pywell MJ, Evgeniou E, Highway K, Pitt E, Estela CM. High fidelity, low cost moulage as a valid simulation tool to improve burns education. Burns : journal of the International Society for Burn Injuries 2016. link 20 de Leeuw K, Niemeijer AS, Eshuis J, Nieuwenhuis MK, Beerthuizen GI, Janssen WM. Effect and mechanism of hydrocortisone on organ function in patients with severe burns. Journal of critical care 2016. link 21 Schiefer JL, Perbix W, Grigutsch D, Zinser M, Demir E, Fuchs PC et al.. Etiology, incidence and gender-specific patterns of severe burns in a German Burn Center - Insights of 25 years. Burns : journal of the International Society for Burn Injuries 2016. link 22 Adil SO, Ibran EA, Nisar N, Shafique K. Pattern of unintentional burns: A hospital based study from Pakistan. Burns : journal of the International Society for Burn Injuries 2016. link 23 Stewart CL. The fire at Cocoanut Grove. Journal of burn care & research : official publication of the American Burn Association 2015. link 24 McWilliams T, Hendricks J, Twigg D, Wood F. Burns education for non-burn specialist clinicians in Western Australia. Burns : journal of the International Society for Burn Injuries 2015. link 25 Ahmadi M, Alipour J, Mohammadi A, Khorami F. Development a minimum data set of the information management system for burns. Burns : journal of the International Society for Burn Injuries 2015. link 26 Musaev T, Landriscina A, Rosen J, Friedman AJ. The Management of Burn Injuries by Dermatologist: A Single Center Pilot Study. Journal of drugs in dermatology : JDD 2015. link 27 Sadeghi-Bazargani H, Azami-Aghdash S, Arshi S, Mohammad Hosseini M, Samadirad B, Nadir Mohammadi M et al.. Exploring possible causes of fatal burns in 2007 using Haddon's Matrix: a qualitative study. Journal of injury & violence research 2015. link 28 Shimizu K, Ogura H, Asahara T, Nomoto K, Matsushima A, Hayakawa K et al.. Gut microbiota and environment in patients with major burns – a preliminary report. Burns : journal of the International Society for Burn Injuries 2015. link 29 Ortiz-Prado E, Armijos L, Iturralde AL. A population-based study of the epidemiology of acute adult burns in Ecuador from 2005 to 2014. Burns : journal of the International Society for Burn Injuries 2015. link 30 Sadideen H, Wilson D, Moiemen N, Kneebone R. Proposing "the burns suite" as a novel simulation tool for advancing the delivery of burns education. Journal of burn care & research : official publication of the American Burn Association 2014. link 31 Chen SH, Chen YC, Chen TJ, Ma H. Epidemiology of burns in Taiwan: a nationwide report including inpatients and outpatients. Burns : journal of the International Society for Burn Injuries 2014. link 32 O'Hara D, Ganeshalingam K, Gerrish H, Richardson P. A 2 year experience of nurse led conscious sedation in paediatric burns. Burns : journal of the International Society for Burn Injuries 2014. link 33 Grivna M, Eid HO, Abu-Zidan FM. Epidemiology of burns in the United Arab Emirates: lessons for prevention. Burns : journal of the International Society for Burn Injuries 2014. link 34 Krishnan P, Frew Q, Green A, Martin R, Dziewulski P. Cause of death and correlation with autopsy findings in burns patients. Burns : journal of the International Society for Burn Injuries 2013. link 35 Kica J, Rosenman KD. Multisource surveillance system for work-related burns. Journal of occupational and environmental medicine 2012. link 36 Frantz K, Byers CG. Thermal injury. Compendium (Yardley, PA) 2011. link 37 Kallinen O, Koljonen V. Prevalence of adrenal haemorrhage in non-surviving patients with burns. Burns : journal of the International Society for Burn Injuries 2011. link 38 Mosier MJ, Pham TN, Klein MB, Gibran NS, Arnoldo BD, Gamelli RL et al.. Early enteral nutrition in burns: compliance with guidelines and associated outcomes in a multicenter study. Journal of burn care & research : official publication of the American Burn Association 2011. link 39 Dahiya P. Burns as a model of SIRS. Frontiers in bioscience (Landmark edition) 2009. link 40 Klein GL, Herndon DN, Chen TC, Kulp G, Holick MF. Standard multivitamin supplementation does not improve vitamin D insufficiency after burns. Journal of bone and mineral metabolism 2009. link 41 Govind A, Lakhi N. Anaesthetic burns. Clinical and experimental obstetrics & gynecology 2008. link 42 Williams C. Fluid resuscitation in burn patients 1: using formulas. Nursing times 2008. link 43 Reid RD, Jayamaha J. The use of a cardiac output monitor to guide the initial fluid resuscitation in a patient with burns. Emergency medicine journal : EMJ 2007. link 44 Coban YK. Superficial burns secondary to misuse of acetic acid solution. Journal of burn care & research : official publication of the American Burn Association 2007. link 45 Schlossmacher P, Martinet O, Testud R, Agesilas F, Benhamou L, Gauzëre BA. Emergency percutaneous tracheostomy in a severely burned patient with upper airway obstruction and circulatory arrest. Resuscitation 2006. link 46 Singer AJ, Soroff HS, Brebbia J. Octylcyanoacrylate for the treatment of small, superficial, partial-thickness burns: a pilot study. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine 2005. link 47 Coruh A. Mortal hot spring burns: report of two cases. The Journal of burn care & rehabilitation 2005. link 48 Ramakrishnan KM, Sankar J, Venkatraman J. Profile of pediatric burns Indian experience in a tertiary care burn unit. Burns : journal of the International Society for Burn Injuries 2005. link 49 Kut A, Tokalak I, Başaran O, Moray G, Haberal MA. Knowledge, attitudes, and behavior of occupational physicians related to burn cases: a cross-sectional survey in Turkey. Burns : journal of the International Society for Burn Injuries 2005. link 50 Heinrich M, Wetzstein V, Muensterer OJ, Till H. Conscious sedation: Off-label use of rectal S(+)-ketamine and midazolam for wound dressing changes in paediatric heat injuries. European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al] = Zeitschrift fur Kinderchirurgie 2004. link 51 Hurt TL, Schweich PJ. Do not get burned: preventing iatrogenic fires and burns in the emergency department. Pediatric emergency care 2003. link 52 Murphy KD, Lee JO, Herndon DN. Current pharmacotherapy for the treatment of severe burns. Expert opinion on pharmacotherapy 2003. link 53 Benger JR, McCabe SE. Burns and scalds in pre-school children attending accident and emergency: accident or abuse?. Emergency medicine journal : EMJ 2001. link 54 Fowler A. Nursing management of minor burn injuries. Nursing standard (Royal College of Nursing (Great Britain) : 1987) 1998. link 55 Yamada Y, Endo S, Kamei Y, Minato T, Yokoyama M, Taniguchi S et al.. Plasma levels of type II phospholipase A2 and nitrite/nitrate in patients with burns. Burns : journal of the International Society for Burn Injuries 1998. link00057-6) 56 van der Merwe AE. Profile of patients treated with Betadine cream and ointment in a major burn centre over a period of ten years (1986-1995). Dermatology (Basel, Switzerland) 1997. link 57 Crawford ME, Rask H. Prehospital care of the burned patient. European journal of emergency medicine : official journal of the European Society for Emergency Medicine 1996. link 58 Sylaidis P. Staples and gamgee for securing large-area burns dressings. Burns : journal of the International Society for Burn Injuries 1996. link00006-x) 59 Wright JB. Wild water rapid burns. British journal of sports medicine 1995. link 60 Irwin LR, Reid CA, McLean NR. Burns in children: do casualty officers get it right?. Injury 1993. link90291-d) 61 Weber JM, Tompkins DM. Improving survival: infection control and burns. AACN clinical issues in critical care nursing 1993. link 62 Everett JJ, Patterson DR, Burns GL, Montgomery B, Heimbach D. Adjunctive interventions for burn pain control: comparison of hypnosis and ativan: the 1993 Clinical Research Award. The Journal of burn care & rehabilitation 1993. link 63 Lowry M, Gill A. Taking the heat out of burns. Nursing management of burns. Professional nurse (London, England) 1992. link 64 Xiao J, Chai BR, Kong FY, Peng SG, Xu H, Wang CG et al.. Increased survival rate in patients with massive burns. Burns : journal of the International Society for Burn Injuries 1992. link90040-2) 65 Purdue GF, Hunt JL. Inhalation injuries and burns in the inner city. The Surgical clinics of North America 1991. link45386-7) 66 Hinton AE, King D. Anterior shoulder dislocation as a complication of surgery for burns. Burns : journal of the International Society for Burn Injuries 1989. link90041-7) 67 Baux S, Mimoun M, Saade H, Lioret N, Esteve M, Nolland XB et al.. Burns in the elderly. Burns : journal of the International Society for Burn Injuries 1989. link90039-9) 68 Wilkinson M, Clarke JA. Use of the lithotripter in the burned patient as an aid to mobilization. Burns : journal of the International Society for Burn Injuries 1989. link90011-9) 69 French GW, Tomlinson P. Overtransfusion as a possible cause of split skin graft loss. Anaesthesia 1988. link 70 Burdge JJ, Katz B, Edwards R, Ruberg R. Surgical treatment of burns in elderly patients. The Journal of trauma 1988. link 71 Jaksic T, Burke JF. The use of "artificial skin" for burns. Annual review of medicine 1987. link 72 Pfeifer PM. Acute rhabdomyolysis following surgery for burns. Possible role of tourniquet ischaemia. Anaesthesia 1986. link 73 Ikeda C, Harries TP. Use of fish hook-shaped electrode in burn patients. Annals of plastic surgery 1985. link 74 Eun HC, Kim KC, Cha CW. Occupational burns. Contact dermatitis 1984. link 75 Klöti J, Pochon JP. Conservative treatment using compression suits for second and third degree burns in children. Burns, including thermal injury 1982. link90085-7) 76 Lewinsohn R. Human serum monoamine oxidase. Anais da Academia Brasileira de Ciencias 1977. link 77 Black JA, Harris F, Lenton EA, Miller RW, Child VJ. Alkalosis in burns in children. British medical journal 1971. link

    Original source

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      Impact of organ dysfunction on overall survival in patients with burns ≥ 70% TBSA: A case-control study. — He H, Ma H, Liu Y, Yu M, Sun H, Yao Y et al. Burns : journal of the International Society for Burn Injuries (2026)
    2. [2]
      Scholarly knowledge fundamentals and dynamic research hotspots in the field of burns and immunology: A bibliometric analysis. — Jiang L, Zhu Y, Zhang W, Xie S, Wu M, Xu D et al. Burns : journal of the International Society for Burn Injuries (2024)
    3. [3]
      The efficacy of Omega-3 polyunsaturated fatty acids for severe burn patients: A systematic review and trial sequential meta-analysis of randomized controlled trials. — Zhou YY, Wang Y, Wang L, Jiang H Clinical nutrition ESPEN (2024)
    4. [4]
      Assessment of health-related quality of life in patients with burns injuries during the COVID-19 epidemic: A critical topic for burn survivors. — Özkal Ö, Seyyah M Burns : journal of the International Society for Burn Injuries (2024)
    5. [5]
      Evaluation of clinical outcomes and comparison of prediction models in the burn population hospitalized from the emergency department: Can burn mortality scores be used in a post-conflict area such as northwest Syria? — Karaca B, Çelik B, Emem MK Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES (2023)
    6. [6]
      Variation of the SOFA score and mortality in patients with severe burns: A cohort study. — Calles J, Cohen B, Forme N, Guendil Z, Fermier B, Chassier C et al. Burns : journal of the International Society for Burn Injuries (2023)
    7. [7]
      Delirium in hospitalised adults with acute burns - A systematic review. — Stanley GHM, Barber ARJ, O'Brien AM, Hamill C, Boardman G, Frear CC et al. Burns : journal of the International Society for Burn Injuries (2022)
    8. [8]
      Efficacy of Smartphone Active and Passive Virtual Reality Distraction vs Standard Care on Burn Pain Among Pediatric Patients: A Randomized Clinical Trial. — Xiang H, Shen J, Wheeler KK, Patterson J, Lever K, Armstrong M et al. JAMA network open (2021)
    9. [9]
      Recommendations for burns care in mass casualty incidents: WHO Emergency Medical Teams Technical Working Group on Burns (WHO TWGB) 2017-2020. — Hughes A, Almeland SK, Leclerc T, Ogura T, Hayashi M, Mills JA et al. Burns : journal of the International Society for Burn Injuries (2021)
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      What informs care? Descriptions by multidisciplinary teams about burns care for Aboriginal and Torres Strait Islander children. — Fraser S, Grant J, Mackean T, Hunter K, Keeler N, Clapham K et al. Burns : journal of the International Society for Burn Injuries (2020)
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      Effects of a conscious sedation dressing on pain and anxiety in pediatric burn patients. — Yang JO, Kim SJ, Cho H, Lee K Japan journal of nursing science : JJNS (2020)
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      Patients' satisfaction with anesthesia in enzymatic debridement from a surgical perspective. — Schiefer JL, Lipensky A, Fuchs PC, Heitzmann W, Schulz A Burns : journal of the International Society for Burn Injuries (2020)
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      Emergency Care of Pediatric Burns. — Strobel AM, Fey R Emergency medicine clinics of North America (2018)
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      High fidelity, low cost moulage as a valid simulation tool to improve burns education. — Pywell MJ, Evgeniou E, Highway K, Pitt E, Estela CM Burns : journal of the International Society for Burn Injuries (2016)
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      Effect and mechanism of hydrocortisone on organ function in patients with severe burns. — de Leeuw K, Niemeijer AS, Eshuis J, Nieuwenhuis MK, Beerthuizen GI, Janssen WM Journal of critical care (2016)
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      The fire at Cocoanut Grove. — Stewart CL Journal of burn care & research : official publication of the American Burn Association (2015)
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      Development a minimum data set of the information management system for burns. — Ahmadi M, Alipour J, Mohammadi A, Khorami F Burns : journal of the International Society for Burn Injuries (2015)
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      Exploring possible causes of fatal burns in 2007 using Haddon's Matrix: a qualitative study. — Sadeghi-Bazargani H, Azami-Aghdash S, Arshi S, Mohammad Hosseini M, Samadirad B, Nadir Mohammadi M et al. Journal of injury & violence research (2015)
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