Inhalation of toxic chemicals, hot vapors of liquids and gases cause injury to the mucosa and lead to burns of the respiratory tract. As a rule, such injuries are difficult to proceed and are treated, and the organs must constantly perform vital functions. Often, serious complications develop, leading to disability, and sometimes death. In the article, we will consider the degrees of the disease, how first aid is provided and what are the methods of treatment.
Classification
Respiratory tract burns are divided as follows:
- Thermal - arising under the influence of high temperatures.
- Chemical - when chemicals 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 an explosion and evaporation of chemicals, or, conversely, contact of highly active compounds with air causes fire.
By locationrespiratory tract burns are upper and lower. 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 - damaged epithelium, in severe cases, muscles, ligaments and cartilage; there is a high probability of severe consequences.
Bottom observed:
- In the trachea - there is respiratory failure, cyanosis, shortness of breath, suffocation and cough. Damage to the trachea, as a rule, occurs simultaneously with the larynx, which significantly aggravates the condition of the victim.
- In the bronchi - damage is accompanied by hyperemia, accumulation of fluid in the lungs, respiratory failure. Lung tissue burns are usually not fixed.
It is noted that the burn of the upper respiratory tract itself rarely occurs, only with a shallow and single inhalation of toxic fumes or hot air. More often, both upper and lower respiratory tracts are damaged.
Degrees of severity
Evaporation of toxic substances, inhalation of hot air, water vapor or ingestion of boiling water causes injury to the mucous membranes of the mouth, nose and throat. The patient's condition and treatment tactics depend on the depth and area of the mucosal lesion. Depending on this, there are four degrees of burns of the respiratory tract:
- The outer layers of the mucous membrane are affected: from the nasal cavity to the larynx. There is mucosal hyperemia,slight wheezing in the lungs. 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 membranes form in the trachea. The patient's condition is characterized as serious.
- The soft tissues of the deep layers are broken. The mucous membranes swell strongly, the voice often disappears, necrosis of the mucous membrane occurs, and laryngo- and bronchospasm is possible. The patient's condition worsens gradually, speech is often absent.
- There is extensive tissue necrosis and cessation of breathing leading to death.
Chemical burn of respiratory tract
Such a burn can be obtained at the workplace by inhaling vapors of various toxic compounds, if safety rules are not followed:
- if personal protective equipment is not used;
- ventilation system not working;
- Chemicals are stored incorrectly.
And also in case of emergency:
- due to violation of the tightness of containers in which toxic substances are stored;
- evaporation of chemicals at high temperatures.
Most often, chemical burns of the respiratory tract affect workers in the chemical industry and personnel who, on duty, have to deal with detergents and disinfectants. These include employees of various laboratories, junior medical staff and workers in water treatment plants.
Damage to the respiratory organs by chemicals occurs simultaneously with damage to the skin of the face, neck and oral cavity. In practice, it is very difficult to determine what vapors (alkalis or acids) have caused damage until a blood test is done.
Thermal burns of the respiratory tract
Thermal damage occurs when inhaling hot air, steam or swallowing a hot liquid. In this case, shortness of breath occurs, the integuments of the skin turn blue, a change in voice occurs. On examination, damage to the upper palate and pharynx is noticeable. The patient is restless due to severe pain and difficulty breathing. In severe cases, he loses consciousness.
A fire burn is very typical. The victim's neck, lips, oral cavity and nostril mucosa are damaged, which are filled with soot. And with a burn of the respiratory tract with steam, laryngospasm occurs. When hot steam is inhaled, 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 result in serious injury.
Burn symptoms
The following are common signs of airway burns:
- hoarse voice;
- dry hacking cough;
- severe pain, asthma attacks;
- breathing heavy and erratic;
- external defects of the dermis of the face and mucous membranes of the nasal cavity and throat.
These symptoms are observed with burns of both the upper and lower respiratory tract. For the severe stagetypical:
- Excessive salivation and serous nasal discharge.
- Vomiting with blood streaks and dead particles of the epithelium.
- Impaired breathing 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. Severe soreness in the pharynx, increasing with inhalation, is necessarily noted. The surface of the lips and oral mucosa are edematous and strongly hyperemic. The victim has an increase in heart rate, body temperature rises, headache, drowsiness and general malaise.
First aid
Having found the victim, you must immediately call the doctors, and before they arrive, quickly and competently provide first aid for burns of the respiratory tract. Purposeful and clear actions help to reduce the number of possible complications that will save the victim not only he alth, but also life. For this you need:
- Secure the victim - get him out of the lesion.
- Provide access to fresh air.
- Give the victim a semi-sitting position if he is conscious, otherwise lay him on his side, and place his head above the body so that the vomit does not enter the respiratory tract.
- Perform artificial respiration if unconscious.
- While self-transporting or waiting for an ambulance, monitor your breathing.
In case of a thermal burn, the patient should rinse the mouth and nasopharynx with water,having room temperature, to which you can add a solution of "Novocaine" to reduce pain. If the burn occurred from contact with acid on the mucous membrane, then a little baking soda should be dissolved in water, and the alkali is neutralized with acetic or citric acid.
First Aid
After the arrival of the brigade, medical workers provide assistance to the victim with a burn of the respiratory tract as follows:
- Analgesics are administered intramuscularly using metamizole sodium or Ketorolac and sedatives, for example, Diphenhydramine, Relanium.
- Wash face and neck with clean cold water, rinse mouth thoroughly.
- Perform breathing using an oxygen mask.
- If there is no breathing, "Ephedrine" or "Adrenaline" is administered intravenously, and if there is no effect, a tracheostomy is performed.
After completing all the activities, the patient is immediately taken to a medical facility for further medical care.
Treatment 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 organism. All treatment activities are aimed at the following:
- elimination of pain shock;
- normalization of breathing;
- decrease puffinesslarynx;
- exclusion of bronchospasm;
- facilitate the removal of accumulated epithelial cells, mucus;
- prevention of pneumonia;
- warnings against atelectasis of the lung, which occurs when the lumen of the bronchus is blocked due to the accumulation of a viscous secret.
All these problems are eliminated with conservative treatment of burns.
Determination of severity
When a person's skin surface is damaged during burns, the specialist can immediately see to what degree of severity this pathology is attributed. With the respiratory organs, everything is much more complicated, an external examination provides far from complete information. It is very difficult to assess the depth and extent of internal tissue damage. When carrying out diagnostic measures, a burn of the respiratory tract is equated to a deep burn injury 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 is no different.
Drug therapy
Treatment of burns of the respiratory tract is standardly carried out according to the following scheme:
- The doctor prescribes bed rest and complete rest to the patient. It is forbidden to talk for at least two weeks, so as not to harm the vocal cords.
- Conducting antishock therapy. Humidified oxygen is supplied to eliminate oxygen starvation. Morphine agonists are used for pain relief.a solution of glucose and a blood substitute is poured in, support is provided by "Dopamine" - the hormone of happiness, "Dobutamine", which stimulates myocardial receptors, "Heparin" to reduce thrombosis and maintain cardiac activity.
- Cervical vagosympathetic blockade. Used for long-term 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, the treatment of burns of the respiratory tract continues:
- antibacterial drugs to prevent secondary infection;
- "Succinic acid" to prevent changes in the acid-base balance;
- vitamin B12 and Neurovitan - to support the body and restore tissues.
In addition, therapy is carried out using aerosol inhalations, in case of respiratory failure, tracheal or bronchial intubation is performed, as well as tracheotomy with the introduction of a special tube to resume respiratory function.
Physiotherapy treatment
Burn disease, in addition to the respiratory system, is accompanied by disorders of the cardiac 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 damagedsurface, accelerate and facilitate the discharge of dead tissue, stimulate the formation of the epithelium. The following procedures are used for this:
- UHF and microwave - to prevent inflammation and improve the flow of lymph.
- UV irradiation, 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. For this, electrosonotherapy, aerotherapy, electrophoresis with drugs are used.
Folk treatments
For the treatment of injured respiratory mucosa, you can use at home:
- Cold treatment. Apply a cold compress to the neck. Break ice into small pieces and use for swallowing.
- Oil. Apply to lubricate the damaged mucosa several times a day. For this purpose, sea buckthorn, rosehip, peach and olive oil, as well as fish oil, are suitable.
- Herbal decoctions. They are prepared from chamomile herb, yarrow, calendula, oak bark. For 200 ml of boiling water, take a tablespoon of dry raw materials. Use room temperature rinse solution 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.
Usuallyall 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 eaten pureed and at moderate temperatures.
Consequences
At a burn of the upper respiratory tract, narrowing of the bronchi is possible, which is caused by muscle contraction. Severe damage to the trachea literally within a few minutes causes suffocation. The occurrence of early consequences associated with impaired breathing is life-threatening for the individual.
Only immediate resuscitation procedures can help the victim. With a burn of the respiratory organs, the most common late complications are:
- Secondary infection of damaged tissues and the formation of purulent processes.
- Structural voice disorders.
- 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 of the lungs - there is an excessive accumulation of air in the lungs due to the destruction of the structure of the alveoli.
- Respiratory, renal and heart failure in the chronic stage.
- The death of tracheal and bronchial tissues, the development of sepsis is an inflammatory reaction during the development of a local infectious process.
Forecast
Injuries to the organs of the respiratory tract, like skin burns, causeserious disorders of all vital processes. The prognosis depends directly on the severity of the injury, competent and timely first aid, the age of the individual and his physical condition, as well as existing chronic ailments.
Injuries related to the first degree of severity with a small percentage of burns of the respiratory tract do not pose a serious threat to he alth. 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 up to 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.
Respiratory burn is a serious injury and can occur even after a few years of healing. Therefore, you should systematically undergo preventive examinations and follow all the doctor's prescriptions.
Preventive measures
Basic preventive measures to prevent burns of the respiratory organs and their consequences include the following activities:
- Full rehabilitation. After careful treatment, the patient must perform physiotherapeutic procedures, exercise therapy, take walks in the fresh air, observe a sparing diet, ensuringthe body with enough minerals and vitamins.
- Rejection of bad habits.
- Compliance with safety regulations for handling toxic liquids, hot air and water.
Conclusion
It is very important to know how to provide first aid for a burn, because the further condition of the victim largely depends on its proper organization. After the event, it is imperative 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 independently assess the state of the mucous membranes inside.
To prevent dangerous situations, you must carefully check the temperature of the liquid used and observe safety precautions when working with substances that can cause burns.
