First Things First (assess & treat for the following)

• Is the patient hypoxemic?
  • High-flow humidified oxygen for all patients
  • Oximetry may be artificially elevated.
• Is there evidence of airway injury?
  • May not be apparent immediately, as long as 24-48 hrs
  • Look for facial burns, singed nasal hair, cough, carbonaceous sputum.
  • Examine for evidence of upper airway edema, hoarseness, stridor, or wheezing.
• Does patient require emergent intubation?
  • Better to secure airway early!
  • Facial or neck burns may become constrictive.
• Does patient have evidence of shock?
  • Hypovolemia is common in burn injuries