When paramedics notice singed hairs in the nose of a burn patient, it is recommended that the patient be intubated. What is the reasoning for the immediate intubation?
a. Carbon monoxide poisoning always occurs when soot is visible.
b. Inhalation injury above the glottis may cause significant edema that obstructs the airway.
c. The patient will have a copious amount of mucus that will need to be suctioned.
d. The singed hairs and soot in the nostrils will cause dysfunction of cilia in the airways.
B
In inhalation injury, the airway may become edematous quickly, making intubation difficult. Early intubation is recommended to protect the airway. Carbon monoxide poisoning may be present, but singed nose hairs are neither a symptom nor a reason for early intubation. Management of secretions is not an indication for intubation. Singed hairs and soot are more commonly symptoms of injury above the glottis rather than lower airway, below-the-glottis, signs and symptoms that will interfere with oxygenation and ventilation.
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