Question 1

A patient has been brought to the emergency department after inhaling superheated steam. Pulmonary injuries unique to this situation include:
1) atelectasis.
2) pulmonary edema.
3) thick secretions.
4) pharyngeal edema.

Accepted Answer

Inhaled superheated steam will burn all the way to the small airways and lungs. Injuries unique to a steam inhalation include pulmonary edema and atelectasis.

Question 2

A patient with carbon monoxide poisoning has a COHb level of 20%. If the patient is given 100% oxygen, what will the approximate COHb level be in 1 hour?

Accepted Answer

Breathing 100% oxygen at one atmosphere pressure will reduce the COHb by half in l hour. A 20% COHb level will be reduced to about 10% after 1 hour of breathing FIO₂ 1.0.

Question 3

Which of the following conditions occurs in 20% to 30% of hospitalized fire victims with facial burns?

Accepted Answer

Between 20% and 30% of hospitalized patients with facial burns develop an upper airway obstruction.

Question 4

Which of the following radiographic findings would be associated with the intermediate stage of recovery from a serious smoke inhalation injury?

Accepted Answer

During the intermediate stage (2 to 5 days after inhalation), signs of pulmonary edema and ARDS may appear on the chest radiograph.

Question 5

In an industrial accident, an adult incurred burns over his head and neck, both arms, and his anterior trunk. What percent of his BSA was burned?

Accepted Answer

Approximately 45% of the patient's BSA was burned: head and neck (9%), both arms (9% * 2 = 18%), and anterior trunk (18%).

Question 6

According to the Parkland Formula, what is the recommended volume of fluid that should be infused over a 24-hour period for each percent of body surface burned?

Accepted Answer

The Parkland Formula recommends 4 mL/kg of body weight for each percent of body surface area burned to be infused over a 24-hour period.

Question 7

A 65-year-old patient has third-degree skin burns over 30% of his body and a smoke inhalation injury. How does the combination of skin burns and smoke inhalation affect his prognosis?

Accepted Answer

The mortality rate almost doubles when a patient has third-degree burns and a smoke inhalation injury compared with having a single problem.

Question 8

What COHb level is associated with a throbbing headache, nausea, vomiting, and impaired judgment?

Accepted Answer

With COHb levels between 20% and 30%, throbbing headaches, nausea and vomiting, and impaired judgment would be expected.

Question 9

What level of carbon monoxide toxicity is associated with coma, convulsions, and Cheyne-Stokes respiration?

Accepted Answer

At carboxyhemoglobin levels of 50% to 60%, coma, convulsions, and Cheyne-Stokes respiration would be likely to occur.

Question 10

The long-term effects of a smoke inhalation injury are:

Accepted Answer

A smoke inhalation injury can cause both obstructive and restrictive lung disorders.

Question 11

Clinical signs of an upper airway thermal injury include:
1) facial burns.
2) atelectasis.
3) mucosal edema.
4) epithelial sloughing.

Accepted Answer

Clinical signs of an upper airway thermal injury include, but are not limited to, facial burns, mucosal edema, and epithelial sloughing of the upper airway tissues.

Question 12

Clinical signs associated with acute upper airway obstruction due to thermal injury include:
1) pleural friction rub.
2) inspiratory stridor.
3) pulmonary edema.
4) painful swallowing.

Accepted Answer

Inspiratory stridor and painful swallowing are two of the clinical signs associated with acute upper airway obstruction due to thermal injury.

Question 13

All of the following classes of medications are commonly used in the care of patients with smoke inhalation injury EXCEPT:

Accepted Answer

A monoclonal antibody, such as omalizumab, would not be indicated in the treatment of a smoke inhalation injury.

Question 14

Which portion of the pulmonary system will be affected by the inhalation of low-water solubility gases such as hydrogen chloride and phosgene?

Accepted Answer

Low-water solubility gases will penetrate and damage the distal airways and alveoli.

Question 15

Late-stage complications of extensive body surface burns include:
1) sepsis.
2) upper airway obstruction.
3) pneumonia.
4) pulmonary embolism.

Accepted Answer

Late-stage complications are those that occur 5 days or longer after the initial injury occurred. During the late stage following burns, a patient with extensive body surface burns (and prolonged immobility) is at risk for sepsis, pneumonia, and a pulmonary embolism.

Question 16

A 10-year-old patient has inhaled hot gases, and an inspection of her mouth shows edema and blisters. What should the respiratory therapist recommend?

Accepted Answer

Endotracheal intubation should be performed as soon as possible because the patient is at a high risk for airway obstruction.

Question 17

All of the following will be typically found in the air of an enclosed house fire EXCEPT:

Accepted Answer

The burning of typical household materials will result in the release of carbon monoxide, hydrogen cyanide, and hydrogen chloride.

Question 18

Which of the following would be recommended for the treatment of cyanide poisoning?

Accepted Answer

Cyanide poisoning can be treated with amyl nitrate.

Quiz 43: Smoke Inhalation, Thermal Injuries, and Carbon Monoxide Intoxication

A patient has been brought to the emergency department after inhaling superheated steam. Pulmonary injuries unique to this situation include: 1) atelectasis. 2) pulmonary edema. 3) thick secretions. 4) pharyngeal edema.