Clinical Challenges in Burn Surgery: Inhalation Injury
Behind The Knife: The Surgery Podcast
Behind The Knife: The Surgery Podcast
4.8 • 1.4K Ratings
🗓️ 1 December 2025
⏱️ 22 minutes
🧾️ Download transcript
Summary
Hosts:
- Kathleen Romanowski – University of California Davis Hospital, Shriners Hospital Sacramento
- Laura Johnson – Grady Memorial Hospital
- Lauren Nosanov – Grady Memorial Hospital
- Victoria Miles – Louisiana State University Health Science Center, University Medical Center New Orleans
- Recognize the clinical features and diagnostic challenges of inhalation injury in burn patients, including differentiation from thermal airway injury and flash burns.
- Apply evidence-based criteria to guide intubation and ventilatory management, including the avoidance of unnecessary intubation.
- Implement key principles of supportive care and complication prevention, including fluid resuscitation, pharmacologic therapies, and long-term airway considerations.
References:
- Hope E Werenski, Anju Saraswat, James H Holmes, John K Bailey, Is Burn Center Admission Necessary After Home Oxygen Ignition Injury?, Journal of Burn Care & Research, 2025;, iraf189, https://doi.org/10.1093/jbcr/iraf189
- Kathleen S. Romanowski, Tina L. Palmieri, Soman Sen, David G. Greenhalgh, More Than One Third of Intubations in Patients Transferred to Burn Centers are Unnecessary: Proposed Guidelines for Appropriate Intubation of the Burn Patient, Journal of Burn Care & Research, Volume 37, Issue 5, September-October 2016, Pages e409–e414, https://doi.org/10.1097/BCR.0000000000000288 https://pubmed.ncbi.nlm.nih.gov/26284640/
- Walker PF, Buehner MF, Wood LA, Boyer NL, Driscoll IR, Lundy JB, Cancio LC, Chung KK. Diagnosis and management of inhalation injury: an updated review. Crit Care. 2015 Oct 28;19:351. doi: 10.1186/s13054-015-1077-4. PMID: 26507130; PMCID: PMC4624587. https://pubmed.ncbi.nlm.nih.gov/26507130/
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Transcript
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| 0:00.0 | Behind the Knife. |
| 0:24.4 | This is Patrick Georgoff. |
| 0:25.5 | I want you to imagine this. |
| 0:26.9 | It's 2 a.m. |
| 0:27.7 | and you're rushing a hypotensive trauma patient to the operating room for exploration. |
| 0:32.3 | Maybe you need to go into the neck, the chest, or the abdomen. |
| 0:35.5 | Are you prepared for what you might find? |
| 0:37.8 | Trauma educational resources are extremely limited. That's why we created the trauma |
| 0:41.4 | surgery video atlas. 24 challenging scenarios with high-yield text, beautiful illustrations, |
| 0:47.3 | and stunning professional grade video that walks you through the approach and management |
| 0:51.5 | of devastating injuries in a step-by-step fashion. |
| 0:55.7 | Check out the link in the show notes. For more, there are group discounts available as well. |
| 0:58.9 | Now, enjoy the episode and dominate the day. |
| 1:03.6 | Welcome to Behind the Knife, the Surgery Podcast. |
| 1:08.5 | Today, we're diving into one of the most complex and high-staking scenarios |
| 1:12.5 | in burn care. Inhalation injury. I'm Dr. Lauren Nassanav from Grady Memorial Hospital, |
| 1:18.5 | and I'm joined today by Dr. Kathleen Romanowski from UC Davis and Shriners, Sacramento, and Dr. |
| 1:25.1 | Victoria Miles from the LSU Health and UMC, New Orleans. Today, we'll |
| 1:31.6 | tackle a clinical challenge, evaluating and managing inhalation injury, using two real-world |
| 1:37.3 | cases, discussing current evidence, and ending with a few quick take-home pearls. So let's jump right into our first case. |
| 1:47.0 | For those of you that have done any level of burn care, this should sound pretty familiar. |
| 1:52.9 | So you've got a call that we're getting a 55-year-old man with hypertension, type 2 diabetes, |
... |
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