Hello, this is the podcast surgery. I see rounds. My name is Jeff Guy. I'm an associate professor of surgery and the director of the burn center of Vanderbilt University. Today, the topic that we want to talk about is smoke inhalation, carbon monoxide poisoning, and cyanide poisoning. As somebody who works and runs a burn unit on a daily basis, we're faced with the challenges of what happens to patients following exposure to smoke.

You may not work in a burn center, but you certainly may come in contact with patients who presented the emergency department with smoke inhalation.

May not have any burns, and the question is then what

do we do with this patient since they don't have burns we probably don't need to send them to a

burn center that's not the truth you probably do need to send them to a burn center and the people who

deal with these injuries the inhalation injury on a routine basis but let's talk about why this is

such a dangerous injury.

What's some of the pathophysiology involved? And what are some of the new and emerging treatments?

And what are some of the roles, the role of some of the older treatments? When you think about

smoke and smoke inhalation, you have to be mindful that smoke is nothing more than products of incomplete combustion.

And when you're involved in a structure fire or a car fire,

that you're really inhaling some very dangerous particulate matter.

Be mindful that smoke inhalation is a more common source of fire-related mortality

than the actual burns themselves. And the presence or

absence of smoke inhalation is a greater predictor of whether somebody is going to live or die

in a patient who has a burn than the size of the burns or the age of the patient. Let's say that again,

that if you have an inhalation of smoke, that is going to be more

predictive of whether a patient will live or die than the sides of the burn, whether they

have a 20% burn, a 50% burn, or a 70% burn, that is going to predict whether they live or die

as much as to whether they have inhaled smoke.

The inhalation of smoke is responsible for approximately 4,000 deaths annually in the United States

and over 20,000 injuries annually in the United States, including roughly about 5,000 firefighters,

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