In today's VETgirl online veterinary continuing education blog, Dr. Garret Pachtinger, DACVECC discusses common concerns following house fire trauma and smoke inhalation in veterinary medicine. How do we treat carbon monoxide toxicosis, cyanide toxicosis, and the respiratory distress seen in these smoke inhalation patients?
General assessment and monitoring principles include:
- Respiratory distress (including signs of tachypnea, coughing, hypoxemia) as a result of direct thermal injury, pneumonitis / pneumonia, and carboxyhemoglobin
- Cardiovascular changes including tachycardia arrhythmias, and hypotension
- Neurologic changes including lethargy, depression, seizures, tremors, and coma. Delayed neurologic signs have also been reported
- Ocular changes including irritation and corneal trauma from debris and direct thermal injury
General treatment principles include:
- Oxygen therapy and associated treatment for respiratory distress
- Judicious fluid therapy for intravascular volume support, but recognizing the risk of pulmonary edema if there is lung disease / inflammation
- Potential use of bronchodilators, which can be helpful to reduce brochospasm
- Antibiotics if there is evidence of pneumonia or other associated infection (Note: these do not need to be administered prophylactically)
- Glucocorticoids if there is concerning upper airway edema and respiratory compromise (Note: these are not recommended prophylactically in animals with smoke inhalation injury)
- Ocular treatment (e.g., lubrication, antibiotic therapy, etc.) with the concern for corneal ulceration or disease
Hopefully with rapid assessment, early intervention, and careful monitoring we can save these patients and get them back to their families quickly! VETgirl members: Check out our VETgirl video on smoke inhalation here!