Also, depending on circumstances, the patient may have other traumatic injuries. During your primary survey, rapidly assess the ABCs and look for life-threatening injuries, such as blunt chest trauma, tension pneumothorax, or inhalation injuries. Once the patient has been stabilized and life-threatening injuries have been ruled out, you'll perform a more thorough secondary survey, which would include assessing the depth and extent of the burn. Immediate assessment of the patient's airway is the first priority. Signs and symptoms of inhalation injury include singed facial hair, carbonaceous sputum, soot in the oropharynx, hoarseness, and neck or face burns.
Stridor is an ominous sign.
Inhalation injury can occur above the glottis or in the lower airways and lung parenchyma and is usually a combination of thermal injury and inhalation of toxic fumes, such as carbon monoxide. Carbon monoxide poisoning is likely if your patient was involved in an enclosed fire. A colorless, odorless gas, carbon monoxide has a much greater affinity for the heme molecule than oxygen, so it displaces oxygen from hemoglobin binding sites. You'll need to monitor arterial blood gases and carboxyhemoglobin levels to gauge the extent of carbon monoxide poisoning. Early signs of carbon monoxide poisoning are headache, nausea, vomiting, and unsteady gait.