Smoke Inhalation Injury in a Pregnant Patient: A Literature Review of the Evidence and Current Best Practices in the Setting of a Classic Case

  title={Smoke Inhalation Injury in a Pregnant Patient: A Literature Review of the Evidence and Current Best Practices in the Setting of a Classic Case},
  author={Ensign Joseph D. Roderique and Abel Gebre-Giorgis and Dane H Stewart and Michael J. Feldman and Andrea L. Pozez},
  journal={Journal of Burn Care \& Research},
For smoke inhalation injury of a pregnant woman, one must treat two patients and be aware of the potential effects of carbon monoxide (CO) and cyanide (CN) poisoning on both the mother and the fetus. In a pregnant woman, the size and age of the fetus and the degree of poisoning allow for tremendous variability in the toxicity of CO and CN and their respective treatment options. The authors will review a case of a 32-year-old woman who was at 37 weeks of gestation and admitted to the Evans… 

Fire smoke inhalation : mecanisms of toxicity and recommendations for management

Smoke inhalation causes systemic and mucosal toxicity due to the asphyxiant and irritant properties of toxic gases. It represents the first cause of death at the fire scene and after hospital

Carbon Monoxide and Cyanide Poisoning in the Burned Pregnant Patient: An Indication for Hyperbaric Oxygen Therapy

Data indicate cyanide may also be displaced by HBO2, a useful adjunct to rapidly reduce the half-life of CO to 20 minutes and the incidence of delayed neurologic sequelae in the burned pregnant patient.

Trauma in the pregnant patient: an evidence-based approach to management.

This issue reviews the evidence regarding important considerations in pregnant trauma patients, including the primary and secondary survey as well as the possibility for Rh exposure, placental abruption, uterine rupture, and the need for a prompt perimortem cesarean section in the moribund patient.

The Diagnosis and Treatment of Carbon Monoxide Poisoning.

High-quality, prospective, randomized trials that would enable a definitive judgment of the efficacy of HBOT are currently lacking, and there is no general recommendation for HBOT.

Burns During Pregnancy: Implications for Maternal-Perinatal Providers and Guidelines for Practice

The available information on early management of burns during pregnancy is summarized and components of best practices for optimal outcome are identified to provide an evidence basis for rapidly assessing maternal and perinatal risk to the burned pregnant patient and making management decisions for immediate or later delivery.

S2k guideline diagnosis and treatment of carbon monoxide poisoning

If CO poisoning is suspected, 100% oxygen breathing should be immediately initiated in the prehospital setting and hyperbaric oxygen therapy (HBOT) should be initiated within 6 h.

Utility and outcomes of hydroxocobalamin use in smoke inhalation patients.

Delivery and management of a preterm infant in the burn unit: a multidisciplinary approach.



Diagnosis and Treatment of Cyanide Toxicity

  • D. Barillo
  • Biology
    Journal of burn care & research : official publication of the American Burn Association
  • 2009
The role of cyanide toxicity in victims of fire has been extensively examined in both the medical and the fire literature in the 1970s, 1980s, and 1990s and the availability of a new cyanide antidote kit prompted revisited this issue.

Toxicity of Fire Smoke

  • Y. Alarie
  • Environmental Science
    Critical reviews in toxicology
  • 2002
An analysis of toxicological findings in fire and nonfire deaths and the results of animal exposures to smoke from a variety of burning materials indicate that carbon monoxide is still likely to be the major toxicant in modern fires.

Effect of Hyperbaric Oxygen Therapy on whole blood cyanide concentrations in carbon monoxide intoxicated patients from fire accidents

CN concentrations in blood from patients admitted to hospital with CO intoxication and smoke inhalation exposure did not differ significantly from controls and the purpose of the present study was to determine whole blood CN concentrations in fire victims before and after HBO treatment.

Effect of inhalation injury, burn size, and age on mortality: a study of 1447 consecutive burn patients.

The presence of inhalation injury is significantly associated with mortality after thermal injury but adds little to the prediction of mortality using %TBSA and age alone, while using multivariate analysis inhalation Injury was found to be an important variable in determining outcome.

Fetal toxicity associated with maternal carbon monoxide poisoning.

Hydroxocobalamin as a Cyanide Antidote

In recent years, weapons of mass destruction (WMD) preparedness education and activities have spawned greater interest in the effective management of cyanide poisoning, especially in the mass