What is the priority in management of a smoke inhalation burn?

• A. Airway management
• B. Fluid resuscitation only
• C. Pain control
• D. Infection control

Answer: (A)

Securing the airway is the immediate priority in smoke inhalation injuries because the airway can become obstructed or severely compromised very quickly due to edema, mucosal burns, and soot. Without a patent airway and adequate oxygenation, death can occur even before other burns are addressed. Start with high-flow 100% oxygen to treat hypoxia and to help displace inhaled toxins like carbon monoxide; be prepared to intubate early if there are signs of airway compromise (hoarseness, stridor, facial burns, singed hairs, or increasing respiratory distress), since edema can progress rapidly. Once the airway is protected and ventilation is stabilized, you can then focus on fluid resuscitation, pain control, and infection prevention.