Abstract
Airway management in both acute and reconstructive burn patients can be a major challenge
for evaluation, intubation, and securing the airway in the setting of altered airway
structure. Airway evaluation in both acute and reconstructive patients includes examination
for evidence of laryngeal and supraglottic edema and structural changes due to trauma
and/or scarring that will impact the successful approach to acquiring an airway for
surgical procedures and medical recovery. The approach to acquiring a successful airway
is rarely standard laryngoscopy and often requires fiberoptic bronchoscopy and a variety
of airway manipulation techniques. Tracheostomy should be reserved for those with
classic requirements of ventilatory and/or mechanical failure or severe upper airway
burns. Even securing an airway for surgical procedures, especially with patients suffering
injuries involving the head and neck, can be nonstandard and requires creative and
flexible approaches to be successful. After much trial and error over the past 30
years in a large burn center, our multidisciplinary team has learned many valuable
lessons. This review will focus on our current approach to safe airway management
in acute and reconstructive burn patients.
Keywords
airway management - bronchoscopy - airway evaluation - pediatric burn
