How should EMS respond to a patient with smoke inhalation and facial burns?

• A. Delay airway management and observe
• B. Ensure airway protection, provide high-flow oxygen, prepare for early intubation if edema is anticipated, and transport urgently
• C. Provide humidified air only
• D. Treat facial burns with ointment and delay transport

Answer: (B)

Airway protection is the priority when there is smoke inhalation with facial burns because the airway can swell rapidly after inhalation injury. Providing high-flow oxygen helps maximize oxygen delivery and supports ventilation in a damaged lung, while planning for early intubation if edema is anticipated reduces the risk of a cannot-intubate scenario as swelling progresses. Transporting urgently ensures rapid access to definitive airway management and burn/inhalation care at a hospital.

Delaying airway management and observing misses the time window when edema is likely to worsen. Providing only humidified air doesn’t address the need for a secure airway in a patient at high risk of obstruction. Treating facial burns with ointment and delaying transport neglects the inhalation injury and the potential for rapid deterioration, risking airway collapse during transfer.