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Prehospital management of a non-intubated inhalation injury patient using transcutaneous monitoring of carbon dioxide
  1. Shota Kikuta,
  2. Satoshi Ishihara,
  3. Shigenari Matsuyama and
  4. Shinichi Nakayama
  1. Emergency and Critical Care Medicine, Hyogo Emergency Medical Center, Kobe, Hyogo, Japan
  1. Correspondence to Dr Shota Kikuta; kikukikukikuun{at}yahoo.co.jp

Abstract

A 46-year-old man experienced facial burns due to a fire in his house. In the prehospital setting, suspecting inhalation injury and carbon monoxide poisoning, an emergency physician decided to bring him to the hospital for carbon dioxide (CO2) monitoring without endotracheal intubation for approximately 20 min because of less severe respiratory distress. On the way to the hospital, the patient’s end-tidal CO2 monitoring ranged from 19 to 30 mm Hg, and transcutaneous carbon dioxide (TcPCO2) remained between 50 and 55 mm Hg. On arrival at the hospital, PaCO2 showed 51.6 mm Hg. Endotracheal intubation using a bronchoscope was performed in the emergency room, and inhalation injury was observed. He was extubated on day 5 and discharged on day 10. In the prehospital setting, TcPCO2 monitoring is useful for initial management of non-intubated inhalation injury patients even with high concentration oxygen.

  • prehospital
  • trauma

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Footnotes

  • Contributors SK joined with the treatment of this patient. SI and SM designed this manuscript. SN gave a final approval to submit this manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared. However, our institution leased TCM5 (RADIOMETER) for free from IMI for 6 months since January 2018.

  • Provenance and peer review Not commissioned; externally peer reviewed.