The initial treatment of inhalational injury above the larynx is supportive. Oxygen should be humidified and given to the patient through a breathing mask at a rate of at least 8 litres per minute. The cervical spine must be protected by immobilization until musculoskeletal injury has been excluded; this is particularly relevant to burns secondary to road traffic accidents and explosions.
There must be constant monitoring as there is a risk of airway obstruction from mucosal oedema and possibly external burns to the neck. There should be a low threshold for endotracheal intubation, particularly in a deteriorating patient with stridor and respiratory distress.
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