The World’s Okayest Medic Podcast BONUS Mini Episode: Burn Intubation
Mar 2, 2026
A concise run-through of airway management in burn patients, including a house fire scenario and why airways can worsen after initial assessment. The case-based sections push for early airway control and show consequences of delay. Practical tips cover resuscitation priorities, video laryngoscopy, large lubricated tubes, and tactics to maximize first-pass success.
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Burned Airway Can Look Normal Early
- Airway burns can be deceptively mild initially due to a sympathetic catecholamine surge that causes vasoconstriction.
- Once catecholamines wane the airway can swell rapidly, so early appearance of a normal voice or breathing is misleading.
Intubate Early For Structure Fire Inhalation
- Be aggressive and intubate early in suspected inhalation injuries from structure or vehicle fires even if the patient appears stable.
- Explain to the patient they may seem fine now but can deteriorate quickly and need definitive airway protection.
Rapid Swelling Seen 15 Minutes After Explosion
- The host described an RSI performed about 15 minutes after a house explosion where the airway already showed marked swelling.
- After intubation the neck became tautly swollen and anatomy for a surgical airway was no longer palpable.