Acute airway obstruction following facial scalding: differential diagnosis between a thermal and infective cause

Airway compromise in children with anterior neck burns: Beware the scalded child

“…Airway obstruction due to subcutaneous and soft tissue oedema of the anterior neck secondary to burn injury would seem to be a potential risk, although there have been only a few case reports documenting this event clinically . Oedema of the anterior neck may also be complicated by respiratory infection and over resuscitation, increasing the risk of airway obstruction in young children …”

“…As flame and explosion injuries have been well recognised to be associated with potential airway compromise and inhalational injury, a thorough airway assessment has generally been promptly undertaken by emergency service health‐care providers . Scald injuries, however, appear rarely recognised as causing significant airway problems, unless scalding fluids are ingested, aspirated or contain noxious gases …”

“…[1][2][3]11 Oedema of the anterior neck may also be complicated by respiratory infection and over resuscitation, increasing the risk of airway obstruction in young children. 11,12 Ten per cent of children with anterior neck burns admitted to our Burn Unit over the 10-year period required intubation: the majority of these patients (54%) were intubated due to airway complications secondary to subcutaneous and soft tissue anterior neck oedema with or impeding airway compression. It is therefore important for clinicians caring for injured children to recognise early signs of impending airway obstruction and to intubate early or consider observation of these children in high dependency areas.…”

“…2,8,13 Scald injuries, however, appear rarely recognised as causing significant airway problems, 14 unless scalding fluids are ingested, aspirated or contain noxious gases. 12,[15][16][17][18][19] Our data have shown that burn injuries to the anterior neck from all mechanisms, including scalds, were implicated in subcutaneous and soft tissue oedema formation and airway compromise in children. In particular, young children with anterior neck burns, with concurrent respiratory tract illnesses, receiving large amounts of fluid resuscitation were particularly at risk of airway compromise.…”

Traumatic supraglottitis

“…Thermal supraglottitis may occur after swallowing or aspirating scalding hot liquids or foods [1][2][3][4][5][6][7][8], from inhalation of hot steam as a consequence of sucking on a teapot spout [9], or from involvement in a fire [10].…”