Smoke Inhalation (cont.)
Exams and Tests
A number of tests and procedures may be performed. Which tests are performed depends on the severity of the signs and symptoms and is at the discretion of the doctor.
- If the patient has respiratory complaints such as persistent cough and shortness of breath, a chest
X-ray should be done.
- The initial chest X-ray may be normal despite significant signs and symptoms.
- A repeat chest X-ray may be necessary during the observation period to determine if delayed lung injury is occurring.
- Pulse oximetry
- A light probe is typically attached to the finger, toe, or earlobe, to determine the amount of oxygen in the blood.
- Pulse oximetry may be inaccurate if the patient has low blood pressure, and enough blood is not getting to parts of the body where the probe is attached.
- Blood tests
- Complete blood count: This test is done to determine if there are enough red blood cells to carry oxygen, enough white blood cells to fight infection, and enough platelets to ensure clotting can occur.
- Chemistries (also called basic metabolic profile): This test reveals any changes of pH in the blood that may happen because of interference with oxygen diffusion, transport, or use. Serum electrolytes (sodium, potassium, and chloride) can also be monitored. Renal (kidney) function tests (creatinine and blood urea nitrogen) are also monitored.
- Arterial blood gas: For people with significant respiratory distress, acute mental status changes, or shock, an arterial blood gas may be obtained. This test may help the doctor to determine the degree of oxygen shortage.
- Carboxyhemoglobin and methemoglobin levels: These levels should be measured in all smoke inhalation victims with respiratory distress, altered mental status, low blood pressure, seizures, fainting, and blood pH changes. It is now routinely done in many hospitals whenever arterial blood gas is assessed.
Christopher P Holstege, MD
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