Airway/Respiratory Irritants 

Assessment

Pediatric Pearls: Signs & Symptoms: Differential: 
□ Fluids and medications titrated to maintain SBP > 70 + (age x 2) mmHg 

□ Consider early airway management		□ Unusual odor /smell
□ Tearing or itchy eyes
□ Burning sensation and burns to the nose, pharynx and respiratory tract
□ Sneezing
□ General excitation
□ Cough
□ Chest tightness
□ Nausea
□ Shortness of breath /dyspnea
□ Wheezing
□ Stridor
□ Dyspnea on exertion
□ Dizziness Upper
□ Change in voice
□ Airway obstruction include laryngospasm and laryngeal edema
□ Pulmonary edema (non-cardiogenic)
□ Seizures
□ Cardiopulmonary arrest		□ Asthma/COPD
□ CHF
□ FB
□ Tracheitis
□ bronchiolitis

Clinical Management Options

EMT-B
• Place in position of comfort
• Oxygen target SpO2 92% – 96%  
• Provide humidified air
10cc normal saline nebulized
Paramedic
• IV / IO access as appropriate for patient condition 
• Consider albuterol for patients with wheezing
• Consider early advanced airway options in patients with stridor, drooling, etc
Consult Online Medical Control as Needed

Pearls

  • Inhalation of a variety of gases, mists, fumes, aerosols, or dusts may cause irritation or injury to the airways, pharynx, lung, asphyxiation, or other systemic effects
  • Inhaled airway/respiratory irritant agents will interact with the mucus membranes, upper and lower airways based on solubility, concentration, particle size, and duration of exposure
  • The less soluble and smaller the particle size of the agent the deeper it will travel into the airway and respiratory systems the inhaled toxic agent will go before reacting with adjoining tissues thus causing a greater delay in symptom onset
  • Smell can help identify toxin
    • Fresh mowed hay= phosgene
    • Rotten Eggs= Hydrogen Sulfide