Preventing Shock and Airway Obstruction through Early Resuscitation in Moderate Burns with Suspected Inhalation Injury: A Clinical Case Report

Abstract

Introduction: Moderate to severe burns often result in complications such as hypovolemic shock and inhalation trauma. Both conditions contribute to mortality if not treated immediately. Proper fluid resuscitation and airway protection from the outset are key to preventing these complications. Moderate burns require precise early management to prevent hypovolemic shock and airway compromise.Case Presentation: We report the case of a 52-year-old female with 17% TBSA burns and suspected inhalation injury, the patient was admitted conscious, GCS 15, with signs of burned hair, eyebrows, and nose hair, but without hoarseness or respiratory distress. Alongside a summary of 17 burn patients treated at Bali Mandara General Hospital (June 2023–June 2025) using EMSB protocols. Fluid resuscitation with Parkland formula and oxygen supplementation via a non-rebreathing mask, analgesia, prophylactic antibiotics, and close monitoring of urine output and hemodynamic status were performed. The wounds were treated with wound gel, gentamicin, and sterile dressings.Discussion: Through titrated resuscitation (3 ml/kg/%) and vigilant airway monitoring, Ny. KS avoided intubation and shock. Within the 17-patient cohort, adherence to EMSB guidelines during the acute phase. The patient showed hemodynamic stability from the outset, with no signs of shock or respiratory failure. The urine output target was achieved (0.5–1 ml/kg/hour). There was no airway obstruction despite clinical signs suggestive of inhalation trauma. Laboratory and radiological evaluations showed no significant respiratory complications. The patient underwent elective debridement, with good clinical outcome and progressive recovery.Conclusion: Standardized EMSB protocols combined with individualized fluid titration are effective in preventing critical burn complications. Measured initial fluid resuscitation, combined with early detection of inhalation injury through close respiratory monitoring, proved effective in preventing shock and airway obstruction in cases of moderate burns. This case emphasizes the importance of an individualized approach, fluid titration based on physiological response, and readiness for airway protection within the first 24 hours.