Which action should be taken first regarding inhalation burns?

• A. Administer intravenous analgesia.
• B. Prepare for an endotracheal intubation.
• C. Immediately calculate burned surface area with Rule of Nines.
• D. Anticipate the need for a fiberoptic bronchoscopy.

Answer: (B)

Airway protection is the priority in inhalation burns because edema from inhalation injury can rapidly obstruct the airway. When inhalation injury is suspected—such as facial burns, singed nasal hairs, soot in the airway, hoarseness, or stridor—or if the patient was exposed in an enclosed space, the safest course is to prepare for endotracheal intubation and secure the airway early. Securing the airway before swelling progresses reduces the risk of a difficult or failed airway and prevents hypoxia. The other steps are important parts of burn care, but they don’t address the immediate threat to life as directly as airway control: estimating burned surface area guides fluid resuscitation, analgesia manages pain without protecting the airway, and bronchoscopy is useful to evaluate or treat airway issues after the airway is secured.