Pulmonary Agents Inhalation Injury Treatment Protocol

Symptom relief for cough and wheezing/reactive airways

Albuterol nebulize 2.5mg in 3mL

Can combine with 3mL 4% or 2% lidocaine (for cough / pain suppression prn)

**only use lidocaine in alert casaulty**

Note: The following treatments do not have robust evidence to support use but may be considered in patients with moderate to severe symptoms that are refractory to supportive care.

Nebulized Bicarbonate + N-acetylcysteine (NAC)

3mL 4.2% Bicarb (1.5 mL 8.4% diluted in 1.5mL Sterile Water) combine w/ 3mL NAC (for acidic inhalation, do not mix with other drugs or use if non-acidic inhalation)

Albuterol + NAC

Albuterol 2.5mg in 3mL combined with 3mL NAC (may repeat q 4-6 hrs)

Corticosteroids

Inhaled (can nebulize or use inhalant device) :

Budesonide 0.5mg-2.0mg BID

or

Fluticasone 200mcg BID

Administration via IV/IO:

Dexamethasone 8mg IV/IO q6hrs

or

Solu-medrol 125mg IV/IM q6hrs