Manchester air disaster.

Abstract

On 22 August 1985 a fire occurred on a Boeing 737 jet airliner at take off at Manchester Airport. One hundred and thirty seven passengers and crew were on board. Fifty two passengers died on the aircraft, 85 escaped. Most survivors had minor physical injuries, but 15 required admission to hospital because of smoke inhalation and two of these had severe burns. At presentation only one survivor required ventilation but within 12 hours a further five required ventilation. Although initially patients suffering from smoke inhalation may seem relatively well, lung function may deteriorate rapidly in the first 24 hours.Careful organisation and regular practice ofprocedures to deal with a major accident are essential to be able to respond adequately to such an event.

Guidelines for Emergency Tracheal Intubation Immediately after Traumatic Injury

“…136,142,221 However, a much greater number of investigators endorse selective tracheal intubation. 134,135,137-143,146 -148,224,225 Numerous authors recommend tracheal intubation for airway obstruction that is clinically present or when severe edema is seen on endoscopy.…”

“…135,137,138,143,146 A few authors endorse tracheal intubation for patients who have bronchospasm, 134 respiratory distress, 135 full-thickness facial burns, 135,146 circumferential neck burns, 135 oropharyngeal burns, 135,146 oropharyngeal soot, 138 hoarseness, 138 or carbonaceous sputum. 142,146 Investigators have described 16 groups of smoke inhalation patients who needed tracheal intubation. [131][132][133][134][135][136][137][138][139][140][141][142][143]224 The overall rate of emergency tracheal intubation was 62.2% (605 of 972).…”

“…142,146 Investigators have described 16 groups of smoke inhalation patients who needed tracheal intubation. [131][132][133][134][135][136][137][138][139][140][141][142][143]224 The overall rate of emergency tracheal intubation was 62.2% (605 of 972). Six groups of patients with smoke inhalation and cutaneous burns (40 -55%) revealed an overall intubation rate of 77.5% (502 of 648; 95% confidence interval [CI], 74.3-80.7%), [131][132][133][134][135]224 whereas five groups of patients with isolated smoke inhalation had an overall intubation rate of 41.7% (65 of 156; 95% CI, 34.0 -49.4%).…”

“…27,30,44,69 In addition, patients with smoke inhalation are at risk for airway obstruction and commonly undergo emergency tracheal intubation. [131][132][133][134][135][136][137][138][139][140][141][142][143] …”

Indoor fire in a nursing home: evaluation of the medical response to a mass casualty incident based on a standardized protocol

“…However, all of the intubated patients displayed one or more physical findings suggesting respiratory tract injury. Except for the Volendam fire [35], in nearly all previous described indoor fires, most deaths were caused by inhalation injury or high concentration of toxics and less due to severe burns [36][37][38][39][40][41][42][43]. Additionally, the intubated patients were of older age, which is an independent major risk factor for mortality [44][45][46][47][48].…”