🌫️ Inhalation Injury Grading (Bronchoscopic AIS)
This tool grades inhalation injury severity by the abbreviated injury score (AIS 0–4) of the initial bronchoscopic appearance, framing airway management and ventilation strategy.
Clinical takeaway
AIS predicts mortality imperfectly; the revised Baux score (age + %TBSA + 17×inhalation) predicts death better, so combine the grade with TBSA and oxygenation. (original synthesis · not guideline verbatim)
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When to use
Use after smoke/inhalation exposure to grade injury from bronchoscopy and anticipate airway compromise — particularly upper-airway edema, which can progress within 24 h.
How it works
Bronchoscopic appearance → AIS 0 (none) to 4 (massive, mucosal sloughing/necrosis). Grades 2–4 carry worse survival and prompt escalating airway clearance and lung-protective ventilation.
Key points
- AIS predicts mortality imperfectly; the revised Baux score (age + %TBSA + 17×inhalation) predicts death better, so combine the grade with TBSA and oxygenation. (original synthesis · not guideline verbatim)
- Facial/oropharyngeal burns, hoarseness, stridor, carbonaceous sputum, or a closed-space fire warrant early airway evaluation and a low threshold to intubate.
- Severe grades need aggressive bronchial hygiene (clearing eschar/pseudomembrane) and lung-protective ventilation.
References
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Bronchoscopic appearance | Grade 0 (none): no carbonaceous deposits/erythema/edema/bronchorrhea/obstruction |
|---|
→Inhalation injury AISGrade 0
- Grade：Grade 0 (no injury). Grades 2–4 have worse survival than 0–1
- Management direction：Mild/none: monitor airway and oxygenation, supportive care
- Airway warning：Facial/oropharyngeal burns, hoarseness, stridor, carbonaceous sputum, closed-space fire history → beware airway obstruction; edema can progress within 24 h of injury, so evaluate/intubate early
| Bronchoscopic appearance | Grade 4 (massive): mucosal sloughing, necrosis, luminal obstruction |
|---|
→Inhalation injury AISGrade 4
- Grade：Grade 4 (massive). Grades 2–4 have worse survival than 0–1
- Management direction：Severe/massive: aggressive airway clearance (bronchoscopic removal of eschar/pseudomembrane), lung-protective ventilation (6–8 mL/kg), high-frequency percussive ventilation if needed; beware upper-airway edema (progresses within 24 h of injury), intubate early; prevent and treat pneumonia
- Airway warning：Facial/oropharyngeal burns, hoarseness, stridor, carbonaceous sputum, closed-space fire history → beware airway obstruction; edema can progress within 24 h of injury, so evaluate/intubate early
Frequently asked questions
- What is Inhalation Injury Grading (Bronchoscopic AIS)?
- This tool grades inhalation injury severity by the abbreviated injury score (AIS 0–4) of the initial bronchoscopic appearance, framing airway management and ventilation strategy.
- How is Inhalation Injury Grading (Bronchoscopic AIS) calculated? What is the core formula?
- Bronchoscopic appearance → AIS 0 (none) to 4 (massive, mucosal sloughing/necrosis). Grades 2–4 carry worse survival and prompt escalating airway clearance and lung-protective ventilation.
- When is Inhalation Injury Grading (Bronchoscopic AIS) used?
- Use after smoke/inhalation exposure to grade injury from bronchoscopy and anticipate airway compromise — particularly upper-airway edema, which can progress within 24 h.
- What are the key clinical points for Inhalation Injury Grading (Bronchoscopic AIS)?
- AIS predicts mortality imperfectly; the revised Baux score (age + %TBSA + 17×inhalation) predicts death better, so combine the grade with TBSA and oxygenation. (original synthesis · not guideline verbatim) Facial/oropharyngeal burns, hoarseness, stridor, carbonaceous sputum, or a closed-space fire warrant early airway evaluation and a low threshold to intubate. Severe grades need aggressive bronchial hygiene (clearing eschar/pseudomembrane) and lung-protective ventilation.
- What are the limits and cautions when using Inhalation Injury Grading (Bronchoscopic AIS)?
- For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
- How is Inhalation Injury Grading (Bronchoscopic AIS) calculated in practice? Can you show a worked example?
- Inputs: Bronchoscopic appearance Grade 0 (none): no carbonaceous deposits/erythema/edema/bronchorrhea/obstruction → Result: Inhalation injury AIS Grade 0（Grade: Grade 0 (no injury). Grades 2–4 have worse survival than 0–1, Management direction: Mild/none: monitor airway and oxygenation, supportive care, Airway warning: Facial/oropharyngeal burns, hoarseness, stridor, carbonaceous sputum, closed-space fire history → beware airway obstruction; edema can progress within 24 h of injury, so evaluate/intubate early） Inputs: Bronchoscopic appearance Grade 4 (massive): mucosal sloughing, necrosis, luminal obstruction → Result: Inhalation injury AIS Grade 4（Grade: Grade 4 (massive). Grades 2–4 have worse survival than 0–1, Management direction: Severe/massive: aggressive airway clearance (bronchoscopic removal of eschar/pseudomembrane), lung-protective ventilation (6–8 mL/kg), high-frequency percussive ventilation if needed; beware upper-airway edema (progresses within 24 h of injury), intubate early; prevent and treat pneumonia, Airway warning: Facial/oropharyngeal burns, hoarseness, stridor, carbonaceous sputum, closed-space fire history → beware airway obstruction; edema can progress within 24 h of injury, so evaluate/intubate early）