A 19-year-old male is coughing and has pain due to burns after being extricated from a fire. What is the priority concern?

In the case of a 19-year-old male who has been extricated from a fire and is experiencing coughing and pain due to burns, the priority concern focuses on the potential for laryngeal swelling. This concern arises because the airway can rapidly become compromised in individuals who have been exposed to smoke or superheated gases.

Inhalation injury can cause inflammation and swelling of the airways, particularly the larynx, leading to laryngeal edema. This swelling can obstruct the airway, resulting in respiratory distress or failure. The presence of coughing indicates that the airway is partially intact; however, the risk of laryngeal swelling must be addressed immediately to prevent a critical airway blockage.

Other factors such as burn management and inhalation injury are indeed significant and require attention, but the urgency of ensuring a patent airway surpasses the immediate concern for the burns or other potential injuries like pneumothorax. By prioritizing the evaluation and management of laryngeal swelling, medical personnel can take the necessary steps to ensure the patient maintains adequate ventilation and prevents life-threatening complications.