Airway Management Practices in Burn Patients: A Protocol for a Scoping Review

BACKGROUND: Loss of airway represents a serious clinical concern in the management of burn patients and frequently prompts early intubation. However, intubation itself carries inherent risks and is not invariably required for optimal care. Concern over the potentially severe consequences of airway compromise may lead clinicians to intubate more often than clinically warranted, thereby exposing patients to complications associated with airway management and mechanical ventilation. The lack of unified guidelines contributes to variation in practice, raising important questions about how burn victims are handled across different clinical settings. We aim to (1) provide a comprehensive overview of studies on airway management in burn patients, (2) describe available clinical decision tools or formal guidelines that support clinicians in deciding when burn-injured patients should undergo endotracheal intubation, and (3) identify and synthesize reported outcomes with particular attention to adverse events associated with intubation in burn patients. METHODS: We will conduct a scoping review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). We will systematically search Embase, PubMed, Scopus, Web of Science, and the Cochrane Library from 2011 onward, including randomized and non-randomized trials, observational studies, and case series with ≥ 5 patients. We will use a Population, Concept, and Context-based approach to define eligibility criteria: Population: burn patients (no age limitations); Concept: airway management of any kind and their associated outcomes; Context: timing of airway management, location, and healthcare provider of airway management. Two authors will independently screen studies, followed by full-text assessment and data extraction. All reported clinical and procedural outcomes will be included. Findings will be synthesized descriptively to highlight key themes, evidence gaps, and areas of clinical uncertainty. DISCUSSION: This review will provide an overview of existing evidence on airway management in burn patients, identify knowledge gaps, and help promote areas for future research.