36 y/o female has been involved in an explosion at a chemical laboratory. She has first and second degree burns to her face. Witnesses state that her shirt had been on fire and stopped burning before they got to her. You should suspect?

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Inhalation injury from smoke and heat in a fire, especially in an enclosed space, is a major threat to the airway. Facial burns alongside exposure from an explosion in a chemical lab strongly suggests the airway mucosa has been exposed to hot gases and irritant chemicals, which can cause edema and obstruction that progresses over minutes to hours. Even if external burns seem limited, the airway may be severely injured, so you should suspect extensive airway burns rather than assuming the airway is safe. This prioritizes airway protection and aggressive management (high-flow oxygen, readiness for early intubation) because airway compromise can develop rapidly. Carbon monoxide poisoning is a real concern in fires, but the immediate and life-threatening issue here is the potential for extensive airway injury from inhalation; chemical inhalation injury is possible too, but the broad and critical risk is airway burns.