Smoke inhalation

Chest | General Practice | Smoke inhalation (Disease)


Smoke inhalation is the primary cause of death in victims of indoor fires.

Smoke inhalation injury refers to injury due to inhalation or exposure to hot gaseous products of combustion. This can cause serious respiratory complications.

It is estimated that 50–80% of fire deaths are the result of smoke inhalation injuries, including burns to the respiratory system. The hot smoke injures or kills by a combination of thermal damage, poisoning and pulmonary irritation and swelling, caused by carbon monoxide, cyanide and other combustion products.

Symptoms range from coughing and vomiting to nausea, sleepiness and confusion. Burns to the nose, mouth and face; singed nostril hairs; and difficulty breathing / carbonaceous sputum are also signs of smoke inhalation injury.

Causes and Risk factors

Smoke inhalation damages the body by simple asphyxiation (lack of oxygen), chemical irritation, chemical asphyxiation, or a combination of these.

About four per cent of burn victims die from their injuries - and in many of these cases the crucial factor is smoke inhalation. The full extent of the damage may only become apparent days after the incident itself.

Diagnosis and Treatment

Tests may be performed to define the extent of injury including looking at the patients airway and lungs with a camera (bronchoscopy).

Treatment depends on the extent of injury and what was burning. Significant burns to the airway may be treated with an artificial airway (mechanical ventilation). High carbon monoxide levels are treated with high flow supplemental oxygen and possibly hyperbaric oxygen. If plastics were burnt in the fire and cyanide is a concern the patient may receive the cyanide kit and/or hydroxocobalamin.


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