Smoke Inhalation
Smoke inhalation is breathing in the harmful gases, vapors, and particulate matter contained in smoke.
Smoke inhalation typically occurs in victims or firefighters caught in a fire, but cigarette smoking also causes similar damage on a smaller scale over a longer period of time. People who are trapped in fires may suffer from smoke inhalation without having skin burns; however, the chance of smoke inhalation increases with the percentage of total body surface area burned. Smoke inhalation contributes to the total number of fire-related deaths each year because the damage is serious, it may be hard to diagnose and patients may not show symptoms until a day or two after the fire. Children under age 11 and adults over age 70 are most vulnerable to the effects of smoke inhalation.
The harmful materials given off in a fire injure the airways and lungs by heat damage, irritation, and cutting off oxygen to body tissues. Signs of heat damage include singed nasal hairs, burns around and inside the nose and mouth, and a swollen throat. Tissue irritation of the throat and lungs may appear as noisy breathing, coughing, hoarseness, black or gray spittle, and fluid in the lungs. Oxygen starvation causes shortness of breath and blue-gray or cherry-red skin color. In some cases, the patient may be unconscious.
In addition to looking for the signs of heat damage, tissue irritation, and lack of oxygen, the doctor will check the patient's condition by evaluating breathing, pulse rate, and blood pressure. Blood tests indicate the oxygen level and byproducts of poisonous gases.
The doctor may visually examine the airways and lungs through a fiber optic tube inserted down the patient's windpipe. Other tests may be performed to measure how efficiently the lungs are working.
Treatment varies with the severity of damage. The primary focus of treatment is to keep the airway open with enough oxygen. If the airway is swelling shut, a tube may need to be inserted to keep an open airway.
Oxygen is often the only medication necessary. However, patients who are wheezing may be given medicine to relax the muscles and ease breathing. There are also antidotes for specific poisonous gases in the blood; dosage depends on the level indicated by blood tests. Antibiotics aren't given unless tests confirm there is a bacterial infection.
If available, hyperbaric oxygen therapy may be used to treat smoke inhalation. This treatment requires a special chamber in which the patient receives pure oxygen at high pressures much faster than normal. Acupuncture can provide support to anyone who has suffered a traumatic injury such as smoke inhalation.
Although the outcome depends of the severity of the smoke inhalation and the severity of any accompanying burns or other injuries, with prompt medical treatment the prognosis for recovery is good. However, some patients may experience chronic breathing problems after smoke inhalation. People who already had asthma or other breathing problems may find their conditions have been worsened by the inhalation injury.
Smoke inhalation can be prevented by avoiding fires by using safe wiring, safely storing flammable liquids, and maintening clean, well-ventilated chimneys, wood stoves, and space heaters. Properly placed and working smoke detectors in combination with rapid evacuation plans will lessen a person's exposure to smoke in the event of a fire. When escaping a burning building, a person should move close to the floor where there is more cool, clear air to breathe because hot air rises, carrying gases and particulate matter upward. Finally, firefighters should wear proper protective gear.
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