Smoke Inhalation and its Effect on the Lungs

Though many don’t realize it, the top cause of fire-related death around the world is actually smoke inhalation, not damage from the heat itself. Smoke inhalation occurs anytime you breathe in products of combustion during a fire—combustion results from burning of various substances. Here are the causes, visible symptoms, and treatments available for smoke inhalation.

Causes

Smoke inhalation causes damage through one or more factors:

• Simple asphyxiation: This refers to a lack of oxygen. Combustion can use up oxygen near the fire, and smoke itself can contain products that take up the space oxygen needs, such as carbon dioxide.
• Irritant compounds: Combustion can lead to the formation of chemicals that cause direct injury when they contact the skin. These substances affect the respiratory tract and can cause swelling, airway collapse and respiratory distress. Common irritants include sulfur dioxide, ammonia, hydrogen chloride and chlorine. High temperatures from smoke can also cause thermal damage to airways.
• Chemical asphyxiants: A fire can produce compounds that damage the body’s use of oxygen at a cellular level. These chemicals include carbon monoxide, hydrogen cyanide, and hydrogen sulfide.

Symptoms

Signs and symptoms of smoke inhalation can vary widely. Signs like soot in air passages or skin color changes can help determine the severity of the damage. Other signs include:

• Cough: Mucus may be clear or black depending on the degree of burned particles
• Shortness of breath: Can be caused by direct injury to the respiratory tract and lead to rapid breathing
• Hoarseness or noisy breathing: Can be a sign that fluids are collecting in the upper airway and may cause a blockage
• Eyes: Eyes can become red and irritated, and corneas may have burns
• Skin: Skin color may range from pale to bluish to cherry red
• Soot: Soot in the nostrils or throat can signal the degree of smoke inhalation
• Headache: Carbon monoxide that’s inhaled can cause headaches, nausea, and vomiting
• Mental status: Chemical asphyxiants and low oxygen levels can lead to issues like confusion, fainting, seizures, and comas.

Anyone who has suffered smoke inhalation has to have their “ABC’s” checked—airway, breathing, and circulation. Call your doctor or go to an emergency room for these. If you experience difficulty breathing, confusion, drawn-out coughing spells or a hoarse voice, call 911.

Treatment and Follow-Up

Several possible tests may be done after smoke inhalation, depending on the severity of symptoms. In some cases, self-care is necessary—remove the person to a location with clean air, and be sure you aren’t putting yourself in danger either.

Medical treatments for smoke inhalation may include:

• Oxygen: This is one of the primary treatments for smoke inhalation with the use of either a nose tube or mask or with a tube put down the throat.
• Bronchoscopy: A procedure that uses a small scope to look at the degree of damage to the airways.
• Hyperbaric oxygenation (HBO): If a person has carbon monoxide poisoning, HBO may be considered to give the person oxygen in a compression chamber. This can potentially reduce symptoms in the nervous system and can make recovery from carbon monoxide poisoning quicker.

After leaving the hospital, it’s common to arrange follow-up care. Medications like inhalers or pain medications might be prescribed, and you may be advised to avoid triggers like cigarette smoke during recovery. If the condition worsens or doesn’t improve as expected, return immediately for medical attention.

Prevention

There are a few strategies to avoid smoke exposure and inhalation:

• Place smoke detectors in every room of an occupied building to allow early detection and evacuation in case of a fire.
• Place carbon monoxide detectors in high-risk locations for carbon monoxide exposure (near furnaces or in garages are common examples).
• Make a plan for escape routes and action if there’s a fire.
• Keep phone numbers for police, fire department and poison control a visible place.

Your doctor can offer further recommendations on treating or preventing smoke inhalation.

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Sources:

“Smoke Inhalation.” WebMD. https://www.webmd.com/lung/smoke_inhalation_treatment_firstaid.htm#1

“Smoke Inhalation.” eMedicineHealth. https://www.emedicinehealth.com/smoke_inhalation/article_em.htm