What to Do in Case of Smoke Inhalation

The number one cause of death related to fires is smoke inhalation. An estimated 50%-80% of fire deaths are the result of smoke inhalation injuries rather than burns.

Smoke inhalation occurs when you breathe in the products of combustion during a fire. Combustion results from the rapid breakdown of a substance by heat (more commonly called burning). Smoke is a mixture of heated particles and gases. It is impossible to predict the exact composition of smoke produced by a fire. The products being burned, the temperature of the fire, and the amount of oxygen available to the fire all make a difference in the type of smoke produced.

1. What causes smoke inhalation?

Burning materials, chemicals, and the gases created can cause smoke inhalation by simple asphyxiation (lack of oxygen), chemical irritation, chemical asphyxiation, or a combination of them. Examples include:

- Simple asphyxiates

There are two ways that smoke can deprive you of oxygen. Combustion uses up the oxygen near a fire, leaving you without oxygen to breathe. Smoke also contains products, such as carbon dioxide, that cause harm by further limiting the amount of oxygen in the air.

- Irritant compounds

Combustion can cause chemicals to form that injure your skin and mucous membranes. These chemicals can damage your respiratory tract, causing swelling and airway collapse. Ammonia, sulfur dioxide, and chlorine are examples of chemical irritants in smoke.

- Chemical asphyxiates

Compounds produced in fires can cause cell damage in your body by interfering with the delivery or use of oxygen. Carbon monoxide, which is the leading cause of death in smoke inhalation, is one of these compounds.

Inhalation injuries can worsen heart and lung conditions, such as:

chronic obstructive pulmonary disease

asthma

emphysema

chronic bronchitis

Your risk for permanent damage from smoke inhalation is greater if you have any of these conditions.

2. Smoke inhalation symptoms

Smoke inhalation can cause several signs and symptoms that can range in severity.

- Cough

The mucous membranes in your respiratory tract secrete more mucus when they become irritated.

Increased mucus production and the tightening of the muscles in your airway lead to reflex coughing.

Mucus may be clear, gray, or black depending on the volume of burned particles in your trachea or lungs.

- Shortness of breath

Injury to your respiratory tract decreases oxygen delivery to your blood.

Smoke inhalation can interfere with your blood’s ability to carry oxygen.

Rapid breathing can result from an attempt to compensate for the damage done to the body.

- Headache

Exposure to carbon monoxide, which occurs in every fire, can cause headache.

Along with headache, carbon monoxide poisoning can also cause nausea and vomiting.

- Hoarseness or noisy breathing

Chemicals may irritate and injure your vocal chords and cause swelling and tightening of the upper airways.

Fluids may collect in the upper airway and result in a blockage.

- Skin changes

Skin can be pale and bluish due to lack of oxygen, or bright red due to carbon monoxide poisoning.

There may be burns on your skin.

- Eye damage

Smoke can irritate your eyes and cause redness.

Your corneas may have burns.

- Decreased alertness

Low oxygen levels and chemical asphyxiates can cause changes such as confusion, fainting, and decreased alertness.

Seizures and coma are also possible after smoke inhalation.

- Soot in the nose or throat

Soot in your nostrils or throat are an indicator of smoke inhalation and the extent of the smoke inhalation.

Swollen nostrils and nasal passages are also a sign of inhalation.

- Chest pain

Chest pain can be caused by irritation in your respiratory tract.

Chest pain can be a result of low oxygen flow to the heart.

Excessive coughing can also cause chest pain.

Heart and lung conditions can be made worse by smoke inhalation and can cause chest pain.

3. Smoke inhalation treatment

Smoke inhalation treatment may include:

- Oxygen

Oxygen is the most important part of smoke inhalation treatment. It’s administered through a mask, nose tube, or through a breathing tube inserted into your throat, depending on the severity of symptoms.

- Hyperbaric oxygenation (HBO)

HBO is used to treat carbon monoxide poisoning. You’ll be placed in a compression chamber and given high doses of oxygen. The oxygen dissolves into the blood plasma so your tissues can receive oxygen while the carbon monoxide is removed from your blood.

- Medication

Certain medications may be used to treat the symptoms of smoke inhalation. Bronchodilators may be given to relax lung muscles and widen airways. Antibiotics may be given to treat or prevent an infection. Other medications may be given to treat any chemical poisoning.

4. When to see a doctor

If you’ve been treated for smoke inhalation and develop a fever, see your doctor right away, as you may have an infection. Call 911 if you experience any of the following:

coughing or vomiting blood

chest pain

irregular or rapid heart rate

increased trouble breathing

wheezing

blue lips or fingernails

5. At-home treatment

In addition to taking medications and following instructions prescribed by your doctor, there are some at-home things you can do following smoke inhalation treatment:

- Get plenty of rest.

- Sleep in a reclined position or prop your head up with pillows to help you breathe easier.

- Avoid smoking or secondhand smoke.

- Avoid things that may irritate your lungs, such as extremely cold, hot, humid, or dry air.

- Carry out any breathing exercises as instructed by your doctor, also known as bronchial hygiene therapy.