Smoke Inhalation

What is Smoke Inhalation

Smoke inhalation means that you have breathed in (inhaled) smoke. Exposure to hot smoke from a fire can damage all parts of the airway including the nose, mouth, throat, windpipe (trachea), and lungs.

If you received a burn injury on the outside of your body from a fire, you are also at risk of having a smoke inhalation injury in your airways.

Smoke inhalation injury is a major determinant of morbidity and mortality in fire victims. It is a complex multifaceted injury affecting initially the airway; however, in short time, it can become a complex life-threatening systemic disease affecting every organ in the body.

Major pathophysiological change is development of edema in the respiratory tract.

What are the causes?

This condition is caused by exposure to smoke from a significant fire.

What increases the risk?

People who are exposed to large fires and smoke, like firefighters, have a greater risk for smoke inhalation.

People with long-term (chronic) lung disease or a history of alcohol abuse have a greater risk for serious complications from smoke inhalation.

What are the symptoms?

Symptoms of this injury include:

• Sore throat.
• Cough, including coughing up mucus from the lungs (sputum) that looks black or burnt.
• Wheezing or abnormal noises when you breathe (stridor).
• Chest pain.
• Trouble breathing.
• A hoarse voice.
• Nausea.
• Dizziness.
• Headache.

The symptoms of smoke inhalation injury can be immediate or be delayed for up to a day after exposure. Symptoms usually improve quickly.

How is this diagnosed?

This condition may be diagnosed based on:

• A history of recent smoke exposure.
• Your symptoms.
• A physical exam.
• Tests, such as:
  • Chest X-rays or CT scans.
  • Inspection of your airway (laryngoscopy or bronchoscopy). This is done by passing a thin tube through your nose or mouth and down into your lungs.
  • Blood tests to check the levels of oxygen, carbon monoxide, and carbon dioxide in your bloodstream.

If your symptoms get worse, you may need further evaluation and treatment in the hospital.

How is this treated?

Treatment for smoke inhalation depends on the severity of the condition. Treatment may include:

• Hospitalization. If you have trouble breathing, you may be admitted to the hospital for overnight observation.
• Breathing assistance. If you develop severe trouble breathing, you may need a breathing tube to help you breathe.
• Supplemental oxygen. If you are not breathing well and your oxygen levels are low, you may be placed on supplemental oxygen therapy.

Follow these instructions at home:

• Do not return to the area of the fire until the proper authorities tell you it is safe.
• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
• Do not drink alcohol until approved by your health care provider.
• Drink enough water and fluids to keep your urine clear or pale yellow.
• Get plenty of rest for the next 2–3 days. Return to your normal activities as told by your health care provider.
• Take over-the-counter and prescription medicines only as told by your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have nausea or vomiting.
• You have a constant cough.
• You have more phlegm.

Get help right away if:

• You are wheezing.
• You have difficulty breathing.
• You have severe chest pain.
• You have a severe headache.
• You have shortness of breath with your usual activities.
• Your heart seems to beat too fast from small amounts of activity or exercise.
• You become confused, irritable, or unusually sleepy.
• You experience dizziness.
• You develop any breathing problems that are getting worse rather than improving.

Summary

• Smoke inhalation means that you have breathed in (inhaled) smoke.
• Exposure to hot smoke from a fire can damage all parts of your airway including your nose, mouth, throat, windpipe (trachea), and lungs.
• Symptoms of this injury include sore throat, cough, and shortness of breath.
• Treatment for smoke inhalation depends on the severity of the condition.
• Keep all follow-up visits with your health care provider. This is important.