Smoke inhalation

Description Occurs when one bre...

Description

Occurs when one breathes in smoke from a fire. Smoke is produced during the burning process. What is burning in the fire, the amount of smoke inhaled, and the length of time the smoke is inhaled all contribute to the severity of the injury. Damage is done by the heat of the smoke as well as the toxins in the smoke. Direct injury to the lung can result in failure of the lungs. Additionally the toxins in the smoke can cause life threatening injuries as well. The most common toxin is carbon monoxide.

Symptoms

Cough, coughing up black sooty sputum, shortness of breath, confusion, blue discoloration of skin, coma, throat swelling. Significant symptoms of shortness of breath can develop hours after the initial injury.

Tests

Common tests used for diagnosis and treatment

Workup:
A history and physical exam will be performed. Tests may be performed to define the extent of injury including looking at the patient's airway and lungs with a camera (bronchoscopy).

Tests:
Complete blood count (CBC), Comprehensive metabolic panel (CMP), Electrocardiogram (EKG), X-ray

Other Specific Tests: Bronchoscopy, carboxyhemoglobin (HbCO), lactate, cyanide levels

Specialists:
Pulmonology, Trauma Surgery, Pediatric Pulmonology

Treatment

Therapy 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.