Smoke inhalation happens when someone breathes in the products of combustion heated particles and toxic gases leading to oxygen deprivation, airway irritation, and possible chemical poisoning. Rapid recognition and prompt first aid can make the difference between recovery and serious complications.
Causes of 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
Recognizing Smoke Inhalation Symptoms
It is crucial to recognize the symptoms of smoke inhalation early so necessary action can be taken to save a life. Here’s the list of symptoms to watch out for:
- Difficulty Breathing: The person might find it difficult to breathe, and he/she can experience shortness of breath, rapid breathing, wheezing, or labored breathing.
- Coughing: Persistent coughing is a common symptom. The cough might produce black phlegm due to the inhaled smoke particles.
- Chest Pain or Tightness: Pain, burning, or tightness in the chest can indicate irritation or inflammation in the airways.
- Soot around Mouth and Nose: If you see blackened areas around a person’s mouth and nose, it is a sign of smoke inhalation.
- Singed Nasal Hairs: Exposure to intense heat from smoke can cause singed nasal hairs.
- Confusion and Disorientation: Due to smoke inhalation, the person might seem confused, disoriented, or unfocused.
- Dizziness: Smoke inhalation can cause lightheadedness or dizziness due to lack of oxygen or carbon monoxide poisoning.
- Burning Eye or Skin Irritation: Smoke can cause irritation in the eyes and skin, leading to redness, watering, and burning.
- Nausea or Vomiting: Nausea and vomiting may also occur due to smoke inhalation.
Even if the symptoms seem mild, it is important to seek medical attention after smoke inhalation.
Immediate First Aid Steps
- Ensure Safety Before approaching, verify that it’s safe to enter the smoke‐filled area. Never put yourself at serious risk; wait for professionals if necessary.
- Move to Fresh Air Lead the victim out of the smoky environment to a well-ventilated area or outdoors. Keep them calm and seated.
- Call Emergency Services Dial 911 (or your local equivalent) and specify “smoke inhalation.” Early activation ensures responders bring oxygen therapy equipment.
- Assess Airway, Breathing & Circulation
- Airway: Look for obstruction or swelling.
- Breathing: Listen for breath sounds; watch chest rise.
- Circulation: Check pulse at wrist or neck. If the victim is unresponsive and not breathing, begin CPR immediately3.
- Administer Basic Support
- Loosen tight clothing around the neck and chest.
- If trained and available, apply supplemental oxygen via mask or nasal cannula.
- Encourage slow, deep breaths to optimize oxygen intake.
- Positioning
- Conscious victims – sit upright to ease breathing.
- Unconscious victims – place in the recovery position (on their side) to maintain an open airway and prevent aspiration.
- Monitor Closely Continuously observe breathing rate, level of consciousness, skin color, and signs of shock (clammy skin, rapid pulse). Be prepared to restart CPR if needed.
What NOT to Do
- Do not give food or drink. Risk of choking or vomiting is high.
- Do not remove embedded particles beyond gentle suction of mouth/nose if trained.
- Do not delay calling for help to perform non-essential tasks.
- Do not leave the victim unattended; smoke-related injuries can worsen quickly.
Prevention
Prevention is key when discussing smoke inhalation. Numerous prevention strategies can be employed to avoid exposure to smoke.
- Put smoke detectors in every room. When smoke is detected early, people can get out sooner.
- Put carbon monoxide detectors in high-risk locations, such as near furnaces and garages.
- Have escape routes and plans for what to do in case of fire. Review them every once in a while.
- Put numbers for the police, fire department, and the local poison control center in visible places.
- Prevent fires at home by never leaving a cooking fire unattended, replacing frayed appliance cords, and cleaning woodstoves and chimneys yearly.
Aftercare and Follow-Up
- Even if symptoms appear mild, encourage medical evaluation for:
- Carbon monoxide and cyanide poisoning tests
- Chest X-ray or pulse oximetry monitoring
- Possible bronchoscopy for airway inspection
- Advise rest, hydration, and avoidance of further smoke or pollutants.
- Educate on installing smoke and carbon monoxide detectors at home to prevent future incidents.
REFERENCES
- Christopher P Holstege, Smoke Inhalation, Gupta K, et al. (2018). Smoke inhalationinjury: Etiopathogenesis, diagnosis, and management. DOI:
https://doi.org/10.4103/ijccm.IJCCM_460_17 - Highlights of the 2010 American HeartAssociation guidelines for CPR and ECC. (2010).
http://www.heart.org/idc/groups/heart-public/@wcm/@ecc/documents/downloadable/ucm_317350.pdf - John Furst, Smoke Inhalation First Aid: # Essential Steps, May 2, 2024, https://www.firstaidforfree.com/first-aid-for-smoke-inhalation/
- Anna Kowalska | Date of publication – May. 13, 2024First Aid for Smoke Inhalation: What to Do in an Emergency, May. 13, 2024, https://www.darwynhealth.com/injuries-and-poisoning/injuries/burns/smoke-inhalation/first-aid-for-smoke-inhalation-what-to-do-in-an-emergency/?lang=en
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