What to know about smoke inhalation

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Smoke inhalation occurs when a person breathes in smoke particles. This typically happens when a person is stuck in an enclosed space with a fire. However, a person may also inhale smoke due to wildfires or bushfires.

Smoke inhalation can affect a person’s body in the following ways:

• asphyxiation due to carbon monoxide, which is a colorless, odorless gas
• poisoning from the inhalation of toxic fumes
• damage to the respiratory system due to toxic chemicals
• burning of the mouth or throat

The three main causes of airway damage due to smoke inhalation include:

Irritants

Fire smoke may contain irritants. For example, it may contain hydrogen chloride and hydrogen bromide, both of which are colorless gases. These may cause a person to cough or experience shortness of breath.

If a person breathes in large amounts of hydrogen chloride, it may lead to fluid building up in the lungs.

Simple asphyxiants

Fire smoke contains simple asphyxiants such as carbon dioxide and methane. A simple asphyxiant is a chemical that displaces oxygen in the immediate environment. This can cause oxygen deprivation in those nearby, possibly leading to asphyxiation.

Chemical asphyxiants

Carbon monoxide and hydrogen cyanide are two common chemical asphyxiates in fire smoke.

Breathing in carbon monoxide can lead to carbon monoxide poisoning. This occurs when the carbon monoxide mixes with the red blood cells carrying oxygen around the body. This can disrupt the blood from carrying oxygen to the vital organs.

According to the Centers for Disease Control and Prevention (CDC), breathing in smoke can cause immediate symptoms such as:

• coughing
• difficulty breathing, including shortness of breath
• stinging eyes
• a scratchy throat
• a runny nose
• irritated sinuses
• chest pain
• headaches
• tiredness
• a raised heartbeat
• confusion
• hoarseness

To confirm whether or not smoke inhalation has caused injury to the respiratory system, a healthcare professional may check using either fiber-optic bronchoscopy or a chest CT scan.

Fiber-optic bronchoscopy involves a doctor inserting an instrument called a bronchoscope down the throat. It contains a light with a camera, allowing the doctor to check for any signs of damage.

Chest CT scans are similar to X-ray scans but can take a detailed picture of the lungs. A doctor will be able to identify any signs of damage from smoke inhalation using this method.

Possible treatments a person may require for smoke inhalation include:

Oxygen

Smoke inhalation can cause a person’s oxygen levels to drop, but receiving oxygen therapy can help increase a person’s oxygen levels.

Smoke and particles in the air can irritate the throat tissue, causing it to swell and constrict airflow. For this reason, it is important to protect a person’s upper airway.

If there is swelling and inflammation around the back of the throat leading to the vocal cords, it might be necessary to place a breathing tube through the vocal cords and into the windpipe to secure a patent breathing airway.

Hyperbaric oxygenation

If a person has carbon monoxide poisoning from smoke inhalation, they may require hyperbaric oxygenation therapy. This is to prevent delayed damage to the heart and central nervous system.

Nebulized treatments

A nebulizer delivers medication to the lungs in the form of a mist.

One study suggests that providing a person with adrenaline in a nebulizer may be useful for smoke inhalation. However, healthcare professionals rarely use this in adults.

Bronchodilators are a more common means of opening up the airways and helping with the bronchospasm and wheezing that can occur with smoke inhalation.

Intravenous treatment

One study suggests that people who experience smoke inhalation require intravenous fluids at the scene — especially if they are dehydrated and have low blood pressure.

There are a number of steps a person can take to avoid smoke inhalation:

• Install smoke alarms inside and outside every bedroom. There should also be smoke alarms on each level of a house. A person should test their household fire alarms once per month and replace them every 10 years.
• Install a carbon monoxide detector and get appliances that burn gas, coal, or oil regularly checked by a professional.
• Do not leave the oven or pans containing oil unattended.
• Do not leave lit candles or cigarettes unattended.
• Properly store flammable products.
• Make sure that everyone in the household has an agreed escape plan.

Smoke inhalation may worsen or trigger certain conditions. Some examples of these include:

• Asthma: The United States Forest Service note that even mild smoke inhalation may trigger asthma attacks in people with asthma.
• Bronchitis: An older study notes that it is not uncommon for people to develop acute bronchitis after experiencing smoke inhalation.
• Cancer: Some chemicals in fire smoke are carcinogenic, meaning that they can cause cancer. Therefore, if a person inhales smoke, there is a chance that they may later develop cancer. However, more research is necessary to confirm this link.
• Chronic obstructive pulmonary disease (COPD): A person with COPD is more likely to develop complications from smoke inhalation.

Even mild cases of smoke inhalation will likely require treatment. Therefore, if possible, a person should seek medical attention if they believe that they have inhaled smoke from a fire or are experiencing symptoms related to smoke inhalation.

Also, if a person has high risk conditions such as asthma, they should consult with a doctor who can assess their situation.

Smoke inhalation occurs when a person breathes in particles and chemicals from a fire. This may irritate or damage the respiratory system. In some cases, it may also cause poisoning or asphyxiation.

People with underlying lung conditions are more likely to develop complications from smoke inhalation.

People should consider taking precautions to prevent house fires by installing several smoke alarms. They should also have an escape plan in place should a fire occur.