More than half of fire-related deaths result from smoke inhalation, according to the Burn Institute. Smoke inhalation occurs when you breathe in harmful smoke particles and gases. Inhaling harmful smoke can inflame your lungs and airway, causing them to swell and block oxygen. This can lead to acute respiratory distress syndrome and respiratory failure.
Smoke inhalation commonly happens when you get trapped in a contained area, such as a kitchen or home, near a fire. Most fires occur in the home, often from cooking, fireplaces and space heaters, electrical malfunctions, and smoking.
If you or someone else has been in a fire and exposed to smoke or showing signs of smoke inhalation, such as trouble breathing, singed nostril hair, or burns, call 911 for immediate medical care.
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:
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.
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.
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:
Your risk for permanent damage from smoke inhalation is greater if you have any of these conditions.
Smoke inhalation can cause several signs and symptoms that can range in severity.
- 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.
- 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 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.
- Smoke can irritate your eyes and cause redness.
- Your corneas may have burns.
- 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 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.
WARNING: Anyone who experiences smoke inhalation requires immediate first aid. Here’s what to do:
- Call 911 for emergency medical assistance.
- Remove the person from the smoke-filled area if it’s safe to do so and move them to a location with clean air.
- Check the person’s circulation, airway, and breathing.
- Start CPR, if necessary, while waiting for emergency help to arrive.
If you or someone else experiences the following smoke inhalation symptoms, call 911:
- trouble breathing
Smoke inhalation can worsen quickly and affect more than just your respiratory tract. You should call 911 instead of driving yourself or someone else to the nearest emergency department. Receiving emergency medical help reduces your risk for serious injury or death.
In Popular Culture: How smoke inhalation caused Jack Pearson’s heart attack
Smoke inhalation has been a hot topic (no pun intended) since fans of the hit TV series “This Is Us” learned of character Jack’s demise. In the show, Jack suffered smoke inhalation after returning into his burning house to help his wife and children escape. He also went back in for the family dog and some important family heirlooms.
The episode brought a lot of attention to the dangers of smoke inhalation and what not to do in the event of a fire. It also left a lot of people wondering if smoke inhalation could cause a seemingly healthy man to have a heart attack. The answer is yes.
According to the New York State Department of Health, fine particles can travel deep into your respiratory tract and reach your lungs. During increased physical exertion, cardiovascular effects can be worsened by exposure to carbon monoxide and particulate matter. The effects of the smoke inhalation, physical exertion, and extreme stress are all taxing on your lungs and heart, which could cause a heart attack.
At the hospital, a doctor will want to know:
- the source of the smoke that was inhaled
- how long the person was exposed
- how much smoke the person was exposed to
Tests and procedures may be recommended, such as:
A chest x-ray is used to check for signs of lung damage or infection.
A series of blood tests, including a complete blood count and metabolic panel, are used to check red and white blood cell counts, platelet counts, as well as the chemistry and function of many organs that’re sensitive to changes in oxygen levels. Carboxyhemoglobin and methemoglobin levels are also checked in those who’ve inhaled smoke to look for carbon monoxide poisoning.
Arterial blood gas (ABG)
This test is used to measure the amount of oxygen, carbon dioxide, and chemistry in the blood. In an ABG, blood’s typically drawn from an artery in your wrist.
In a pulse oximetry, a small device with a sensor is placed over a body part, such as a finger, toe, or earlobe, to see how well oxygen is getting to your tissues.
A thin, lighted tube is inserted through your mouth to view the inside of your airway to check for damage and collect samples, if needed. A sedative may be used to relax you for the procedure. Bronchoscopy may also be used in the treatment of smoke inhalation to suction debris and secretions to help clear the airway.
Smoke inhalation treatment may include:
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.
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.
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
- blue lips or fingernails
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.
Recovery from smoke inhalation is different for everyone and depends on the severity of the injuries. It also depends on your overall lung health prior to injury. It’ll take time for your lungs to fully heal and you’ll likely continue to experience shortness of breath and tire more easily for a while.
People with scarring may have shortness of breath for the rest of their lives. Hoarseness for some time is also common in people with smoke inhalation.
You may be given medication to take while you recover. You may need long-term inhalers and other medications to help you breathe better, depending on the damage to your lungs.
Follow-up care is an important part of your recovery. Keep all scheduled follow-up appointments with your doctor.
To help prevent smoke inhalation, you should:
- Install smoke detectors in every sleep room, outside of each sleeping area, and on every level of your home, as per the National Fire Protection Association.
- Install carbon monoxide detectors outside sleep areas on each level of your home.
- Test your smoke and carbon monoxide detectors monthly and replace batteries every year.
- Make an escape plan in case of fire and practice it with your family and others living in your home.
- Don’t leave lit cigarettes, candles, or space heaters unattended and extinguish and dispose of smoking related items properly.
- Never leave the kitchen unattended while cooking.
Smoke inhalation requires immediate medical care even if there are no visible symptoms. Early treatment can help prevent further complications and death.