Smoke Inhalation

Description

• Suspect smoke inhalation in anyone involved in a fire within a closed space or with a history of loss of consciousness
• May cause direct injury to the upper (supraglottic) airway structures
• May cause chemical/irritant effect to lower airway structures
• May cause systemic toxicity from inhaled substances

Etiology

• Direct heat injury from heated gases/smoke:
  • Limited to supraglottic structures because of the heat-dissipating properties of the upper airway
• Irritant effect from smoke components
• Systemic toxicity from inhaled cellular toxins:
  • Carbon monoxide
  • Hydrogen cyanide

• Steam has ∼4,000 times the heat-carrying capacity of hot air
• Can rapidly cause obstructive glottic edema, thermally induced tracheitis, and hemorrhagic edema of the bronchial mucosa