Smoke Inhalation



  • 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


  • 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

Inhalation of steam can be rapidly fatal:
  • 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

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