Smoke inhalation syndrome from fires varies in severity depending on the material being burnt, smoke temperature, ambient oxygen, burning time, distance to the source and residual soot.
It manifests with significant shortness of breath, purple lips, soot in the upper airways and in severe cases loss of consciousness due to inhalation of carbon monoxide (CO) and hydrogen cyanide (CN).
Diagnosis is clinical by questioning and physical examination. Blood tests will be used to determine the toxicant and to follow the evolution of the poisoning.
Treatment includes oxygen therapy and medication to treat airway spasm. In severe cases, orotracheal intubation may be necessary. If hydrocyanic inhalation is suspected, the antidote hydroxycobalamin should be administered. Treatment should be based on clinical severity rather than laboratory results.
- Ronald P Mlcak, PhD, MBA, RRT, FAARC. Inhalation injury from heat, smoke, or chemical irritants. UpToDate. Mar 15, 2016.
- Woodson CL. Diagnosis and treatment of inhalation injury. In: Total Burn Care, 4 ed, Herndon DN (Ed), 2009.
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- American Burn Association. Advanced Burn Life Support Course, Provider Manual. 2007 https://evidencebasedpractice.osumc.edu/Documents/Guidelines/ABLSProviderManual_20101018.pdf. (21 Nov 2016).
- Indalecio Morán, Jaume Baldirà, Luís Marruecos, Santiago Nogué. Intoxicación por humo de incendio. Intoxicación clínica. Capítulo 24. Páginas 303-310. Grupo Difusión.
