About Inhalation Injuries
More than a hundred known toxic substances are present in fire smoke.
When inhalation injuries are combined with external burns the chance of
death can increase significantly. According to the National Fire
Protection Association in 1997, 4,675 firefighters suffered burn
injuries as a result of performing their assigned duties, of which 3,770
also suffered inhalation injuries.
Because of the damage that can be caused by inhaling smoke, steam or
noxious gas, it's important that rescue workers remove patients as soon
as possible from the harmful area and allow them to breath fresh air or
receive oxygen therapy.
Types of Injuries
Fire can cause three different types of inhalation injuries:
Damage from Heat Inhalation
True lung burn occurs only by directly breathing in a hot air or
the flame source, or by having high pressure force the heat into
you. In most cases, thermal injury is confined to the upper
airways, because the trachea usually shields the lung from
thermal loads. However, secondary airway involvement can occur
if steam is inhaled, because steam can hold more heat than dry
air. When hot air enters the nose, it can cause damage to the
mucous membranes, because the nose, mouth and throat act as a
Damage from Inhaled Toxins
Systemic toxins affect our ability to absorb oxygen. If someone
is found unconscious or acting confused in the surroundings of
an enclosed fire, systemic toxins could be a possible cause.
Toxin poisoning can cause permanent damage to organs, including
the brain. In some cases, as with carbon monoxide, poisoning can
appear symptomless up until the point where the victim falls
into a coma.
Damage from Smoke Inhalation
Smoke intoxication is frequently hidden by more visible injuries
such as burns as a result of fire. In a disaster situation, this
can lead to not receiving proper medical attention because
rescue teams may take care of patients that seem to need more
help first. Patients who appear as though they are unharmed can
collapse due to major smoke inhalation. In fact, 60% to 80% of
fatalities resulting from burn injuries can be attributed to
Symptoms and Treatment
Symptoms of inhalation injury usually appear within 2 to 48 hours after
the burn has occurred. Symptoms can include:
Soot around the mouth or nose
Singed nasal hairs, eyebrows or eyelashes
Burns around the face or neck
Swelling of the upper airway is the earliest consequence of inhalation
injury. This usually occurs the first 6 to 24 hours after injury.
Patients who have difficulty breathing are intubated and monitored