Fire-Related Injuries
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 cooling chamber.
- 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 smoke inhalation.
Symptoms and Treatment
Symptoms of inhalation injury usually appear within 2 to 48 hours
after the burn has occurred. Symptoms can include:
- Fainting
- Difficulty breathing
- 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
closely.
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