Smoke Inhalation

When to Seek Medical Care

If the smoke inhalation victim has no signs or symptoms, home observation may be appropriate. If in doubt, call your doctor or go to your local emergency department for advice.

Seek medical attention if you experience the following symptoms with smoke inhalation:

• Hoarse voice
  
  
• Difficulty breathing
  
  
• Drawn out coughing spells
  
  
• Mental confusion

Decide whether to call an ambulance with care.

• Someone with smoke inhalation can get worse quickly.
  
  
• If such a person were transported by private vehicle, significant injury or death could occur on the way that could have been avoided if that person were transported by emergency medical services.

Exams and Tests

A number of tests and procedures may be performed. Which tests are performed depends on the severity of the signs and symptoms and is at the discretion of the doctor.

• Chest x-ray
  
  
  • If you have respiratory complaints such as persistent cough and shortness of breath, you should get a chest x-ray.
    
    
  • The initial chest x-ray may be normal despite significant signs and symptoms.
    
    
  • A repeat chest x-ray may be necessary during the observation period to determine if delayed lung injury is occurring.
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• Pulse oximetry
  
  
  • A light probe is attached typically to the finger, toe, or earlobe, and the degree of oxygen in your blood is determined by noninvasive means.
    
    
  • Pulse oximetry has limitations and may be inaccurate if you have low blood pressure, and enough blood is not getting to parts of the body where the probe is attached.
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• Blood tests
  
  
  • Complete blood count: This test is done to determine if you have enough red blood cells to carry oxygen, enough white blood cells to fight infection, and enough platelets to ensure clotting can occur.
    
    
  • Chemistries (also called basic metabolic profile): This test reveals the change of pH in your blood that may happen because of interference with oxygen diffusion, transport, or use. Serum electrolytes (sodium, potassium, and chloride) can be monitored. Renal (kidney) function tests (creatinine and blood urea nitrogen) are also monitored.
    
    
  • Arterial blood gas: For people with significant respiratory distress, acute mental status changes, or shock, an arterial blood gas may be obtained. This test may help the doctor to decide the degree of oxygen shortage.
    
    
  • Carboxyhemoglobin and methemoglobin levels: This level should be obtained in all smoke inhalation victims with respiratory distress, altered mental status, low blood pressure, seizures, fainting, and blood pH changes. It is now routinely done in many hospitals whenever arterial blood gas is assessed.

Smoke Inhalation Treatment

Self-Care at Home

Remove the person with smoke inhalation from the scene to a location with clean air.

Make sure that you are not putting yourself in danger before you attempt to pull someone from a smoke-filled environment. If you would be taking a serious risk to help the person, wait for trained professionals to arrive at the scene.