It’s not just fires that can cause smoke poisoning. If medical help is on the scene early, smoke poisoning usually has a favorable outcome.
What is smoke inhalation?
Smoke poisoning usually results from inhaled toxins found in fire smoke. For the majority of people who experience smoke poisoning, the poisoning usually happens while they are sleeping. One reason for this is that various respiratory toxins in fire smoke are odorless to humans and therefore do not cause the person to wake up. Most fatalities after fires do not die from burns, but due to severe smoke inhalation. Typical symptoms of smoke inhalation include severe shortness of breath and the onset of dizziness. The severe shortness of breath is often accompanied by a feeling of suffocation. Headaches are also among the common symptoms of smoke poisoning. Occasionally, sufferers also experience seizures and/or palpitations.
Causes
Smoke poisoning is most often caused by building fires. However, since it is not the smoke itself that causes smoke poisoning, but the respiratory toxins contained in the smoke, such as carbon monoxide (an alternative name for smoke poisoning in medicine is therefore also flue gas poisoning), various other factors can also be responsible for the poisoning. For example, some smoke poisonings are the result of inhaling large amounts of exhaust fumes. Faulty boilers or stoves can also be the cause of smoke poisoning. Severe consequences of smoke poisoning, such as unconsciousness, which can lead to the death of an affected person, are caused in fires, for example, by the respiratory poison cyanide. This respiratory poison is produced, among other things, by the various burning objects. Inhaled cyanide blocks the functioning of body cells, causing a lack of oxygen in the cells. As a result, internal suffocation often occurs.
Symptoms, complaints, and signs
Symptoms of smoke inhalation can be varied. Likewise, the time of onset of symptoms can vary. This depends on the type and intensity of the gas. Typical signs of smoke poisoning include violent coughing and shortness of breath. In addition, severe headaches, dizziness and nausea often develop as a result of the inhaled substances. Impairment from the gases can also cause sweating and muscle cramps. The toxic substances of the smoke can likewise cause a feeling of drowsiness and confusion. Reddish/bluish skin discoloration may also occur as a symptom of smoke intoxication. Indications of smoke intoxication may also include burns to the neck and face. Clues to smoke intoxication may also include soot particles in the mouth and burnt-smelling hair. Classic signs also include difficulty swallowing, severe inner restlessness, and recognizable feelings of anxiety. Speaking may involve great effort and may be interrupted by the coughing up of mucus. Depending on the pollutant, weakness of the limbs as well as burning pain in the area of the respiratory tract may occur. Burns of the respiratory mucous membranes are also possible due to heat exposure. Heart palpitations may set in as a result of smoke inhalation. Smoke poisoning that is noticed late or left untreated can lead to unconsciousness. In the worst case, respiratory arrest occurs.
Diagnosis and course
Because patients with smoke inhalation requiring acute treatment are often unconscious, an emergency diagnosis must usually be made based on a patient’s observable condition. Mobile emergency physicians are unable to detect a cyanide concentration in the blood, so rapidly required treatment for smoke inhalation is often based on the suspected diagnosis. The course of smoke poisoning varies between individuals and depends, among other things, on the degree of poisoning and the symptoms that occur. In particular, rapid medical intervention has a positive influence on the course of smoke poisoning:
If appropriate poisoning can be treated early, it is usually accompanied by a good prognosis. However, if medical help is not on the scene early, smoke inhalation can be fatal.
Complications
Depending on the pollutant inhaled, smoke inhalation can cause several complications.Generally, acute complications occur, such as seizures, palpitations and unconsciousness. As the disease progresses, pulmonary edema forms, which, if left untreated, can lead to pneumonia and, in extreme cases, to the death of the patient. Late effects can also occur as a result of severe poisoning. If the mucous membranes are damaged, this favors infections and diseases of the immune system. Scarring of the lung tissue impairs blood circulation and can cause respiratory distress and damage to the heart, among other things. In cases of severe damage, shortness of breath occurs even at rest. The shortness of breath often leads to panic attacks in the affected person and, in the long term, to psychological complaints. In the treatment of smoke inhalation, for example, prescribed medication can cause discomfort. CPR can lead to rib or sternum fractures and liver and spleen injuries. In addition, air or blood can enter the area between the pleura and the lung, causing vomiting and aspiration. If blood gets into the pericardium, it can result in a heart attack. During ventilation, there is a small risk of injury and infection to the nasopharynx.
When should you see a doctor?
If dizziness, nausea, or unsteadiness of gait occur, there is cause for concern. In smoke inhalation, the surrounding air is impure, leading to a gradual decrease in internal strength. The lack of oxygen triggers the affected person to sweat, develop internal heat, or feel weak. A doctor is needed when consciousness is clouded, there are disturbances in concentration as well as attention, and confusion sets in. Irregularities of memory function, disorientation or anxiety are alarm signals of the organism. A doctor must be consulted, as there is a need for immediate action. Often a fear of suffocation develops, leading to panic behavior. Vomiting, coughing and shortness of breath are further signs of smoke poisoning. In the event of unconsciousness, an ambulance must be alerted. Persons present are at the same time obliged to initiate first aid measures to ensure the survival of the person affected. Breathing activity must be supported to avoid further complications. Restrictions in movement, a loss of muscle strength and a scratchy throat also indicate inconsistencies. In case of headaches, general dysfunction or sudden fatigue, the affected person needs help. A visit to the doctor is necessary to determine the cause.
Treatment and therapy
Smoke poisoning requires particularly rapid treatment if the respiratory toxin cyanide is involved, because cyanide affects the body’s cells comparatively quickly. However, since cyanide involvement cannot be detected in the emergency situation, general emergency medical measures are usually taken on site first: If smoke poisoning is present, for example, the patient’s airways are first kept clear. Stabilization of the heart and circulation are also among the important immediate measures. In parallel, a patient is also supplied with sufficient oxygen and fluids. If seizures occur in the course of smoke inhalation, these are also treated in an emergency. If, for example, there is a strong suspicion on the basis of various characteristics of the accident site that the affected person has smoke poisoning with the involvement of cyanide, an antidote can be administered by medical personnel. Such an antidote causes cyanide that has already penetrated the body’s cells to be neutralized. Thus, death from asphyxiation of an affected person can be prevented. The administration of antidote in smoke poisoning is usually carried out with the aid of an infusion. If smoke poisoning has already led to circulatory and/or respiratory arrest, resuscitation measures via cardiopulmonary massage or respiratory donation become necessary. This is often followed by artificial respiration.
Prevention
Since most smoke inhalations occur during the night, an effective method of prevention is to adequately equip one’s residence with fire alarms. Appropriate fire alarms will sound an early alarm in the event of a fire. This allows medical helpers to be on the scene quickly, often preventing serious consequences of smoke inhalation.
Aftercare
Follow-up care for smoke inhalation can be arranged with a primary care physician or pulmonary specialist.The aim is to optimize regeneration and to rid the organism of harmful substances in the long term. It is important to fill the lungs and bronchial tubes as well as the nose with fresh air again. Walks in natural surroundings are therefore particularly suitable. On the other hand, those affected should avoid spending time in traffic-intensive areas for some time. Those who can afford it in terms of time and money can treat their bodies to a change of air at the seaside or in the high mountains, which is ideal for aftercare following smoke inhalation. Conscious breathing and gently dosed exercise can make the process of aftercare even more optimal in this context. Breathing exercises can also be included in aftercare following a severe form of smoke inhalation. These can be learned from a physiotherapist and incorporated into home practice. Yoga can also help with breathing recovery. Pranayama, the breathing exercises found in nearly every yoga class, often positively regulate the flow of breath. Great care should also be taken to maintain good air in living rooms, bedrooms and offices after smoke inhalation. Regeneration after smoke inhalation is also promoted by drinking a large amount of fluids. It serves to carry out remaining pollutant particles in the respiratory system or the rest of the organism more easily on the body.
This is what you can do yourself
If there is a suspicion that you yourself or another person has suffered smoke poisoning, first aid must be administered. After the emergency physician has been alerted, the first aider must open windows and doors to ensure oxygen supply. The affected person must be taken out of the danger zone and placed in a calm position. In the case of mild smoke poisoning, it is important to remain calm or to have a calming effect on the poisoned person. Depending on the cause of the smoke poisoning, first aiders should also find out whether other people are in danger and whether there are any other health risks from escaping gases. If the victim is in respiratory distress, he or she should be positioned with the upper body elevated. Jackets and tight tops should be loosened. If the victim is unconscious, life-saving measures such as breathing or cardiopulmonary resuscitation should be initiated if necessary. After smoke inhalation, victims usually feel ill and weak. Rest and recuperation are important. In addition, no strenuous sports should be performed for one to two days. The doctor in charge will usually suggest a further check-up, which should be taken up in order to minimize the health risks. After a severe smoke inhalation, the affected person must spend a few days in the hospital. Self-care focuses on working through any trauma or shock and following the doctor’s instructions.
