Treating Smoke Inhalation What Not to Do

Fires kill more than 3,000 Americans each year. Most die not from burns but from oxygen deprivation due to smoke inhalation. Immediate survivors of the blaze are not out of the woods. The consequences of smoke inhalation can show up hours or even days later. Apparently healthy people can die even when they seem able to breathe. When treating smoke inhalation, here’s what not to do—and what you must do instead. 


Don’t Continue the Smoke Exposure 

First responders may have protective gear, but smoke inhalation survivors rarely do. Before treating the patient, move them far away from smoky buildings and cars. If there are visible ashes or smoke, the area is too smoky to be safe. 


Don’t Assume the Patient Is OK 

Anyone who emerges from a smoky building or car may have suffered life-threatening smoke inhalation. Some patients initially seem fine, only to collapse into hypoxia or shock later. Do not rely on superficial signals of wellness. Instead, transport all patients that have been exposed to smoke. If a patient is resistant to being transported, explain to them that the symptoms of smoke inhalation do not always appear immediately. 


Don’t Ignore Symptoms of Smoke Inhalation 

The signs and symptoms of dangerous smoke inhalation can be subtle. In addition to obvious clues like low blood oxygen, rapid breathing, loss of consciousness, and confusion, smoke inhalation survivors may display any of the following symptoms:


  • Wheezing or shortness of breath
  • Black or gray saliva
  • Ashes or soot around the nose or mouth 
  • Chest tightness or pain 
  • Giddiness or euphoria 
  • Swollen airways
  • Burns in the nose, throat, or mouth 
  • Hoarseness
  • Vision changes, especially blurry or double vision 
  • Rapid heart rate
  • Low or high blood pressure 
  • Chest pain or tightness 
  • Tingling or numb arms or legs 


Don’t Ignore Other Issues 

Smoke inhalation is not the only or the primary threat of exposure to a burning building. People with respiratory or heart health issues may experience new or worsening symptoms, so it is important to get a patient’s full health history when deciding on their course of treatment. Do not assume that smoke inhalation caused every symptom. There may be other issues as well, including: 


  • Burns 
  • Broken bones from falling objects 
  • Exposure to toxic chemicals 
  • Exposure to allergens 
  • Chemical burns, both external and in the airway 
  • Severe dehydration and electrolyte imbalances 

Don’t Ignore the Patient During Transport 

When a patient is transported and seems fine, the temptation is to treat it as a mere formality, particularly if other more seriously injured people need care. But some patients decline rapidly in the minutes following exposure to smoke. You must be prepared to promptly tend to patients who suffer breathing issues, electrolyte imbalances, and even sudden cardiac arrest. Ensure that someone is monitoring the patient at all times. Sometimes simply talking to the patient about their experience is all it takes to ensure they are healthy. Doing so can also help them process the immediate trauma of surviving a fire, potentially improving their long-term mental health. 


Do Deliver Prompt Care 

The right treatment for smoke inhalation depends on the symptoms the patient displays, as well as factors such as burns and exposure to other irritants, such as combustible chemicals. Patients may need fluids and will almost always need oxygen. It’s also important to monitor the airway, because smoke inhalation can cause swelling. In an unconscious patient, it may also trigger aspiration if the patient vomits. 


The right portable emergency suction machine ensures that you can seamlessly deliver care to smoke inhalation survivors, without moving them or delaying treatment. When every second counts, choose the right device for your agency. Our free guide, The Ultimate Guide to Purchasing a Portable Emergency Suction Device, can help. 

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