Treating Smoke Inhalation What Not to Do

In 2021, fires killed 4,316 Americans, and over the past 10 years, fire deaths have increased by almost 18%. Most die not from burns but from oxygen deprivation caused by 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. 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.


End 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. The area is too smoky to be safe if there are visible ashes or smoke.


Guide: Portable Emergency Suction: A Critial Tool In Avoiding Aspiration  Pneumonia


Don’t Assume the Patient Is Okay

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:


  • Cough
  • Shortness of breath
  • Hoarseness of voice
  • Headache
  • Nausea and or vomiting
  • Drowsiness or confusion
  • Eye irritation
  • Change in vein color from blue to cherry red
  • Soot in nostrils with swelling of the nasal passage

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. However, 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 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.


New: Determining the Contents of Your First-In Bag: What Every Paramedic  Should Consider.  Free Guide & Checklist


 Do Deliver Prompt Care 

The right treatment for smoke inhalation depends on the patient’s symptoms 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 critical 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.


Editor's Note: This blog was originally published in February 2020. It has been re-published with additional up-to-date content.


New Call-to-action