Structural fires cause a large number of smoke-inhalation-related deaths each year. Often, people don't develop symptoms of smoke inhalation for twenty-four to forty-eight hours after the fire, and may not be diagnosed or treated correctly and in a timely manner. Inhaled smoke may cause damage to the body such as burns to the tissues in the mouth, nose, and upper respiratory system from the hot air. Some substances in smoke can be toxic to cells or can cause damage by contact with tissues. Smoke may also harm the body by interfering with the oxygen supply by preventing oxygen from reaching cells, causing cell and tissue death.

Signs and symptoms of smoke inhalation include the following:

• Singed nose hairs

• Burns on the throat and inside the nose

• Swelling of the throat

• Coughing

• Hoarseness

• Black or gray saliva

• Fluid in the lungs resulting in noisy breathing

• Shortness of breath

• Bluish-gray or cherry-red skin color

• Respiratory arrest and loss of consciousness

First Aid for Smoke Inhalation

Check for ABCs, begin CPR if needed, and manage for shock as outlined in Chapter 2. In addition:

• Make sure the person is getting enough oxygen by taking steps to open the airway.

• A person with smoke inhalation can get worse quickly, so exercise caution when deciding whether to transport the person to a hospital yourself — when in doubt, call 911.

• Call 911 for anyone who has a hoarse voice, difficulty breathing, long coughing spells, or mental confusion.

Those with moderate symptoms and prompt treatment tend to recover completely, but some people may develop chronic respiratory or pulmonary (lung) disorders, particularly people with existing respiratory problems such as asthma.