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Please add the profiles for those who died of Smoke Inhalation.

Smoke inhalation is the primary cause of death for victims of fires. The inhalation or exposure to hot gaseous products of combustion can cause serious respiratory complications.

Burning materials, chemicals, and the gases created can cause smoke inhalation by simple asphyxiation (lack of oxygen), chemical irritation, chemical asphyxiation, or a combination of them. Exposure to smoke that arises from a burning environment may result in three types of injury: (1) direct thermal injury to the airways, particularly the upper airways; (2) chemical injury to the airways, including those of the lower respiratory tract, and lung parenchyma; and (3) systemic injury as a result of inhalation of toxic compounds and immunologic responses to injury.

Some 50–80% of fire deaths are the result of smoke inhalation injuries, including burns to the respiratory system. Smoke is a mixture of heated particles and gases. The products being burned, the temperature of the fire, and the amount of oxygen available to the fire all make a difference in the type of smoke produced. The hot smoke injures or kills by a combination of thermal damage, poisoning and pulmonary irritation and swelling, caused by carbon monoxide, cyanide and other combustion products.

Major airway, pulmonary, and systemic complications occur after inhalation injury, and this increases the incidence of mortality among burn patients.

Signs and Symptoms

Inhaling harmful smoke can inflame the lungs and airway, causing them to swell and block oxygen. This can lead to acute respiratory distress syndrome and respiratory failure.

  • Coughing
    • due to irritation of mucous membranes which results in more mucus and bronchospasms. The mucus can be either clear or black depending on the degree of burned particles.
  • Shortness of breath
    • caused by direct injury to the respiratory tract, leading to decreased oxygen delivery to the blood, the decreased ability of blood to carry oxygen because of chemicals in smoke, or the inability of the body's cells to use oxygen. Rapid breathing may also result in attempt to compensate for these injuries.
  • Hoarseness or noisy breathing
    • may be a sign that fluids are collecting in the upper airway and may cause a blockage. Chemical irritants may cause vocal cord spasm, swelling and constriction of the upper airways.
  • Eyes:
    • may be red and irritated by smoke & there may be burns on the corneas in the eyes.
  • Skin color
    • color may range from pale to bluish to cherry red.
  • Headache
    • due to exposure to various quantities of carbon monoxide (headache, nausea, confusion & vomiting are symptoms of carbon monoxide poisoning.)
  • Changes in mental status
    • chemical asphyxiants and low levels of oxygen can lead to mental status changes, including confusion, sleepiness, fainting, seizures and coma.
  • Soot in the nose or throat
    • when seen in the nostrils or throat indicate smoke inhalation & the extent of smoke inhalation. Swollen nostrils & nasal passages are also a sign of inhalation.
  • Chest pain
    • can be caused by irritation to the respiratory tract & results from low oxygen flow to the heart. Excessive coughing can also cause chest pain. Heart and lung conditions can also worsen and cause chest pain.

Burns to the nose, mouth and face, singed nostril hairs, difficulty breathing, and carbonaceous sputum (burned saliva) are signs of smoke inhalation injury. Approximately one third of patients admitted to burns units have pulmonary injury from hot smoke inhalation.

Any person with apparent signs of smoke inhalation should be immediately evaluated by a medical professional such as a paramedic or physician. Advanced medical care may be necessary to save the life of the patient, including mechanical ventilation, even if the person is conscious and alert. Pending advanced intervention, the patient should be brought into fresh air and given medical oxygen if available.

What are the risks of smoke inhalation?

Smoke inhalation is a serious injury, and treatment is needed as soon as possible. If it is not treated early, the smoke may damage your lungs and cause breathing problems. Your lungs may become infected, swollen, and filled with fluid. Fluid in the lungs causes severe shortness of breath and may lead to respiratory failure. This may affect your heart and brain, and it may be life-threatening. Even with treatment, you may have permanent lung damage.

Statistics & Mortality

  1. National Fire Protection Association - Fatal effects of fire. by: J...
  2. American Burn Association - Burn Incident Fact Sheet (2016)
  3. NCBI - Inhalation injury as a prognostic factor for mortality in bu...
  • According to the National Safety Council, 3,900 people died from exposure to fire, flame, and smoke in the United States in 2001, the most recent year as of 2004 for which data were available.
  • The death rate of patients with both severe burns and smoke inhalation can be in excess of 50%.
  • Smoke inhalation accounts for the majority of deaths in home fires. Children under age 11 and adults over age 70 are most vulnerable to the effects of smoke inhalation.
  • Approximately 80% of fire-related deaths are due not to the airway burn injury itself but to the inhalation of toxic products, especially carbon monoxide and hydrogen cyanide gases.
  • Death certificates show a 2-to-1 ratio of smoke inhalation to burns for fire deaths overall, while fire incident reports show an 8-to-1 ratio for home fire deaths.
  • Deaths involving both smoke inhalation and burns account for about one-quarter of fire deaths reported on death certificates and about half of home fire deaths reported in fire incident reports.
  • Fire and inhalation deaths are combined because deaths from thermal burns in fires cannot always be distinguished from deaths from inhalation of toxins in smoke.
  • Prior to 1999, smoke inhalation fire deaths outnumbered burn deaths in fires by roughly 3-to-1 in death certificates, and the gap had been widening steadily for at least 20 years.
    • Death certificate coding was changed so that more than one fatal condition could be coded. It was now possible to categorize deaths as (a) involving both burns and smoke inhalation, (b) involving smoke inhalation but not burns, (c) involving burns but not smoke inhalation, or (d) involving one or more conditions but not smoke inhalation and not burns. The percentages of deaths falling into the four categories suggest that all or nearly all of the deaths now coded as involving burns and smoke inhalation were being coded only as smoke inhalation prior to 1999.

Notables dying of smoke inhalation:

  1. Ranker - Famous People Who Died of Smoke Inhalation (23 people listed as of 8/24/18)
  2. List Verse - Top 10 Actors Who Died in Fires. By Patrick Weidinger,...

Resources & Additional Reading

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