Smoke Inhalation

Smoke inhalation is when you breathe in large amounts of smoke, like if you’re in a house, vehicle or forest fire. The smoke can damage your airways and lungs. It can also carry chemicals like carbon monoxide and cyanide that can be deadly if you breathe in too much of them.

Go to the emergency room or seek immediate medical attention if you’ve been in a fire, have symptoms of smoke inhalation or think you’ve inhaled a large amount of smoke.

Even smaller amounts of smoke, like from wildfires that are far away, can irritate your airways and eyes. It’s important to stay inside with the windows closed or wear a mask if there’s smoke in the air. This is especially true if you have a condition that affects your airways, like COPD (chronic obstructive pulmonary disease) or asthma.

Symptoms of smoke inhalation injuries include:

• Shortness of breath
• Hoarseness
• Chest pain
• Sore throat
• Cough
• Noisy breathing, like wheezing or stridor
• Headache
• Dizziness
• Confusion
• Fainting
• Seizures

Even small amounts of smoke can sting your eyes, irritate your sinuses and throat, or cause an asthma attack.

What happens if you breathe in a lot of smoke?

There are three main ways smoke inhalation can hurt you:

• Heat can damage your upper airways.
• Chemicals from toxic gases, vapors and fumes can irritate and cause inflammation in your lower airways and lungs.
• Carbon monoxide, cyanide and other chemicals can prevent oxygen from getting to your tissues and cause organ damage.

Smoke inhalation can quickly lead to life-threatening complications, including:

• Acute respiratory distress syndrome (ARDS), a type of respiratory failure caused by fluid buildup in your lungs
• Asphyxiation, when your body doesn’t get enough oxygen
• Coma, a long period of unconsciousness
• Heart attack, lack of blood flow to your heart
• Methemoglobinemia, a blood disorder that prevents you from getting enough oxygen to your tissues
• Pneumonitis, inflammation in your lungs
• Pulmonary edema, fluid in your lungs
• Stroke, lack of blood flow to your brain

Breathing in a lot of smoke isn’t good for anyone. But small amounts of smoke are more likely to cause health problems if you have chronic conditions, including:

• Asthma
• Chronic kidney disease (CKD)
• COPD
• Diabetes
• Heart disease

Women who are pregnant and children are also at higher risk.

How to lower your risk

Keep an eye on air quality alerts to know if there are high levels of smoke or other pollutants in your area. They’re included on most weather reporting services. On days when the air quality is less than healthy, you can protect yourself by:

• Staying indoors with the windows closed (turn the air conditioner on if you have one, as it filters the air it brings in)
• Using a HEPA (high-efficiency particulate air) filter in your home
• Wearing a well-fitted respirator mask if you can’t avoid going outdoors

Healthcare providers diagnose smoke inhalation injuries based on your symptoms and tests. These could include:

• Pulse oximetry, a small device on your finger that measures your blood oxygen level
• Blood tests
• Chest X-rays or CT scans
• Pulmonary function tests
• Arterial blood gas
• Bronchoscopy

How is smoke inhalation treated?

If you’ve been in a fire or around a lot of smoke, the first step is to get to fresh air as soon as possible. Emergency treatment could include:

• Supplemental oxygen and sometimes, hyperbaric oxygen therapy to deliver additional oxygen to your lungs
• Bronchodilators to open up your airways
• Mucolytics to break up mucus
• Anticoagulants (anti-clotting drugs)
• Hydroxocobalamin (a form of vitamin B12) for cyanide poisoning
• Methylene blue for methemoglobinemia
• Intubation and mechanical ventilation if you can’t breathe on your own

What should I do if I inhaled smoke?

Seek emergency medical care if you’ve been in a fire or inhaled a lot of smoke — even if you feel OK. Quick treatment can save your life.