Smoke inhalation requires urgent medical attention in order to prevent permanent damage to the airways. Immediately following smoke inhalation, it is important to move yourself to an open area with plenty of ventilation and to lie down on the ground, preferably on your side.

In the case of a fire, your first action should be to call 911 or your local emergency number after getting yourself to safety. Extreme heat exposure and smoke inhalation can cause serious respiratory problems that could lead to death.

If you are trying to help other victims in the vicinity, wet a T-shirt with water and rub it over your face, then tie it around your head to cover your nose and mouth and keep your hands free. This will provide some protection against smoke inhalation while you are trying to help others.

People protecting themselves from fire smoke

How to protect yourself

The following tips can help minimize the effects of smoke inhalation:

Crouch down and cover your nose and mouth with a damp cloth. Smoke rises, consuming the oxygen available in the room. Stay close to the ground where there is more oxygen;
Avoid breathing through your mouth, as the nose is better able to filter out toxic gases in the air;
Look for a ventilated area where you can wait for help, such as next to a window, for example;
Cover any gaps in the door frame with clothes or sheets to prevent smoke from entering the room where you are located. If possible, dampen the clothes with water, or whatever it is you are using to block the fire and smoke;
Before opening a door, use your hand to check the temperature, asa very hot door could mean there is a fire on the other side. Avoid opening that door, which is protecting you from the fire;
If your clothes catch fire, stop, drop, and roll to put out the flames, because running will only feed the fire and quickly result in burns to the skin.

It is only recommended to jump out of the window of a house or building if you are on the ground level or first floor. If you are up higher, wait for the fire department to arrive.

What to avoid

Do not use elevators because electricity is cut in the event of a fire and you could be stuck inside the elevator, which could catch fire or fill with smoke;
Do not go to the upper floors of the building, unless you are following an emergency exit plan or it is necessary to go up the stairs to escape a fire;
Do not stay in the kitchen, garage, or inside the car, as gas and gasoline are explosive.

Health effects

A fire can result in severe burns as well as oxygen deprivation and respiratory infections that may arise hours after the fire. These conditions can be fatal.

When a person loses consciousness (faints), they are still able to breath, but their chances of survival are lower if they remain where they are. Reduced levels of oxygen can cause death in as little as 10 minutes. For this reason, removing victims from the vicinity should be done as quickly as possible.

In addition to the risk of burns from the fire itself, extreme heat can burn the airways and smoke can consume the oxygen in the air, leaving large quantities of CO₂ and toxic particles that cause poisoning when inhaled.

In summary, a person may die from the fire itself, from immediate smoke inhalation, or as a result of respiratory infections caused by the heat or smoke inhalation.

Symptoms of toxic smoke inhalation

After being exposed to large quantities of smoke, symptoms of respiratory toxicity may arise that could put your life at risk. These symptoms include:

Difficulty breathing, even in a well-ventilated area with fresh air;
Wheezing or shortness of breath;
Severe cough;
Breath that smells like smoke or chemicals;
Confusion, such as not knowing where you are or what happened, or mixing up people, dates, and names.

Headache, nausea, and vomiting may also occur after being exposed to toxic smoke.

What to do after

Anyone presenting with symptoms of respiratory toxicity after smoke inhalation should receive emergency medical attention, even if they never lost consciousness. Call 911 or go to the nearest emergency room.

Some dangerous substances present in smoke may take 24 hours to cause symptoms, which is why it is recommended to observe victims of smoke inhalation closely, whether at home or in the hospital.

Treatment options

Treatment of smoke inhalation should be done urgently in the emergency department, and will depend on the severity of the symptoms as well as the type of substance inhaled.

Treatment usually involves giving oxygen through a face mask. If there is a concern for airway burns, a breathing tube will be inserted through the nose or the mouth to allow for the flow of air.

In the case of wheezing, inhaled medications such as salbutamol can be administered in addition to oxygen to help open up the airways.

Mechanical ventilation may be needed if an injury to the lungs is causing persistent shortness of breath.

Can I rescue other victims from a fire?

In the case of a house fire or forest fire, ideally you should wait for the fire department to come rescue the victims, as they are professionals who are trained in the most efficient ways to control a fire and save lives. However, if you can help others while waiting for the fire department to arrive, it is important to follow certain recommendations.

If you come upon a victim of a fire you should:

1. Carry the victim away from the fire to a well-ventilated area far from the smoke. Wet your face with a damp T-shirt soaked in water or normal saline to minimize discomfort while rescuing the victim.

2. Check to see if the person is conscious and breathing:

If the person is not breathing, call 911 and initiate mouth to mouth resuscitation and CPR;
If the person is breathing, but unconscious, call 911 and lay the person down on their side.

Smoke inhalation is highly toxic and can cause serious damage to the body. Because of this, all victims of smoke inhalation should be seen for a prompt evaluation in the emergency department, even if they never lost consciousness and are showing no symptoms.

Respiratory complications like pneumonia or bronchiolitis are common causes of death following a fire, and may arise hours after the fire. For this reason, anyone in the vicinity of a fire should be evaluated by a doctor.