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    Smoke Inhalation

    When to Seek Medical Care

    Everyone who has suffered from smoke inhalation needs to have their “A.B.C’s” checked. That is Airway, Breathing, and Circulation. Call your doctor or go to your local emergency department for advice. If you have no signs or symptoms, home observation may be recommended.

    Call 911 if you experience the following symptoms with smoke inhalation:

    • Hoarse voice
    • Difficulty breathing
    • Drawn out coughing spells
    • Mental confusion

    Someone with smoke inhalation can get worse quickly. If such a person were transported by private vehicle, significant injury or death could occur on the way that could have been avoided if that person were transported by emergency medical services.

    Exams and Tests

    A number of tests and procedures may be done. Which tests depends on the severity of the signs and symptoms.

    • Chest X-ray: Respiratory complaints such as persistent cough and shortness of breath, indicate the need for a chest X-ray. The initial X-ray may be normal despite significant signs and symptoms. A repeat X-ray may be needed during the observation period to determine if there is delayed lung injury.
    • Pulse oximetry: A light probe is attached typically to the finger, toe, or earlobe to determine the degree of oxygen in the person's blood. Pulse oximetry has limitations. Low blood pressure, for instance can make it inaccurate if not enough blood is getting to the parts of the body where the probe is attached.
    • Blood tests
      • Complete blood count : This test determines whether there are enough red blood cells to carry oxygen, enough white blood cells to fight infection, and enough platelets to ensure clotting.
      • Chemistries (also called basic metabolic profile): This test reveals the change of pH in the blood that may be the result of interference with oxygen diffusion, transport, or use. Serum electrolytes (sodium, potassium, and chloride) can be monitored. Renal (kidney) function tests (creatinine and blood urea nitrogen) are also monitored.
      • Arterial blood gas: For people with significant respiratory distress, acute mental status changes, or shock, an arterial blood gas may be obtained. This test can help the doctor decide the degree of oxygen shortage.
      • Carboxyhemoglobin and methemoglobin levels: This level should be obtained in all smoke inhalation victims with respiratory distress, altered mental status, low blood pressure, seizures, fainting, and blood pH changes. It is now routinely done in many hospitals whenever arterial blood gas is assessed.

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