Smoke Inhalation
Smoke inhalation commonly occurs in fire victims and is associated with high morbidity and mortality. In addition to thermal injury, burning organic and inorganic materials can produce a very large number of different toxins, leading to chemical injury to the respiratory tract as well as systemic effects from absorption of poisons through the lungs. “Smoke bombs” do not release true smoke but can be hazardous because of irritant components, particularly zinc chloride.
Mechanism of toxicity. Smoke is a complex mixture of gases, fumes, and suspended particles. Injury may result from the following:
Thermal damage to the airway and tracheobronchial passages.
Irritant gases, vapors, and fumes that can damage the upper and lower respiratory tract (See Gases, Irritant). Many common irritant substances are produced by thermal breakdown and combustion, including acrolein, hydrogen chloride, phosgene, and nitrogen oxides.
Asphyxia due to consumption of oxygen by the fire and production of carbon dioxide and other gases.
Toxic systemic effects of inhaled carbon monoxide, cyanide, and other systemic poisons. Cyanide is a common product of combustion of plastics, wool, and many other natural and synthetic polymers.
Toxic dose.
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