Smoke inhalation occurs when someone breathes in the products of combustion during a fire. Combustion (burning) produces the rapid breakdown of a substance by heat. The materials being burned, the temperature of the fire, and the amount of oxygen available to the fire all determine the type of smoke produced.
Generally, everyone is aware of the dangers of carbon monoxide (CO) poisoning resulting from structural fires. What is less recognized is the danger of acute cyanide poisoning. In addition to CO, fire smoke also can contain deadly hydrogen cyanide (HCN) gas, which can be given off even after a fire is extinguished but burned materials continue to smolder.
CO and cyanide poisoning can be fatal. Synthetic materials are widely used in house furnishings, and large amounts of cyanide gas can be released during a house fire. Other common sources of cyanide gas during a house fire can come from silk, paper, wool and cotton.
Cyanide poisoning develops quickly, within seconds after smoke inhalation, so quick recognition and treatment of victims is essential.
First aid measures for victims of smoke inhalation
Non-specific measures
Decontamination should never post-pone supportive and antidotal treatment.
1. Remove the person from the source of the smoke to a location with fresh air.
2. Cardiopulmonary resuscitation. Cardiopulmonary resuscitation (CPR) is a lifesaving technique used when someone has stopped breathing or if his heart has stopped beating. CPR involves two elements: chest compressions combined with rescue breathing.
Remember the “ABCs” Airway, Breathing and Circulation
AIRWAY: Clear the victim’s airway
1. Put the person on his or her back on a firm surface.
2. Kneel next to the person's neck and shoulders.
3. Open the person's airway using the head-tilt, chin-lift maneuver. Put your palm on the person's forehead and gently tilt the head back. Then with the other hand, gently lift the chin forward to open the airway.
4. Check for normal breathing: Look for chest motion, listen for breath sounds, and feel for the person's breath on your cheek and ear. Proceed directly to chest compressions to restore circulation.
BREATHING:
Currently, mouth-to-mouth breathing is not recommended in cyanide poisoning due to the danger to the rescuer. A resuscitation bag and mask will be used and oxygen will be administered when emergency staff arrives at the scene.
CIRCULATION: Restore blood circulation with chest compressions
1. Place the heel of one hand over the center of the person's chest, between the nipples. Place your other hand on top of the first hand. Keep your elbows straight and position your shoulders directly above your hands.
2. Apply your body weight as you push straight down on (compress) the chest. Push hard and push fast — give two compressions per second, or about 120 compressions per minute.
3. Continue CPR until there are signs of chest movement or until emergency medical personnel take over. If the victim still has no pulse, an automatic external defibrillator, if available, can be used. The user should follow the instructions as given
Ventilation – The victim should be brought out into the fresh air. Oxygen will be administered by face mask or nasal prongs when emergency staff arrives on the scene.
Call for help. One person should call the emergency services (for example 911 in the US, 112 in Europe, 15 or 18 in France).
Signs suggesting cyanide poisoning
Victims may have numerous signs and symptoms of smoke inhalation.
Symptoms may include cough, shortness of breath, hoarse voice, headache, dizziness and alteration of consciousness.
Soot in the nostrils or mouth may be a clue in cyanide poisoning. Victims may also have a characteristic almond breath odor.
Specific measures
These measures include administration ASAP of a specific antidote for cyanide poisoning. It is usually reserved for emergency medical professionals who can administer hydroxocobalamin at the scene and it may be repeated at the sceneorafter the victim is transferred to the hospital. Studies have shown that this antidote is safe and effective when administered promptly.
Cyanide poisoning from fire smoke inhalation can be deadly. First aid measures can help to save lives before emergency medical professionals arrive at the scene.
Based on reports published in:
www.Emedicinehealth.com/smoke_inhalation.
www.mayoclinic.com/health/first-aid-cpr