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Review
. 2013 May-Jun;39(3):373-81.
doi: 10.1590/S1806-37132013000300016.

Smoke inhalation injury during enclosed-space fires: an update

[Article in English, Portuguese]
Ana Carolina Peçanha Antonio  1 , Priscylla Souza Castro, Luiz Octavio Freire
Affiliations
Review

Smoke inhalation injury during enclosed-space fires: an update

[Article in English, Portuguese]
Ana Carolina Peçanha Antonio et al. J Bras Pneumol. 2013 May-Jun.

Abstract
in English, Portuguese

In view of the tragic fire at a nightclub in the city of Santa Maria, Brazil, which culminated in the sudden death of 232 young people, we decided to review the literature regarding smoke inhalation injury caused by enclosed-space fires, which can be divided into direct thermal damage, carbon monoxide poisoning, and cyanide poisoning. Such injuries often call for immediate orotracheal intubation, either due to acute airway obstruction or due to a reduced level of consciousness. The diagnosis and the severity of the thermal injury can be determined by fiberoptic bronchoscopy. The levels of gases and gas by-products in the bloodstream should be assessed as rapidly as possible, even while still at the scene of the incident. First responders can also treat carbon monoxide poisoning, with immediate administration of oxygen at 100%, as well as cyanide poisoning, with oxygen therapy and hydroxocobalamin injection.

Aproveita-se o trágico incêndio ocorrido em uma boate na cidade de Santa Maria, RS, que culminou na morte imediata de 232 jovens, para revisarmos a literatura com relação à lesão por inalação de fumaça em ambientes fechados, que pode ser dividida em dano térmico direito, intoxicação por monóxido de carbono e intoxicação por cianeto. Essas condições frequentemente levam à necessidade de intubação orotraqueal imediata, seja por obstrução aguda de vias aéreas, seja por depressão do nível de consciência. O diagnóstico e a gravidade da injúria térmica podem ser determinados pela fibrobroncoscopia. Quanto aos envenenamentos, a dosagem dos gases ou de seus subprodutos na corrente sanguínea é possível e deve ser realizada ainda na cena do incidente. Da mesma maneira, o tratamento da intoxicação por monóxido de carbono consiste na administração imediata de oxigênio a 100%, enquanto o da intoxicação por cianeto consiste em oxigenoterapia e hidroxicobalamina injetável como antídoto.

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Figures

Figure 1
Figure 1. In A and B, severe thermal injury in a patient with extensive burns. In C, particulate matter extracted from the airway.
See this image and copyright information in PMC

References

    1. Ryan CM, Schoenfeld DA, Thorpe WP, Sheridan RL, Cassem EH, Tompkins RG. Objective estimates of the probability of death from burn injuries. N Engl J Med. 1998;338(6):362–366. http://dx.doi.org/10.1056/NEJM199802053380604 - DOI - PubMed
    1. Barillo DJ. Diagnosis and treatment of cyanide toxicity. J Burn Care Res. 2009;30(1):148–152. http://dx.doi.org/10.1097/BCR.0b013e3181923b91 - DOI - PubMed
    1. O'Brien DJ, Walsh DW, Terriff CM, Hall AH. Empiric management of cyanide toxicity associated with smoke inhalation. Prehosp Disaster Med. 2011;26(5):374–382. http://dx.doi.org/10.1017/S1049023X11006625 - DOI - PubMed
    1. Anseeuw K, Delvau N, Burillo-Putze G, De Iaco F, Geldner G, Holmström P, et al. Cyanide poisoning by fire smoke inhalation: a European expert consensus. Eur J Emerg Med. 2013;20(1):2–9. http://dx.doi.org/10.1097/MEJ.0b013e328357170b - DOI - PubMed
    1. Cancio LC. Airway management and smoke inhalation injury in the burn patient. Clin Plast Surg. 2009;36(4):555–567. http://dx.doi.org/10.1016/j.cps.2009.05.013 - DOI - PubMed