This is the podcast, ICU rounds.

My name is Dr. Jeffrey Guy.

I'm an associate professor of surgery and director at the Burns Center

at the Vanderbilt University School of Medicine in Nashville, Tennessee.

This topic we're going to discuss is that of smoke inhalation,

and it's important to recognize that smoke inhalation is one of the most common cause of fire-related deaths.

Structure of fires contain about 400 toxic compounds.

When you break down what is smoke, smoke is basically products of incomplete combustion, and it basically results in a particulate matter or for lack of a better descriptor dust.

And that dust then is inhaled and it has toxic effects on the airways and the lung parankuma.

Some common materials that are toxic that are infound in smoke typically include things such as carbon monoxide, polyvinyl chloride, carbon dioxide, ammonia as well as cyanide.

Now, the isolated smoke injury, basically somebody who is involved in a structure of fire

inhales smoke but doesn't have associated burn injuries, has a mortality rate of approximately

10%. And that's referenced by Thompson and colleagues in the Journal of Trauma, 1986, Volume 26, pages 163 to 165.

Now, when you combine a smoke inhalation injury with a thermal burn, that will actually increase the mortality rate to about 20% for the smoke inhalation. Now, that has to be

compounded with what is the mortality of the other associated trauma, be it a 50% burn

or multiple fractures. So smoke inhalation is clearly problematic and taking care of patients

with burn-related injuries. Now, there are several elements of a smoke-related injury.

There is the asphyxiation.

There is the actual thermal injury of inhaling heated gases, and then there's what we

call delayed toxic lung injury.

Let's take what some people would consider perhaps the most obvious, and that is the thermal

injury of inhaling hot gases.

...