Diseases and Conditions Treated with Hyperbaric Oxygen Therapy

conditions image

Smoke Inhalation

Definition and Causes

Smoke inhalation is the leading cause of death related to fire. Victims of smoke inhalation suffer a combination of injuries from airborne particles, burns to the throat and lungs, and chemical poisoning.

The combustion of plastics, textiles, and other synthetic materials produces a highly toxic mix of cyanide and carbon monoxide. Both carbon monoxide (CO) and cyanide bind to hemoglobin in red blood cells and block their capacity to carry oxygen to cells and tissues.

Inhaling even small amounts of fire smoke can be fatal. Serious and sometimes permanent neurological effects may be delayed days or weeks after acute poisoning.

Hyperbaric Oxygen Approval Status

FDA Cleared: Yes Learn more about clearance
and approval status »
UHMS Approved: Yes

Read the Carbon Monoxide Poisoning and Cyanide Poisoning pages in the Undersea and Hyperbaric Medical Society resource library to learn more about cyanide poisoning, the rationale for hyperbaric oxygen therapy, and key clinical evidence, outcomes, and success factors.

Treatment with Hyperbaric Oxygen Therapy

Hyperbaric oxygen therapy (HBOT) is indicated for the emergency treatment of carbon monoxide poisoning complicated by cyanide poisoning after smoke inhalation. HBOT dissolves additional oxygen in the blood plasma and has been shown to work effectively alone and in combination with hydroxocobalamin (Cyanokit) and other cyanide antidote kits.

hyperbariclink commentary

The emergency treatment of smoke inhalation offers perhaps the single best reason for the healthcare community to demand 24/7 access to hyperbaric chambers across the US. Cyanide, carbon monoxide, inhaled particulates, and thermal injuries together require speedy action to save the lives of firefighters and other fire victims. The clinical evidence for HBOT may not be as strong for nonfire cyanide poisoning as for nonfire carbon monoxide poisoning, but the benefits of oxygen are well established. As [Medscape] puts it: “Oxygen and sodium thiosulfate are the most widely accepted cyanide antidotes…. The mechanism of action of oxygen as a cyanide antidote is unclear, but it potentiates the effect of other antidotes. When used in the setting of smoke inhalation, it is also therapeutic for CO poisoning. Thus, high concentrations of oxygen should be promptly delivered.” Ongoing surveillance projects and prospective trials may bolster the clinical case for HBOT in the routine treatment of smoke inhalation.

Approved
FDA cleared, widely reimbursed
Compelling
Strong body of evidence
Promising
Repeatedly favorable results
Scant
Early or mixed results
None
Unfavorable or no evidence
Disproved
Strong evidence against HBOT

Learn more about Evidence Index ratings, the research we use, and how we assign scores »

Patient Resources

HyperbaricLink recommends the following websites for anyone seeking authoritative information, patient advocacy, and community support for smoke inhalation.

National Fire Protection Association (NFPA)

A leading authority on fire, electrical, and building safety, the NFPA provides free PDF downloads with excellent carbon monoxide safety tips and CO detector guidelines.

US Consumer Product Safety Commission (CPSC)

Protecting consumers and families from products that pose a fire, electrical, chemical, or mechanical hazard, the CPSC provides information about smoke alarms and carbon monoxide detectors.

Clinical Resources

Start with the following resources to explore current research activities and the peer-reviewed medical literature on hyperbaric oxygen therapy for smoke inhalation.

Centers for Disease Control and Prevention (CDC)
US Department of Health and Human Services (HHS)

The CDC is dedicated to protecting health and promoting quality of life through the prevention and control of disease, injury, and disability. Its programs reduce the health and economic consequences of the leading causes of death and disability. The CDC website includes resources on Fires in its section on home and recreational safety.

ClinicalTrials.gov
National Institutes of Health

ClinicalTrials.gov keeps the official list of human clinical trials currently enrolling, in progress, and recently completed. One may reasonably question the size and legitimacy of any study not listed here.

Search ClinicalTrials.gov for current studies of hyperbaric oxygen therapy and smoke inhalation poisoning

Google Scholar

A specialized Google search engine, Google Scholar indexes scholarly articles, patents, and legal opinions and journals. Google Scholar may generate excessive search results, but entries provide easy access to full-text journal articles.

Search Google Scholar for "smoke poisoning" and "hyperbaric oxygen"

Medscape

A service of WebMD, Medscape offers specialists, primary care physicians, and other health professionals robust and integrated medical information and educational tools. The website devotes several well-referenced paragraphs to hyperbaric oxygen therapy under Emergency Department Care for smoke inhalation.

PubMed.gov
US National Library of Medicine
National Institutes of Health

PubMed keeps the official list of scientific papers published in reputable peer-reviewed medical journals. One may reasonably question the importance and legitimacy of any study not listed here.

Related Terms

  • Asphyxiation
  • Carbon monoxide (CO) poisoning
  • Cyanide antidote kit (CAK)
  • Cyanogen chloride (CNCl) (CK)
  • Emergency medical services (EMS)
  • Emergency medical technician (EMT)
  • Fire
  • Firefighter
  • Hydrogen cyanide (HCN) (AC)
  • Hydroxocobalamin (Cyanokit)
  • Paramedic
  • Potassium cyanide (KCN)
  • Sodium cyanide (NaCN)
  • Sodium thiosulfate
  • Vitamin B12

News About Smoke Inhalation and Hyperbaric Oxygen Therapy

Summer Reading List: Young Men and Fire, by Norman Maclean

Wednesday, 6/13/2012

Across the western US today thousands of firefighters battle 19 active wildfires, on the ground, from the air, under thankfully improving weather conditions. Our thoughts with them. And to our readers once more we recommend read more...

More news from O2.0 – the HyperbaricLink blog


Complete smoke inhalation archive from O2.0 — the HyperbaricLink blog

Further Reading

HyperbaricLink suggests
Young Men and Fire
by Norman Maclean
University of Chicago Press
1992

Young Men and Fire, Norman Maclean
Sources
Undersea and Hyperbaric Medical Society, Indications, Carbon Monoxide Poisoning. Retrieved 26 November 2011.
www.uhms.org/?page=CMP
Undersea and Hyperbaric Medical Society, Indications, Cyanide Poisoning. Retrieved 27 November 2011.
www.uhms.org/?page=CP
WebMD, emedicinehealth, Smoke Inhalation. Retrieved 27 November 2011.
www.emedicinehealth.com/smoke_inhalation/article_em.htm
Page Data
Updated: 30 Nov 2011 02:38 PM
Created: 30 Nov 2011 02:48 PM
By: About the authors »