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.
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
Carbon Monoxide Poisoning
pages in the Undersea and Hyperbaric Medical Society resource library to learn more about carbon monoxide poisoning and carbon monooxide poisoning complicated by 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 and 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.
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
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
HyperbaricLink recommends the following websites for anyone seeking authoritative information, patient advocacy, and community
support for smoke inhalation.
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.
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.
Start with the following resources to explore current research activities and the peer-reviewed medical literature on
hyperbaric oxygen therapy for smoke inhalation.
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
in its section on home and recreational safety.
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
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"
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
Emergency Department Care
for smoke inhalation.
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.
Search PubMed.gov for journal articles relating to hyperbaric oxygen therapy and smoke inhalation
- Carbon monoxide (CO) poisoning
- Cyanide antidote kit (CAK)
- Cyanogen chloride (CNCl) (CK)
- Emergency medical services (EMS)
- Emergency medical technician (EMT)
- Hydrogen cyanide (HCN) (AC)
- Hydroxocobalamin (Cyanokit)
- Potassium cyanide (KCN)
- Sodium cyanide (NaCN)
- Sodium thiosulfate
- Vitamin B12
Young Men and Fire
by Norman Maclean
University of Chicago Press