Monday, June 04, 2007

Smoke inhalation

I was trying to explain the different varieties of smoke inhalation to a reporter the other day, actually to a few reporters in separate phone conversations over the last few days. Not all deaths from smoke inhalation have the same etiology.

Breathing in the products of combustion (smoke) can kill in several ways. Carbon monoxide is produced from burning stuff and is the most common poison in smoke that kills and the most common cause of smoke inhalation death. It is a cellular respiration toxin, for those of you inclined to detail, although it is often spoken of as a more general toxin. There can be other toxins in the smoke that are equally fatal, such as cyanide from burning plastics. Particulates in the smoke can cause airway irritation, airway swelling, airway “compromise” and death. One smoke inhalation insult that is unusual, but did cause a death in our county the other day, is breathing in the super-heated air of the fire with resultant airway damage and death from asphyxia. An even more unusual cause of smoke inhalation death is lack of oxygen in the immediate environment around the fire causing asphyxia, so I guess it really isn’t exactly a smoke inhalation death, but certainly belongs in the “same family”.

The whole mix is then complicated by underlying disease states, concomitant other substance exposure, and all the other stuff that can complicate stuff.

Not all smoke inhalation is the same and it isn’t always what it may seem at first blush. Death is seldom simple.

5 comments:

Anonymous said...

Interesting! As always, this blog is a learning experience. Of the smoke inhalation types mentioned, I'd prefer carbon monoxide. I hope everyone has their smoke detectors and CO detectors in place!

Anonymous said...

Is there a difference between carbon monoxide death from car exhaust and carbon monoxide death from a house fire?

Dr. Richard Keller said...

Carbon Monoxide is Carbon Monoxide, and death from carbon monoxide will be the same regardless of the source. That being said with a house fire you would expect to see much more soot, ash, and particulate matter in the upper airways from all of the assorted materials that would burn. Also, in a house fire, you often have a component of cyanide poisoning as well. Many plastics release cyanide when burned.

I hope that answers you question, thanks for asking.

Unknown said...

Why would they list Inhalation of Products of Combustion and manner of death SUICIDE

Dr. Richard Keller said...

If the investigation of the events surrounding the individual's death reveal that the fire in which they died from inhalation of smoke, etc was intentionally set by them in an attempt to kill themselves the manner would be deemed Death by Suicide. The cause would then be Inhalation of Products of Combustion.