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.