Last reviewed: 6 Nov 2021
Last updated: 19 Nov 2019

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • similarity of symptoms to those of others at site of exposure
  • cough
  • dyspnoea
  • hoarseness or dysphonia
  • headache
  • dizziness
  • tachypnoea
  • hypoxia
  • facial burns
  • upper airway oedema
  • stridor
  • wheezing
  • crackles
  • loss of consciousness
  • seizures

Risk factors

  • known inhalation exposure

Diagnostic investigations

1st investigations to order

  • pulse oximetry
  • arterial blood gas
  • carboxyhaemoglobin (CO-Hb) level
  • CXR
  • ECG
  • cardiac telemetry monitoring
  • urine toxicology screen
  • serum ethanol level

Investigations to consider

  • pulmonary function tests (PFT)
  • laryngoscopy and bronchoscopy
  • serum lactate

Treatment algorithm

Contributors

Authors

Matthew R. Stutz, MD

Fellow

Section of Pulmonary and Critical Care Medicine

Department of Medicine

University of Chicago

Chicago

IL

Disclosures

MRS declares that he has no competing interests.

Jason T. Poston, MD

Associate Professor

Section of Pulmonary and Critical Care Medicine

Department of Medicine

University of Chicago

Chicago

IL

Disclosures

JTP declares that he has no competing interests.

Acknowledgements

Dr Matthew R. Stutz and Dr Jason T. Poston would like to gratefully acknowledge Dr Karen C. Dugan and Dr John P. Kress, previous contributors to this topic. KCD and JPK declare that they have no competing interests.

Peer reviewers

Leopoldo C. Cancio, MD

Critical Care Fellow

US Army Burn Center

US Army Institute of Surgical Research

Brooke Army Medical Center

Fort Sam Houston

TX

Disclosures

LCC declares that he has no competing interests.

Rhys Thomas, MD

Honorary Consultant in Anesthesia and Intensive Care

Queen Victoria Hospital

East Grinstead

Honorary Consultant

Royal London Hospital

London

UK

Disclosures

RT declares that he has no competing interests.

Brendan Madden, MD, MSc, FRCP, FRCPI

Professor of Cardiothoracic Medicine

St George's Hospital

London

UK

Disclosures

BM declares that he has no competing interests.

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