Other than burns, smoke inhalation is the greatest threat posed by fires. Smoke can burn delicate airways and deprive your body of oxygen. It also contains poisonous gases that can badly damage your throat, lungs, heart, brain, and other organs. Inhaling even a little smoke may affect breathing. Exposure to large amounts can be fatal.
When to go to the emergency room (ER)
Smoke inhalation is a medical emergency. Call
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A cough.
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Shortness of breath.
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Hoarseness or noisy breathing.
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Headaches, nausea, or vomiting.
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Changes in skin color, ranging from blue to "cherry red."
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Confusion, fainting, or seizures.
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Death.
What to expect in the ER
Heart rate, breathing, and blood pressure will be checked, and the affected person will be examined carefully. One or more tests may be done.
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A chest X-ray may help show damage to lungs.
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Pulse oximetry checks oxygen levels using a light probe attached to the finger.
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A carboxyhemoglobin test measures blood levels of carbon monoxide, a deadly gas found in smoke.
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A blood test may be used to measure cyanide. This is another deadly gas found in smoke from house, vehicle, and industrial fires.
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An electrocardiogram (ECG) detects heart problems.
Treatment
Treatment focuses on keeping airways open and providing oxygen. Oxygen may be given through a mask or a nasal cannula. This is a thin tube with two prongs that fit inside the nostrils. If the airways are swollen or you can't breathe on your own, the doctor may place a breathing tube through your nose or mouth into your throat. If you have a severe case of smoke inhalation or carbon monoxide poisoning, you may be transferred to a hyperbaric oxygen center. There, you will be given oxygen in a special compression chamber. In severe cases, you may need treatment for other poisonous gases released by the fire, such as cyanide. You may be given I.V. (intravenous) antidotes for cyanide poisoning. If you were exposed to a lot of the gas, you will likely need to stay in the hospital for at least 24 hours.
If you're caught in a building with smoke
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Drop to your knees, and crawl to the nearest exit. Because smoke rises, there is less smoke near the floor.
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Put your shoulder against a wall to guide you.
Online Medical Reviewer: Eric Perez MD
Online Medical Reviewer: Ronald Karlin MD
Online Medical Reviewer: Tara Novick BSN MSN
Date Last Reviewed: 06/01/2025
© 2000-2026 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.
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