MEDICAL-FORENSIC FILES: Effects of Smoke Inhalation

How Would Smoke Inhalation Affect My Police Officer?

Q: In my story, a police officer suffers smoke inhalation while trying to extinguish a barn fire before fire fighters arrive. What injuries would he have that would hospitalize him for a few hours to a day, but wouldn't result in enough long-term damage to end his career as an active police officer?

A: The major effect of smoke and soot in the air is irritation of the eyes, throat, and bronchial tubes in the lungs. This would cause inflammation, swelling, and weeping of fluids from these tissues. His eyes would water and become red and painful. The same would occur in the throat and the bronchial tubes. He would experience chest burning, cough, and might produce small amounts of watery sputum that could be tinged with black dots of soot and red flecks of blood.

If you have ever had severe bronchitis as part of the flu, and I’m sure you have, this discomfort is exactly what breathing and coughing would feel like in this situation. The difference is that a flu typically lasts for several days or a week, while this could only last a few hours or a day or two at the most—unless a secondary bacterial infection took hold, which can happen when the bronchial tubes are damaged in this way. This would change simple bronchial irritation into an acute bacterial bronchitis and that would require antibiotics and take a while to clear. I don’t think this is what you want, however.

Since he is a police officer, and this would be a job-related injury, he would be taken to the emergency room for evaluation and treatment. They would check the oxygen content of his blood by a gadget called a pulse oximeter—this is a clip placed on the finger that measures the amount of oxygen in the blood. They would also take a chest x-ray, which would likely be normal. He would then be treated with a couple of days of steroids and a week of antibiotics.

The steroids would help reduce the inflammation and the antibiotics would prevent any secondary infection, as I mentioned above. The steroids could be Prednisone, Medrol, dexamethasone, hydrocortisone, and others.  Antibiotics for this include amoxicillin, ciprofloxacin, azithromycin, and others.

If all he had was a cough and a bit of chest discomfort and his oxygen saturation and chest x-ray were normal, he would be discharged and instructed to rest and avoid air-born irritants and exercise. After a couple of days, he would likely be fit for duty. On the other hand, if his chest x-ray was abnormal, his oxygen levels reduced, or his chest pain considerable, he might be held in the hospital overnight for observation. 

DP Lyle, MD

www.dplylemd.com

This question originally appeared in MORE FORENSICS & FICTION by DP Lyle