Recognition and management of smoke inhalation.

In spite of its significance, smoke inhalation has received little attention in the medical literature. Three representative case histories demonstrate the variable course of this entity and the need for individualized care of the victims. Of particular importance is recognition of the 6- to 48-hour latent period which may ensue before complications of acute bronchial obstruction, pneumonia, pulmonary edema, and eventual cardiopulmonary failure develop. Management may require tracheostomy, prolonged intermittent positive-pressure breathing with appropriate concentrations of oxygen and high humidity, and, when indicated, administration of systemic antibiotics and steroids. Frequent arterial blood gas measurements are essential for proper evaluation in these cases, both to delineate the status of the patients and to guide and determine the effectiveness of therapy. If victims of smoke inhalation can be managed through the acute phases of their illness, they often make a complete recovery.