Dysphonia and bronchial ronchi are predictive of delayed lung injury possibly resulting in acute respiratory failure. Irritant gases contained in smoke are responsible for the ocular and respiratory mucosal injuries. The occurrence of hypotension, abnormal respiratory pattern and/or significant lactic acidosis (with plasma lactate concentration ≥10 mmol/l) is consistent with smoke inhalation induced-cyanide poisoning. In smoke inhalation victims, loss of consciousness may result from either CO or CN inhalation, although differentiating the exact role of each of them remains quite impossible. Carbon monoxide and cyanide are the main gases produced during combustion in fires: they are responsible for a syndrome of oxygen deprivation. It represents the first cause of death at the fire scene and after hospital admission. Smoke inhalation causes systemic and mucosal toxicity due to the asphyxiant and irritant properties of toxic gases.
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