Inhalation of smoke and harmful gases is the leading cause of death related to a fire, by causing asphyxiation and respiratory failure. This is explained by the Spanish Society of Emergency Medicine (SEMES) on the occasion of the Valencia event, in which at least nine deaths have been recorded.
The president of this medical society, Tato Vázquez, explains that smoke inhalation syndrome is an intoxication derived from the products of combustion, such as when there is a fire. And it is mainly due to three substances, although there are more than 60 gases in a complete combustion.
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Irritating gases
The first ones are irritating gases, and there are many of them, according to Vázquez, such as nitrous oxide or phenols. They produce an irritating condition in the mucous membranes: tearing in the eyes, dysphonia, hoarseness and if these gases go down to the tracheobronchial level, they produce chemical pneumonitis, which can lead to bacterial superinfections.
But in addition to the irritating effect, the expert cites the high temperatures that these gases reach and that can cause burns in the airways.
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“Emergency professionals, when we see that the vibrissae, the hairs on the nose, are burned, we assume that the gas has reached high temperatures and has caused burns in the airway, and we proceed to isolate it to prevent asphyxiation” says the president of SEMES.
Matters in suspension
The suspended matter They are other substances, normally derived from carbon. They are small molecules that are deposited in the airways and can cause respiratory diseases.
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The silent killers
In third place are the most dangerous substances, they are non-irritating gases but asphyxiants, mainly two: carbon monoxide and cyanide.
The first of them, carbon monoxide, is absorbed very quickly when inhaled. It fixes on hemoglobin and prevents it from transporting oxygen to the tissues, causing their death. Symptoms are headache, chest pain, and sometimes nausea, vomiting, and diarrhea.
“It is an extremely toxic gas and is not routinely detectable, it is odorless and tasteless, we call it the silent killer,” emphasizes Vázquez.
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As soon as to cyanide, is produced by the combustion of plastic. It is also very quickly absorbed and does not allow the use of oxygen by the cells, which leads to death.
Inhalation of these gases requires specific treatment.
For carbon monoxide poisoning, oxygen in high concentrations is indicated and in severe cases, hyperbaric oxygen. The cyanide one, with cyanocobolamine, which is available in most emergency services in the country, says the president of SEMES.
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Burns on the skin
On the other hand, the Spanish Society of Intensive Care Medicine and Coronary Units (SEMICYUC) points out that ICUs are the “cornerstone” for the recovery of major burns. These are patients with more than 20% of their body burned or who suffer less extensive burns but with an age or comorbidities that require extensive intravenous fluid replacement.
“The skin is just another organ and its loss has repercussions on the entire body,” says Manuel Sánchez, a specialist in major burns at the Intensive Medicine service at the La Paz University Hospital in Madrid.
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As indicated, it is common for these patients to simultaneously need treatments and techniques that are commonly used in ICUs, such as control of fluid intake and medication to maintain adequate blood pressure, mechanical ventilation, dialysis techniques, sedation, or treatment of infections.
In addition, in these units there are dressings that facilitate healing and creams that eliminate eschar. The burnwhich can avoid surgeries.
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“In Spain we have been pioneers in the use of some types of monitoring that provide important information for the initial treatment, in the search for treatments that address the cause of complications rather than their consequences and in the use of creams that remove dead tissues without the need for surgery,” emphasizes the expert.
Adequate initial treatment prevents the deepening of the burn and the development of complications in other organs, it abounds.
(With information from EFE)
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