When the environmental temperature is too high, such as in a fire, inhaling hot air into the body damages the airways from the nose to the lungs, causing internal burns, making it difficult to observe, difficult to treat, and dangerous complications.
Doctor Diep Que Trinh, Head of the Department of Radiology and Plastic Surgery, Children’s Hospital 1 (HCMC), explained that respiratory burns will first cause edema and fluid secretion in the airways. After that, the airways narrow and the lack of oxygen entering the body becomes even more lacking, causing even more edema. At some point, the body will be poisoned due to lack of oxygen.
According to doctor Nguyen Thai Ngoc Minh, Department of Emergency Resuscitation, Le Huu Trac National Burn Hospital (Hanoi), respiratory burns are a special type of burn, accounting for about 30% of the total number of severe burn patients. Respiratory burns occur when inhaling burning agents such as fire, hot gas, hot steam, or chemical products formed from burning substances. The degree of respiratory damage depends on factors such as the heat of the agent, the burning agent and the duration of exposure to the burning agent.
Basically, each fire produces different types of smoke depending on the toxic materials present at the scene. For example, PVC plastic can produce hydrogen chloride, phosphagen; Wood and fabric create hydrogen cyanide, ammonia, hydrogen sulphide… However, when burned, almost all materials create toxic gases, the most common being carbon monoxide (CO) and carbon dioxide (CO2).
Therefore, according to Dr. Trinh, in addition to skin burns, victims can also be poisoned by gases formed during the burning process such as CO and cyanide, leading to death very quickly. At Le Huu Trac National Burn Hospital (Hanoi), respiratory burns are an independent risk factor that increases the death rate from burns.
“About 20-40% of patients with respiratory burns without gas poisoning will die, but if combined with inhalation of toxic gases, the death rate can reach 90%,” said Dr. Minh.
A patient in a motel fire in Trung Kinh, Hanoi, treated at the Transport Hospital on the morning of May 24. Image: Mr. Phu
Respiratory burns cause three types of damage: direct heat damage and airway necrosis; inhaling toxic gases, stimulating airway damage, lung damage; Toxic gases CO and cyanide seep from the lungs into the blood.
Respiratory burn patients often suffer very serious lung damage, leaving many complications such as respiratory failure. In the early stages, the patient’s airway is blocked by mucus, the mucous membrane becomes necrotic and falls off into the airway, leading to death. In the late stage, patients develop pneumonia and progressive acute respiratory distress syndrome, with a mortality rate of 80%.
Therefore, patients with respiratory burns need to be treated promptly, taken to a well-ventilated area or given oxygen support immediately to remove CO and cyanide from the body. The patient will have an airway endoscopy to look for foreign objects, suction out blocked sputum, and diagnose the burn location and extent of the burn to have an appropriate treatment regimen.
Experts recommend that when inhaling smoke or gas, you should not be subjective and seek medical attention because there is a potential risk of pneumonia. In particular, when there are symptoms of cough, mild difficulty breathing, spitting up black phlegm like soot, headache, nausea, rapid breathing, rapid pulse, you must go to the hospital immediately.
Regarding escape skills, experts advise that when there is a lot of smoke when there is a fire, find the way out by crouching low, close to the floor, and do not stand tall. Exit to the balcony and wait for rescue or go down the stairs. Use a wet towel to cover your nose and mouth to prevent toxins from entering the respiratory tract.
In the early morning of May 24, a fire broke out in a boarding house in Trung Kinh, Hanoi. 14 people died, 6 people were taken to the emergency hospital, most with respiratory burns. Among them, an 84-year-old woman has the most serious condition, deep respiratory burns, with no prognosis for treatment.