When is hospitalization indicated in the treatment of smoke inhalation injury?

Updated: Oct 15, 2021
  • Author: Keith A Lafferty, MD; Chief Editor: Joe Alcock, MD, MS  more...
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Answer

Patients with smoke inhalation should be monitored for 4-6 hours in the ED. Those who are at low risk for injury and whose vital signs and physical examination findings remain normal can usually be discharged with close follow-up and instructions to return if symptoms develop. Patients with any of the following should be strongly considered for hospitalization:

  • History of closed-space exposure for longer than 10 minutes

  • Carbonaceous sputum production

  • Arterial PO2 less than 60 mm Hg

  • Metabolic acidosis

  • Carboxyhemoglobin levels above 15%

  • Arteriovenous oxygen difference (on 100% oxygen) greater than 100 mm Hg

  • Bronchospasm

  • Odynophagia

  • Central facial burns


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