What is the primary focus of the initial workup of smoke inhalation?

Updated: Oct 15, 2021
  • Author: Keith A Lafferty, MD; Chief Editor: Joe Alcock, MD, MS  more...
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In the workup of inhalation injuries caused by toxic smoke, the primary investigation focuses on the pulmonary system. Other tests may be clinically indicated based on history, physical examination, and underlying health problems. Initial blood tests should include lactate and CO-oximetry in addition to electrolytes and arterial blood gases. Carbon dioxide levels also may be monitored, since patients with prior lung disease such as asthma and chronic obstructive pulmonary disease may be affected more severely and are at greater risk to retain carbon dioxide.

Studies may include the following:

  • Pulse oximetry and CO-oximetry

  • Arterial blood gases (ABGs)

  • Carboxyhemoglobin level

  • Lactate

  • Complete blood cell count (CBC)

  • Chest radiography

  • Electrocardiogram

  • Serial cardiac enzymes (in patients with chest pain)

  • Pulmonary function testing

  • Direct Laryngoscopy and fiberoptic bronchoscopy

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