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Methemoglobinemia resulting from smoke inhalation
1New York City Poison Control Center, New York 10016.
Veterinary and Human Toxicology
|April 1, 1989
Summary
Methemoglobinemia after fire exposure is often overlooked. This condition, causing tissue hypoxia and cyanosis, can complicate diagnoses alongside carbon monoxide and cyanide poisoning in fire survivors.
Area of Science:
- Emergency Medicine
- Toxicology
- Environmental Health
Background:
- Fire-related deaths and illnesses are typically linked to burns, trauma, or carbon monoxide poisoning.
- Cyanide poisoning from burning plastics is an emerging concern in fire victim assessment.
- Methemoglobinemia is an underrecognized complication of smoke inhalation.
Observation:
- This study presents three cases of significant methemoglobinemia in individuals who survived a house fire.
- Observed methemoglobin levels were 19%, 12%, and 12% in the affected survivors.
- Symptoms of methemoglobinemia, like cyanosis and hypoxia, can be masked by other fire-related injuries.
Findings:
- Methemoglobinemia can occur following fire exposure, independent of or in conjunction with other toxic exposures.
- The presence of methemoglobinemia can exacerbate the effects of carbon monoxide poisoning on oxygen delivery.
- Diagnosing methemoglobinemia in fire survivors presents a clinical challenge due to overlapping symptoms.
Implications:
- Clinicians should consider methemoglobinemia in fire survivors presenting with hypoxia or cyanosis, even with other apparent injuries.
- Early recognition and treatment of methemoglobinemia are crucial for improving outcomes in fire victims.
- Further research is needed to understand the prevalence and management of methemoglobinemia in fire-related incidents.