5-15. PATIENT HISTORY/PHYSICAL EXAMINATION
a. Patient History. When taking patient history, be sure to include the following
The duration of exposure to the toxic inhalant.
(2) Whether the patient was in a closed or open environment during
exposure. A person in a closed environment is more liable to have respiratory tract
damage. Inhaling of a substance in the open, however, can cause similar damage to
the respiratory tract.
(3) Whether the patient lost consciousness. If the patient lost
consciousness, mechanisms that usually protect the lower respiratory tract may not
Identity of the toxic agent(s), if possible.
b. Physical Examination. The physical examination of the patient suffering
from inhalation of toxic substances should include inspection of the mouth and face,
visual examination of the throat, and auscultation of the chest.
5-16. COMMON SIGNS/SYMPTOMS
A person who has inhaled something toxic will commonly experience irritation to
the eyes, sneezing, coughing, dyspnea (labored or difficult breathing), and/or choking.
a. First, establish and maintain an airway.
If laryngeal edema develops rapidly, you may need to perform an
endotracheal intubation or cricothyrotomy in the field.
b. Assist ventilation as needed.
c. Administer humidified oxygen in the highest concentration available to all
toxic inhalant patients, whether they seem to need oxygen or not.
d. Establish an IV lifeline with a solution of water with five percent dextrose.
e. Monitor cardiac rhythm and general status of patients who have suffered
intense exposure to smoke or toxic fumes. Continue monitoring for 18 to 24 hours.
f. Refer to table 5-1 for signs/symptoms and treatments for ammonia gas,
nitrogen oxide, sulfur oxide (SMDG), and cholorinated hydrocarbons-petroleum