Inhalation burns are injuries to the mouth, throat and airway caused by breathing in hot air, smoke, steam or toxic fumes. They are among the most dangerous burns because the delicate lining of the airway swells quickly, and breathing can become impossible within hours. Any person rescued from a fire in an enclosed space, or with burns to the face or front of the chest, should be assumed to have inhalation burns until a doctor decides otherwise.
When to Suspect Inhalation Burns
- The person was in a fire, an enclosed space with smoke or an explosion
- Burns to the face, lips, neck or front of the chest
- Singed nose hair, eyebrows or eyelashes
- Soot around the nose or mouth, or sooty sputum
- Hoarse voice, a harsh cough or noisy breathing
- Difficulty swallowing, pain in the mouth or throat
- Drowsiness, confusion or headache, which may point to carbon monoxide poisoning
Initially the person may look well, but symptoms can worsen over the first 24 hours as swelling develops.
Inhalation Burns First Aid Steps
- Ensure your own safety. Do not enter a smoke-filled or burning area unless trained and equipped. Call the fire service and the ambulance.
- Move the person to fresh air and away from further smoke.
- Check DRABC. Open the airway and check breathing using the DRABC primary survey. Start CPR if breathing stops.
- Sit them upright if they are breathing, which makes breathing easier, and loosen tight clothing around the neck and chest.
- Give oxygen if you are trained and equipment is available. High-flow oxygen is recommended for suspected smoke inhalation because of the risk of carbon monoxide poisoning.
- Cool any skin burns with cool running water for 20 minutes where possible, as in burns first aid, without delaying airway care.
- Monitor continuously for hoarseness, noisy breathing and increasing drowsiness. Record breathing rate, pulse and alertness regularly using our vital signs observations guide.
Why Inhalation Burns Need Hospital Care
Swelling of the throat can develop quickly and block the airway, sometimes after an initial period of apparent recovery. Hospital teams can examine the airway, give oxygen, treat poisoning and, if needed, place a breathing tube before it becomes impossible. Smoke can also carry carbon monoxide and cyanide, which starve the body of oxygen without obvious burns. See our guide to carbon monoxide poisoning.
Hot Drinks and Chemical Swallowing
Burns to the mouth and throat can also follow swallowing very hot liquids or corrosive chemicals. Keep the person upright, give nothing to eat or drink unless a poison centre advises, and call for urgent help. For corrosive swallowing see corrosive poisoning first aid.
Inhalation Burns Prevention at Work
Working near hot processes, welding, fires or confined spaces needs fire detection, escape plans, smoke hoods or respirators, and trained first aiders. After any fire incident, send everyone who breathed smoke for medical review, even if they feel fine. Recognising inhalation burns early saves lives.
Frequently Asked Questions
Can inhalation burns appear hours later?
Yes. Airway swelling can develop over several hours, so people exposed to smoke should be observed and assessed by a doctor.
Is a cough after smoke exposure serious?
It can be. A persistent cough, hoarse voice or noisy breathing needs urgent evaluation.
References and Further Reading
Last updated: November 2026
Prepared by: EHS Guidelines Editorial Team
This article is general educational information and is not a substitute for accredited first aid training or professional medical care. In an emergency, call your local emergency number immediately. Emergency numbers, medicines and protocols differ between countries, so follow local guidance.
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