Score of Clark et al for Smoke Inhalation

 

Parameters:

(1) history of being trapped in a house or industrial fire in an enclosed space

(2) carbonaceous sputum (black, gritty)

(3) perioral and/or facial burns

(4) altered level of consciousness or confusion at any time

(5) symptoms of respiratory distress (sense of suffocation, choking, breathlessness, wheezing) or discomfort affecting the eyes or throat (with irritation of the mucous membranes)

(6) signs of respiratory distress (stertorous/sonorous, laboured breathing, tachypnea) or ausculatory abnormalities such as crepitations or rhonchi?

(7) hoarseness or loss of voice

Parameter	Response	Points
history of being trapped in a house or industrial fire in an enclosed space	no	0
	yes	1
carbonaceous sputum	no	0
	yes	1
perioral and/or facial burn	no	0
	yes	1
altered level of consciousness or confusion at any time	no	0
	yes	1
symptoms of respiratory distress or discomfort affecting the eyes or throat	no	0
	yes	1
signs of respiratory distress or ausculatory abnormalities	no	0
	yes	1
hoarseness or loss of voice	no	0
	yes	1

 

aggregate score =

= SUM(points for all 7 items)

 

Interpretation:

• minimum score: 0

• maximum score: 7

• A score > 2 indicates unequivocal smoke inhalation.

• The higher the score, the greater the severity of inhalation injury.

 

The score could be modified to include blood gas data or need for ventilatory support, but this data probably would not be available prior to arrival at the hospital.

 

Limitations:

• A person may have thermal burns to the face and mucous membranes without smoke inhalation.

• A person may be confused or have altered consciousness for other reasons than smoke inhalation and indeed this might have contributed to the starting of the fire.