An evaluation of the Airway, Breathing, and Circulation (the ABCs) should receive first priority. The history should include the time, location, and circumstances of the injury, where the patient was found, and their condition. Past medical and social history, current medication usage, drug allergies, and tetanus status should be rapidly determined.Smoke inhalation causes more than 50% of fire-related deaths. Patients sustaining an inhalation injury may require aggressive airway intervention. Most injuries result from the inhalation of toxic smoke; however, superheated air may rarely cause direct thermal injury to the upper respiratory tract.Patients who are breathing spontaneously and at risk for inhalation injury should be placed on high-flow humidified oxygen. Patients trapped in buildings or those caught in an explosion are at higher risk for inhalation injury. These patients may have facial burns, singeing of the eyebrows and nasal hair, pharyngeal burns, carbonaceous sputum, or impaired mentation. A change in voice quality, stridorous respirations, or wheezing may be noted. The upper airway may be visualized by laryngoscopy, and the tracheobronchial tree should be evaluated by bronchoscopy. Chest radiography is not sensitive for detecting inhalation injury.