A 23-year-old female rescued from a fire coughs up black phlegm. What gas should you suspect she inhaled?

The presence of black phlegm in a patient rescued from a fire is indicative of inhaling smoke and potentially toxic gases produced during combustion. In this context, cyanide is a strong possibility because it is often released when organic materials such as plastics and other carbon-based substances are burned.

When inhaled, cyanide can cause severe respiratory distress and metabolic toxicity. The heat and byproducts produced in a fire commonly lead to the production of both carbon monoxide and cyanide gas, particularly in enclosed spaces. Black phlegm primarily suggests that the person has inhaled soot or smoke from the fire, which often contains particulates along with toxic gases. Given these factors, the identification of cyanide as a potential inhalation threat is appropriate, especially when considering the nature of organic combustion in fire scenarios.

Understanding the types of gases that can be inhaled during a fire, including their effects on the body, is crucial for emergency responders when evaluating and treating victims of smoke inhalation.