Tag Archives: Burns

Straight, No Chaser: Fireworks Safety

Trauma, Health Prevention, , , , , , ,

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For many, the Fourth of July is a time of celebration, happiness and creation of good family memories. In the emergency room it’s one of the two worst days to have to work (excluding any Friday the 13ths that occur during a full moon…). I’d bet it’s even worse for firefighters, as over 50,000 fires are caused each year as a result of using fireworks. The presence of fireworks, grills, alcohol, driving and other hazardous activities make for an eventful day filled with many different types of trauma and drama, including the following:

  • Burns
  • Eye injuries
  • Finger/hand lacerations and amputations
  • Motor vehicle collisions

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That said, this isn’t about us; it’s about you. Let’s take advantage of this opportunity to provide you with some safety tips to prevent injuries and enjoy your holiday. Yes, some of these may sound simplistic, but failure to follow these tips are the reasons people end up in emergency rooms.

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  • Tip #1 is to leave the fireworks to the professionals. If you want to enjoy a fireworks celebration, attend a public display. Your biggest risk here will be getting stuck in traffic.
  • If you like fireworks, get the legal kind. You can always identify legal fireworks by their being labeled with the manufacturer’s name and address. Also don’t try to make your own fireworks. Doesn’t that just sound like a formula for disaster?
  • Speaking of disasters, if you are going to use fireworks, don’t drink alcohol until everything’s done. Think about it. Alcohol + fire + explosives by design aren’t meant to have a happy ending.
  • Store your animals. They will become spooked by the fireworks and can have their hearing damaged by the blasts or otherwise hurt themselves escaping.

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  • If you allow fireworks in the home, don’t allow use by kids – or do so at your own risk. Did you know that sparklers, which many parents allow as a “safer” alternative to firecrackers, can get as hot as 1,800 degrees Fahrenheit?
  • Keep any fireworks outdoors, and keep a water supply nearby. These things cause fires.
  • Here’s a common mistake: do not light fireworks while holding. This is how your hands get burned or fingers get blown off.
  • Wear eye shields when using fireworks. Folks have lost vision and eyes playing with fireworks.
  • Do not keep fireworks in your pocket, as the friction can ignite them.
  • Never point fireworks at anything other than the sky or an open space. Buildings can catch on fire, and individuals will be injured.
  • Do not light fireworks in glass or metal containers. They explode and end up stuck in people.
  • Only attempt to light one firework at a time.
  • Never attempt to relight a dud. If it ends up not being a dud, it can fire unpredictably. If you have a dud, soak it in water for twenty minutes before attempting to discard it.
  • In fact, soak all fireworks in water prior to trashing them.
  • Do not allow kids to pick up fireworks after an event. You and they don’t know if any are still active.
  • Finally, remember that fireworks are not legal everywhere. You’re rather check and be safe then be fined or arrested if your activity is discovered.

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To be complete, here are some tips in the unfortunate event that an injury occurs as a result of fireworks.

  • Go to the closest major medical center immediately. This is an example of “time is tissue.” Don’t dally at home, and I’d recommend not even stopping at the closest emergency room. In the example when your eye or limb is at risk, you’re going to want to be at a trauma and/or burn center.
  • If an eye injury occurs as a result of fireworks, don’t rub or otherwise touch it. You’re more likely to cause additional damage than do anything constructive. Along the same line, don’t spend the time attempting to flush your eyes. Grab a shield or anything that can be used to protect the eye, and get to the emergency room. If you have sustained this injury, your eye is at risk.
  • If a minor burn occurs as a result of fireworks, remove clothing, and avoid ice. If you have access to water while waiting for an ambulance, run cool (not cold) water over the burn.

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Happy Fourth of July, and I hope you feel that way at day’s end.

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what 844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.

Straight, No Chaser: Toxic Shock Syndrome

Infectious Disease, Obstetrics and Gynecology, , , , , , , , , ,

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Straight, No Chaser has addressed Staphylococcus (aka Staph) infections on several occasions; in fact, Staph is the microorganism that is responsible for all those MRSA (methicillin-resistant Staph Aureus) infections that the general public holds in such fear. Toxic shock syndrome is also primarily caused by Staph. The early take home message is you just don’t want to get this infection, and you would really do well to learn and practice preventive measures to avoid Staph infections. You may not have known it, but part of your big talks with your children about hygiene (e.g. feminine hygiene and keeping object out of your body) occur with this in mind.
Toxic shock syndrome (TSS) is a very serious disease combining fever, shock and dysfunction of several bodily organ systems. There was a time when TSS was a much bigger deal, back when extra absorbent tampon usage was very high. Tampon usage has declined as the dominant cause of TSS, but TSS cases are still around and are every bit as dangerous. The toxic part of the name refers to Staph (or in a similar syndrome, an organism called Streptococcus) releasing a toxin that travels through the body causing havoc. Picture a microorganism releasing a series of hand grenades into your blood stream, and you’ll get the picture.
Having an infection is not enough to develop toxic shock syndrome; not everyone with a Staph infection develops TSS. Here are risks for developing the disease.

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  • Burns
  • Menstruation
  • Presence of foreign bodies or packings (e.g. “lost” tampons, surgical tissues or any other objects in your body parts, nasal packings used to treat nosebleeds)
  • Recent childbirth
  • Staph infection
  • Surgery
  • Tampon use (especially if you leave one in for a long time)
  • Wound infection after surgery

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There’s not a lot of guesswork with a patient with toxic shock syndrome. The other meaning of toxic in the name is patients are very ill. By the time they come in for treatment, they tend to be confused with a low blood pressure. They may exhibit nausea, vomiting and diarrhea. High fever, chills, muscles, headaches and a violent-appearing rash resembling sunburn are to be expected. Untreated, the toxins can cause seizures and failure of multiple organ system of the body.
Treatment of toxic shock syndrome is complicated and critical, addressing a critically ill patient in shock, preserving the body’s organ systems, treating an infection, removing any foreign objects found and draining any infections (such as a surgical wound). Patients with toxic shock syndrome often find themselves in intensive care units, and the mortality rate (those who die) approaches 50%.
Your best bet in avoiding toxic shock syndrome is practicing good hygiene and avoiding the use of highly absorbent tampons. If you do use tampons, change them frequently (as directed); it’s just not a good idea to leave them in for extra periods of time trying to be frugal. Similarly the presence of any other cloth material retained anywhere inside of you (e.g. objects broken off in the ear, certain types of vaginal or anal instrumentation) is to be avoided. If you ever receive a nasal packing for a nosebleed, you should be placed on antibiotics at the same time. Be diligent after surgery, looking for any signs of fever or infection at the surgical site. Get significant burns treated.
This is something you should think about. Your simple steps of prevention really can be life-saving. I welcome your questions.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what 844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.
 

Straight, No Chaser: Your Questions on Treatment of Fire Related Injuries

Medical Treatment, Health Prevention, , , , , , , , ,

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Questions, you’ve got questions (Why are you so shy about posting them?).  Here we go.  Today, your focus is on the aftermath and treatment of fire related injury.
1)   What does carbon monoxide poisoning look like?

  • Carbon Monoxide (CO) poisoning is very dangerous because the gas is colorless and odorless.  You should suspect that you’re feeling its effect when you’re feeling like you have the flu after perhaps being in a contained area with a motor running or after a fire.  Headache is the most common symptom, and you may also feel nauseated, with malaise (feeling ‘blah’) and fatigue also being common symptoms.

2)   How are the burns treated?

  • Burns cause serious illness.  The thermal component can cause direct damage to your airway.  The toxins contained within (carbon monoxide and cyanide) can kill you independent of any other consideration.  Burns are especially prone to infection, so you don’t want significant skin burns exposed to everything outside of a burnt house while you’re waiting for the ambulance.
  • The burns will be treated according to the severity.  A lot of intravenous fluid, pain management, clear blister removal and infection control will be in order.  Especially serious burns may require a burn unit and skin grafting.

3)   What can I do to treat while waiting for the ambulance?

  • Keep calm, and keep them calm.
  • Be prepared to start CPR if necessary.
  • If any injuries have occurred to the head and neck, lay the person down and don’t move them.
  • Cover any bleeding areas, and apply enough pressure to stop external bleeding.
  • If you have a clean sheet, wrap the person in it.

4)   I know someone who says she was intubated (i.e. had a ‘breathing tube’ placed), and they were feeling fine after a fire.  Why would this have been done?

  • It’s hard to comment on the management of individual cases sight unseen, but most likely soot or burning was noted somewhere inside the airway (e.g. the mouth, nose or oral cavity).  Intubation would have been done to protect and secure the airway before in collapses.  If you wait until the last possible moment, it could be too late.

Straight, No Chaser: The Roof Is On Fire – The Trauma of Residential Fires

Health Prevention, Trauma, , , , , , , , , , , , ,

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As Trauma Week winds down on Straight, No Chaser, we work our way back home, which sadly is the site of most traumatic injuries.  In fact, about 85% of all U.S. fire deaths occur in homes.
The good news is the number of residential fire-related deaths and associated injuries is going down, but that won’t help you if you aren’t aware of how to prevent them and get to safety and cared for in the event a fire occurs in your home.  Let’s address this right off the bat.  You’re most likely to die or be injured from a fire if you’re in one of the following groups, according to the Center for Disease Control (but of course, the fire doesn’t check who’s being burnt):

  • Poor
  • Rural
  • African-American
  • Native American
  • Ages less than 4 or over 65

In the U.S. (2010 data), someone dies every 169 minutes and is injured every 30 minutes, amounting to over 2,500 deaths and over 13,000 injuries (and that’s not including firefighters).  Interestingly, victims aren’t burning to death as much as they are dying from inhalation injuries from smoke and gases (estimated to be the cause of death in between 50-80% of cases).  Speaking of smoke, although cooking is the #1 cause of fires, smoking is the leading cause of fire-related deaths.  Alcohol consumption is a contributing factor in 40% of residential fire deaths.  Most fires occur in the winter.
So What To Do?

  • Install a smoke alarm.  They work.  Over one-third of residential fire deaths occur in homes without alarms.
  • Plan your escape in advance.  Have an exit strategy based on where a fire might break out in your home.
  • Don’t fight the fire.  Nearly ½ of fire related injuries occur from efforts to fight the fire.  Get out of the house.  Of course if you have easy access to an extinguisher, use at your discretion.

Tips on How You’ll Be Treated
Fire-related injuries commonly involve burns and bony injuries (bruises, sprains, fractures), which will be addressed as needed.  However, the most important fire-related injuries involve the airway.  These injuries may be due to the heat’s effects on the airway (burns, swelling and inflammation) and/or the effects of carbon monoxide and/or cyanide (inability to oxygenate).  One important fact for families to realize is the presence of any soot/burns anywhere near or in the mouth or nose needs to be evaluated.  Such signs and symptoms are powerful predictors of potential airways damage and imminent failure.