January 2011 Archives

January 28, 2011

Accommodating Workers With Burns (partII)

Psychological issues that burn patients may deal with may include anxiety, depression, post traumatic stress disorder (PTSD). Employers and supervisors can provide support to the burn victims by:

  • Written job instruction provision.
  • Positive praise and reinforcement.
  • Long term and short term goals establishment.
  • Developing good strategies to deal with problems before they arise.
  • Developing a procedure in order to evaluate the effectiveness of the accommodation.
Coworkers' interaction:
  • Providing sensitivity training to supervisors and coworkers.
  • Employees' education on their accommodation rights.
  • Employees are encouraged to move non work related conversations out of the work place.
In case the burn victim has difficulty dealing with his/her emotions, the following things can be done by the employer to help:
  • Referring employees who need help to counseling assistance.
  • Allowing telephone calls to be made during work hours to doctors and other support groups.
  • Allowing support animals to be present at work place.
  • Allowing brakes to be taken by the employee as needed.
In case of sleep disorders, employers can help by:
  • Allowing work hours to be flexible.
  • Allowing breaks to be taken frequently.
  • Allowing work to be done from home.
This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.
January 27, 2011

Fast Treatment of Smoke Inhalation Critical to Recovery


In a small town in England last week, a man was saved from his burning car by firefighters. But it was the fimmediate action of paramedics in getting the man fitted with an oxygen mask and breathing pure oxygen that just as likely saved his life too.

The man, who was suffering from shock as a result of the fire, was not able to tell paramedics if he had breathed in smoke, so the paramedics gave him pure oxygen as a precaution. This was wise, as it turned out that a later examination revealed that he did in fact breathe in the poisonous fumes contained in smoke.

Anyone who gets within close proximity of a fire should take oxygen therapy afterwards, because the damaging effects of smoke inhalation can present themselves over days, weeks, and months--even if a person feels okay right after a fire. And with children, who have smaller lungs than adults which will fill completely with smoke and become damaged more quickly, it is imperative they take oxygen even if there's no evidence of first-, second-, or third-degree burns or other obvious physical ailments.

If smoke inhalation goes untreated, it could lead to death within a day or two of exposure, even if the person doesn't appear to have any symptoms immediately afterward. Smoke inhalation damages lung tissue, making it difficult for the body to absorb oxygen. What's more smoke inhalation can actually worsen over time if proper care is not taken immediately, leading to complications months and years later that can permanently handicap, or even kill, a person. Taking oxygen immediately after exposure can not just keep you alive, but also allow you to have a normal life in the years to come.

Lastly, if you think smoke is the last thing you need to worry about if you are caught in or near a fire, consider this: A few years back, a Georgia man was found dead in his home after a fire. He had no burns; he suffered smoke inhalation. But the incredible thing was this: He lived in a small mobile home! In other words, all this man had to do to have a chance of surviving was move a few feet to a door or window--yet he could not even make it that far before losing consciousness. This demonstrates just how poisonous smoke is to your lungs.

January 26, 2011

Smoke Inhalation, Not Fire, Results in Devistating Injury

A mother of 3 fell asleep, on the living room couch, with her infant in her arms. Her 2 other elementary school age children went to sleep in their room. While she slept, in the early morning hours, her 6 year old son played with either a lighter or matches. As a result the couch cought on fire. The son, petrified, ran back to his room. It did not take long for the fire to engulf the sofa and spread to the entire room. The mom woke up to a couch that was on fire and a home filled with smoke. She could not see anything (because of the smoke), but she could hear a neighbor yelling from the other side of the door. She was able to feel around through the smoke and get to the door. Unfortunately she was unable to open the door. As she made her way to the back of the apartment she was overcome by smoke. She passed out due to smoke inhalation. She was found by the fire department unconscious, near the childrens' bedroom. She was hospitalized for 2 months during which time she was placed in a medically induced coma. She suffered 3rd degree burns that were treated but the reason for the lengthy hospital stay was the fact that she suffered from smoke inhalation. The infant that she was sleeping with on the couch did not survive.

Now at first glance you might think that the landlord could not possibly have any responsibility because the fire was started by a child playing with matches or a lighter. We (Kramer & Pollack, LLP) thouroughly investigated the case and we were left with some very pointed questions. Where did the matches or lighter come from? Why couldn't the mother get out the side door? Well, the stove in the apartment would not light without using matches or a lighter. She could not open the door because months prior to the fire someone had attempted to break into the apartment through the side door. They did not break in, but they did break the lock. The mother had complained to the landlord that the stove did not work properly and that the door was inoperable. If the stove worked properly there would be not need for a lighter or matches. If the woman were able to open the side door escape would have been possible.

You can only imagine the sadness and grief not to mention the pain and suffering that the mom has endured. Even more compelling is the guilt that her son will contend with for the rest of his life.

January 25, 2011

Smoke Detectors / Smoke Alarms Prevent Deadly Smoke Inhalation--if They're Working

In one of my posts last week, I mentioned a fatal fire that started because an extension cord had shorted out and set fire to clothes that were laying on top of it. This is a very preventable type of fire--but it can be prevented only when people living in a house or apartment practice good fire safety. The best way to do this: Take two minutes every day to check around your house or apartment for situations that could start a fire, or cause a fire to spread, or block the escape path to a door or window.

Besides this, there is another very simple precaution that people can take. And even though this precaution cannot prevent a fire, it can do something even more important: it can prevent a fire from trapping victims and inflicting terrible third-degree burns and poisonous smoke inhalation. What is that precaution? Installing a minimum of one smoke detector on the ceiling of each level of the house, preferably in the hallway near the bedrooms. It is advisable to put a smoke detector in each bedroom as well.

Sure enough, the blaze that was started by the shorted-out extension cord, which killed a mother and her three children who were asleep at the time, took place in a home that did not have a smoke alarm. So even though the fire began in the living room, in an electrical outlet that was also being used to power a stereo system, a computer, and other appliances, the lack of a smoke detector meant there was too little time to escape once family members woke up and realized there was a fire. The fire had engulfed much of the first floor and created dark, choking smoke that rose up and filled the rooms of the second floor before any of the sleeping victims had a chance to escape. And believe it or not, many victims who die of smoke inhalation are not even awakened by the smell of smoke. Smoke can poison your lungs and cause unconsciousness so quickly that there is no time to wake up!

So if you own your home, it takes less than $20 to buy a battery-operated smoke detector and about ten minutes to install one. And if you rent your house or apartment, make sure to ask the landlord to install smoke alarms in your apartment. One last thing to remember: It is the tenant's responsibility to check the battery in each smoke detector every few months to make sure it is working, and to REPLACE the battery once a year. If you don't do this, the smoke detector might be of no use in keeping your family safe!

To read reviews on many types of smoke detectors, click here. Lastly, anyone who cannot afford a smoke alarm can contact their local fire department to see if they will install one for free. In Philadelphia, for instance, residents can sign up to get a free smoke detector by visiting www.FreedomFromFire.com.

January 24, 2011

Accommodating Workers With Burns (part I)

Accommodating an employee with burn injuries returning to work depends on many factors which include the total body surface area involved in the burn, the extent of the burn, the degree of the scaring that affected the patient and the limitations that resulted because of these scars. (see preventing and dealing with scars I, II)

An employer should consider what limitations an employee with a burn injury has; to what extent do the limitations affect the work performance; and the specific job tasks that are problematic as a result of these limitations. The burned person has to inquire about the available accommodations to decrease or eliminate the problems that he/she are facing as a result of the injury. The burned person should meet with his/her supervisor or employer to discuss the effectiveness of the accommodations and to determine whether or not other accommodations or services are needed.

Motor impairment which often result from contracture, may lead to difficulty in walking and standing. Burns affecting the arms and hands can lead to difficulty in lifting and carrying things, difficulty in reaching for objects and compromise of fine motor movement such as writing and grasping. The following accommodations can be made for people with gross and fine motor impairment.

For gross motor impairment the following can be done:

  • Work site modification to make it accessible.
  • Automatic door installation.
  • Work place modification to make it accessible.
  • Moving the workstation closer to other work area.
  • Providing an accessible way of travel to other work area.
  • Making materials within reach.
  • Accessible entrance provision.
  • Close parking provision.
  • Accessible restroom provision.
  • Material lifts provision.
  • Stand or lean stools provision.
For fine motor impairment:
  • Alternative computer access provision.
  • Alternative telephone access provision.
  • Writing and grip aids provision.
  • Arm support provision.
  • Anti vibration gloves provision.
  • Tool balancer provision.
This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.
January 21, 2011

Scald Burns in Restaurant Workers (part II)

What employers can do to reduce the risk of scaled burn injury:

  • Place microwaves at a safe height within easy reach for all users to avoid spills. The face of the person using the microwave should always be higher than the front of the door.
  • Provide splash screens for frying foods.
  • Maintain equipment to ensure that lids are tight fitting; handles are securely attached on vessels that contain hot liquids.
  • Ensure that workers are trained on the hazards of hot liquids and safe work practice. Supervisors should encourage and when necessary enforce safety rules.
  • Designate someone each shift to be responsible for immediately cleaning up spills.
  • Ensure someone on each shift knows and can use first aid procedures for managing burns.
  • Always practice good housekeeping, keep floors clean of liquids and other debris. Slips, trips and falls are responsible for almost a third of all restaurant scald burns.
  • Use non slip matting, no- skid waxes and coat floors with grit, especially in areas where cooking oils and other liquids may spill.
What employees can do to reduce the risk of a scald burn injury:

The most important things you can do is to make sure you are aware of how to assess burn hazards in your workplace and how you can reduce your risk of being burned or burning one of your co-workers. Good communication between co-workers, understanding and following all of the safety procedures at your workplace can help to reduce your risk of serious potentially life altering injury from a scaled burn.

  • If manually transferring hot liquids ensure the liquid is at a safe level for carrying (1/2 full), use splash guards, or secure lids for all vessels containing hot liquids.
  • If transferring hot liquids using a rolling cart, ensure the vessel is secure on the cart so that sudden stops or jarring will not allow the container to tip or fall.
  • Carefully handle micro waved liquids, assume they are hot. Micro waved foods and liquids can reach temperatures greater than boiling without the appearance of bubbling.
  • Always practice good housekeeping, keep floors clean of liquids and other debris. Slips, trips and falls are responsible for one in three restaurant scald burns.
  • Use hot pads, potholders, or appropriate size gloves or mitts when appropriate.
  • Wear protective shoes; open toed shoes, sandals or boots, where hot oil can pool, are not appropriate. Also wear shoes with slip-resistant soles to avoid slipping or falling.
This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.
January 20, 2011

Putting Out Fires Yourself: A Recipe for Third-Degree Burns

In my previous post two days ago, I wrote about the need to be aware of fire hazards not just inside your home, but surrounding your home as well. The reason: Careless neighbors can cause a fire that spreads to where you live too. Such a situation nearly happened to me not long ago, and my neighbor almost got burned badly because she tried to put the fire she started rather than calling firefighters to let them do it.

Sure enough, a story appeared in a London newspaper the next day, January 17, about a British man there who did the same thing as my neighbor. Unfortunately, that man now has third-degree burns and smoke-inhalation injuries to his lungs that threaten his life. Here is part of that article:

"A man barely escaped with his life after an early-morning fire Monday in an apartment in London's east end. The man was cooking and likely fell asleep, only to be woken up by his smoke detector. 'He tried to put the fire out himself but sustained burns to his face, his forearms, and hands, plus he suffered some smoke inhalation,' district chief Jeff Adams reported."

"Although the man was conscious and talking when firefighters arrived, paramedics consider his injuries life-threatening because of the facial burns and smoke he inhaled. Adams said, 'I think 50 percent of people would try to put out the fire, but you have to be very careful. We like to tell people to close the door and let the professionals handle it.'"

"Most of the damage was to the kitchen -- the stove, the cupboards above the stove and the wall, plus there was smoke damage throughout."

Even so, another tenant of the eighth floor of the apartment complex says that he saw smoke coming from under the door, and that he was the one who called authorities for help. By the time firefighters arrived, the fire was mostly out--but smoke had filled the entire hallway. This means that sleeping neighbors were at risk for dangerous smoke inhalation too, and might not have woken up in time to get out.

The lesson here: The greatest home-fire threat to you might actually be outside your home. So monitor your home's surroundings occasionally for things that could start or accelerate a fire.

And the day before this London fire took place, a house caught fire in Springfield, MO due to something that most of us would never even think about: An extension cord connected to a space heater shorted out, igniting clothes that were laying on the cord. Now, having clothing laying around is not a rare situation in many homes, including mine. But if you just take a moment and think about where you're setting those clothes or any other flammable item, you can avoid a dangerous situation.

In this case, two young girls were rescued from the home, one of them thanks a thermal-image camera that lets firefighters see through the smoke. Still, the girls suffered burns and smoke inhalation, as did one of the firefighters.

See the full article here.

January 19, 2011

Third Degree Burns, Smoke Inhalation, The Human Spirit

A woman awoke in the early morning hours to a neighbor pounding on her door who was screaming "there is a fire you need to get out". She jumped out of bed, grabbed her toddler and her 3 year old. She woke up her 6 year old and said follow me, we have to get out. She ran down the stairs from the 3rd floor to the sidewalk carrying the 2 younger children. When she got out of the building she put the kids down and she turned around only to discover that her 6 year old had not followed her. With the strength of a mother's love for her child, she broke free from the grasp and ignored the warnings of her neighbors as she braved the fire and ran back to her 3rd floor apartment. Her son was petrified and frozen in the kitchen.

With the fire now engulfing the stairs she and her son were trapped. She did the first thing that came to her mind. She went to the bathroom and turned on the shower. That was the last thing she remembered. She turned on the shower because she knew that the fire department was on their way and she only needed to buy a little time. Unfortunately the ceiling collapsed because of the fire and she suffered severe third degree burns. Fortunately she survived. Unfortunately her son died several days later from smoke inhalation. His funeral was held while his mother was in a medically induced coma.

As it turned out the fire was started as the result of a dispute between a drug dealer and the very neighbor who knocked on the door alerting the family. If there was any good fortune in this most horrible circumstance she retained me, Larry Kramer of Kramer and Pollack, LLP to represent her. While comforting family members at the hospital burn center, the neighbor who knocked on her door arrived with a woman claiming to be a community activist. This "activist" was nothing more than a runner trying to steer the family to an attorney that she worked for! The family wisely and firmly declined the help offered by the activist and sent her on her way.

We set out to expose the fact that this horrible situation could have been avoided. In the end we successfully recovered the entire proceeds of her landlord's insurance policy because we proved that he had the window child guards screwed into the window frame with tamper proof screws. Initially the insurance company took the position that the landlord was not responsible because the fire was started by a criminal act. In the end they acknowledged that the landlord had a responsibility to maintain a means of escape and that the landlord's actions blocked the fire escape.

January 18, 2011

Lessons in Home Fires: Don't Get Burned by Careless Neighbors

Sometimes, it does not matter how much precaution you take in keeping your home safe from a fire. Here's a situation that recently affected my own family:

We have small fire extinguishers in the corner of each bedroom, plus one in the hallway closet that's between the kitchen and the front door. Each fire extinguisher is rated ABC (so it's effective on just about every type of house fire--electrical, cooking, etc.). Each one cost us about $40, and is useful for about three years. We know ours are still good because the gauge on top of each extinguisher shows us how much firefighting chemical is left in the extinguisher. Once the gauge points to the red zone, it's time to discard or refill the extinguisher. And even though the instructions for use are printed on each extinguisher, we've all learned how to use it so no time is wasted during an emergency.

So we thought we were fully prepared to handle any fire situations involving the home. Problem is, we live in an apartment building, and one of our neighbors is not as careful about fire safety as we are--she's an elderly woman who likes to smoke. One night, we heard fire trucks outside our building, and when I opened our apartment door to step into the hallway, I could see and smell acrid smoke coming from under the door of our neighbor's unit.

The firefighters raced up the one flight of stairs and banged on our neighbor's door until she reluctantly opened it. Wielding heavy-duty foam extinguishers, they pushed past her and coated the entire apartment to ensure that whatever was on fire could not ignite anything else. It turns out that the woman's mattress had caught fire from a cigarette--and the bottom of her nightgown was burned and still smoking as the firefighters finished their job!

The woman was trying to smother the mattress fire when firefighters arrived, and was too embarrassed to open her door and let them in. But if they had not gotten into that apartment in time, our adjacent apartment likely would have caught fire too. Our small extinguishers probably would have bought us enough time to get to an exit without receiving serious, third-degree burns or significant smoke inhalation, but we probably would have lost our home.

The moral of this story: Fire safety does not end beyond your front door. Keep aware of hazardous situations surrounding your home too. Careless neighbors can cause disaster for themselves, and for you. And if you ever have a situation near your home you think might be a fire hazard, call us at (212) ANSWERS and we will gladly answer your questions.

January 18, 2011

January 17, 2011

Scald Burns in Restaurant Workers (part I)

Scaled burns are one of the most common causes of burns in restaurants. They occur when the skin comes into contact with hot liquids or steam. Scalds with hot oil are generally more severe than those from hot water because oil heats to higher temperatures than water and oil is thicker so it may remain on the skin for a longer period of time. Scalds from water are very frequent in the restaurant industry and can cause third degree burns, (see also third degree burns part II) almost instantaneously if the water is boiling or simmering.

Job site hazards:

  • Slip or trip hazards can cause workers to stumble or fall. Slips, trips and falls are common events leading to restaurant worker burns. Many serious burns occur when employees slip and reach to steady themselves. This action often knocks hot liquids off of counters/stovetops on to the worker.
  • Carrying full containers of hot liquids is very dangerous to the employee carrying the container and to those working around them.
  • Cooking with boiling water, hot oil or other hot liquids puts you at risk of being burned from splashes or spills. Follow all safety procedures when cooking using hot liquids,
  • Working with or around pressurized cooking equipment is also dangerous. If pressurized equipment is not properly maintained or used, it can explode causing serious steam injuries.
  • Steam from microwaves can reach temperatures greater than 200 degrees rapidly in covered containers. Puncture plastic wrap or use vented containers to allow steam to escape while cooking in the microwave, or wait at least one minute before removing the cover.
  • Cleaning deep fryers or around deep fryers are common tasks associated with burn injuries in restaurants. Extreme caution should be used when cleaning the deep fryer and surrounding kitchen area.
Scaled burns are preventable and both the employers and the employees can reduce the risk of these injuries. This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.
January 11, 2011

Work Related Burn injuries in fast food restaurants to youth and how to prevent them

According to the report, injury risk factors may include inexperience, a reluctance to ask questions, absence of awareness of their legal rights and others.

When there is a burn injury at the job site, the immediate and proper first aid treatment may decrease the severity of the burn injury. Clean and flush the area with cool water, don't apply ice as it may cause more injury, cover the burn area with a clean dressing then seek medical help.

In restaurants, employers and employees should have easy access to first aid materials and should be trained on how to perform the basic first aid when there is a burn injury.
Among the proven measures to reduce burn injury in work places are frequent cleaning the floor with a grease cutting agent that can help preventing burns from the slip of an employee and getting in contact with a hot grill, coarse quarry tiles for flooring, using mates that are slip resistant and using gloves and handles equipped grill screens, scrapers and bricks can help prevent burns in employees who are working with or cleaning grills.

This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.


January 11, 2011

I Suffered A Burn Injury, Do I Have A Case?

When someone suffers a burn injury, their immediate concern is their health, well being and what the future holds. The burn victim and their family should also consider whether or not the burns were the result of negligence. This question is best analyzed, considered and answered by a lawyer who has a considerable amount of experience in handling burn injury accident cases. One firm has a reputation of being very knowledgeable, diligent and savvy in this particular area of the law, that firm is Kramer & Pollack, LLP.. They have handled various burn cases resulting from fires, scalding water, stove tip overs, explosions, electrocutions , etc (here are some of the cases they have been involved with). They have been there for many families in the hours and days following catastrophic burns suffered by children and adults alike. They have held the hands of parents as their children lie trembling in pain in the burn unit. Their advice and guidance has been priceless and cherished by so many people.

We will ask Mr. Kramer to comment on different burn cases regarding liability or negligence. Liability or negligence means fault. In other words, Mr. Kramer will analyze different burn cases with respect to the role or responsibility other people or entities may have had which led to or could have avoided the burn injury. Most of the analysis will deal with 3rd degree burns (see also third degree burns part II).

You may think at first that the facts leading up to a burn injury are not sufficient to form the basis of a lawsuit. For example if you learned that someone was burned in a fire started as the result of a drug dispute you might think... how could the landlord be responsible. Or in another situation you may learn that a fire was started by a child who was playing with matches. If you thought in both situations that there was no case you would be wrong. These and many other cases will be analyzed in upcoming posts.

January 10, 2011

Chemical Peels

Are chemical solutions that are used to slough off and peel off the damaged outer layer to improve and smooth the texture of facial skin. Chemical peels can be used for facial blemishes, wrinkles and uneven skin pigmentation. It can also be used to remove precancerous skin growth and soften and reduce acne scaring. Chemical peels are most commonly performed for cosmetic purposes.

Formulas used as chemical peels include Alphahydroxy acids (AHAs), Trichloroacetic acid (TCA) and phenol.

Alphahydroxy acids: such as glycolic acid, salicylic acid and fruit acid, are considered as light chemical peels that may be used to treat areas of dryness, fine wrinkling, pigmentation which is uneven and acne.

Trichloroacetic acid: can be used in many concentrations. It's used as an intermediate to deep peeling agent, it may be used for treating superficial blemishes, fine surface wrinkles and skin pigmentation problems. TCA is preferred for darker skin patients; it can be used on the neck or other areas of the body and may require treatment with AHA or Retin-A cream.

Phenol: it's used to produce deep chemical peels; it is the strongest among the chemical solutions and its effect is long lasting. It should only be used for facial peels. It is used for the treatment of blotches caused by sun exposure or aging, precancerous growth and coarse facial wrinkles. Phenol effect is long lasting. Phenol peels may take several months to heal and may cause permanent lightning of the skin.

Complications of chemical peels:

Possible complications of chemical peels may include swelling, infection, burns, scarring, cold sore outbreaks and skin pigment change.

This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.