April 11, 2011

Necrotizing Fasciitis and Third Degree Burns (Part II)

Risk factors for Necrotizing fasciitis:

  • Trauma to the skin (minor or major).

  • Burns

  • Immunosuppression and imunosuppressive drugs such as prednisolone.

  • Diabetes.

  • chronic diseases such as chronic renal failue.

  • Malignancies.

  • Alcoholism and intravenous drug misuse.

  • Obesity.

  • Peripheral vascular disease.

  • malnutrition.

  • Age over 60 years.

  • Varicella.


  • Clinical features:
    There are local and systemic signs and symptoms of Necrotizing fasciitis:

    Local signs and symptoms may include:

    1. Skin erythema.

    2. Skin edema (swelling).

    3. Skin ulceration with gangrenous edges.

    4. Skin necrosis.

    5. Skin numbness.

    6. Pain which is out of proportion to the degree of inflammation.

    7. Grayish-brown discharge.

    8. Vesicles, bullae.

    9. Crepitus (crackling or grating feeling or sound under the skin).


    Systemic signs and symptoms may include:
    1. Fever.

    2. Chills.

    3. Hypotension (decrease blood pressure).

    4. Tachycardia (increased heart rate).

    5. Diaphoresis (excessive sweating).

    6. Hemodynamic instability.

    7. Altered mental status.

    8. Organ failure.

    Diagnosis:
    Necrotizing fasciitis is a life threatening rapidly expanding infection that can lead to systemic toxicity and death therefore early diagnosis and treatment is critical to reduce the risk of complications and death. Diagnosis include:

    • Full history and physical examination including all parts of the body to search for skin inflammation.
    • Lab work .
    • Tissue biopsy which can reveal necrosis of deep tissues.
    • Plain x-ray which can demonstrate subcutaneous gas.
    • CT scan and MRI.
    • Surgical exploration.
    Differential Diagnosis:Diseases that may have similar features of necrotizing fasciitis include:
    • Cellulitis.
    • Erysipelas: an infection of the superficial dermis with well defined borders.
    • Gas gangrene.
    • Lymphangitis.
    Treatment:
    • Treatment of necrotizing fasciitis is composed of patient stabilization, surgical debridement and rapid administration of broad spectrum antibiotics. Some patient may need to be admitted to the intensive care unit for monitoring and treatment may involve an interdisciplinary care team. Patients are typically taken to surgery based on a high index of suspicion determined by the patient's clinical features. During surgical debridement collection of tissue cultures and tissue samples are done for microscopic evaluation, excision of all nonviable tissue, and delineation of the extent of the disease. Multiple surgical debridement may be needed leaving a large opened wound which may reuire skin grafting.
    • Intravenous antibiotics should be started as soon as necrotizing fasciitis is suspected. Wide spectrum antibiotics are usually used.
    • Amputation of the affected organ or organs may be needed.
    • Hyperbaric oxygen may be used as an adjunct to surgery and antibiotics.
    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.
    April 7, 2011

    A Hot Debate About Fire Sprinklers in Homes and Condos

    An article written for the Associated Press this past week covered a topic that every head of a household should know something about: A regulation calling for homes built after January 1, 2011 to install fire sprinklers.

    This rule in some areas has ignited a fight around the country between fire safety officials, who say home fire sprinklers save lives, and home builders who are struggling to recover from the real-estate crash. Many of the builders contend that sprinkler installations should be voluntary, meaning it's up to the home buyer.

    The International Code Council, an organization of building inspectors, fire officials and others who set building standards, recommended in 2009 that states and municipalities adopt codes requiring sprinkler systems in homes and town houses less than three stories high. These regulations took effect this past January.

    But with the home-building business down so much in the past few years, the last thing builders want is a new rule requiring them to spend thousands of dollars to install home sprinkler systems that many customers don't even say they want.

    According to the National Fire Sprinkler Association, such systems have been required in most nightclubs, hotels, schools and other public buildings (depending on their height) for more than 60 years. And in 2009, more than 2,000 people died in one- and two-family homes, while 9,300 burn and smoke-inhalation injuries occurred as well.

    The National Fire Protection Association says sprinklers will particularly help young children, the elderly and the disabled by giving them time to escape burning homes. On the other hand, a spokesman for the National Association of Home Builders countered that studies do not show that mandatory sprinklers improve safety. Smoke detectors, required by most building codes for decades now, help save lives, as do better materials used in home construction, the association claims.

    As of now, officials in California, Maryland, Pennsylvania and South Carolina and numerous local jurisdictions have adopted the code, according to the National Fire Protection Association. Maryland will allow counties to opt out and Pennsylvania lawmakers are taking steps to repeal the rules. A measure to adopt the fire code has lost momentum in the Connecticut legislature. And six other states--Arizona, Florida, Georgia, Idaho, Louisiana and South Dakota--actually prohibit sprinkler requirements.

    One real-estate executive in Connecticut said many of his customers refuse to buy homes that have sprinkler systems because of the very unlikely possibility that sprinklers will go off accidentally and ruin furniture, carpets, and belongings. The $8000 price tag only makes the idea less friendly to home buyers.

    At the least, any head of a household should weigh the pros and cons of having home fire sprinklers in addition to smoke detectors. If there are children, elderly, or handicapped people living in a dwelling, sprinklers could give them enough time to escape a fire without suffering third-degree burns or deadly smoke inhalation.

    April 5, 2011

    Real-World Lessons for Preventing Home Fires, Severe Burns, and Smoke Inhalation

    Here are three items that were in the news last week that provide good lessons for anyone--but especially families--as they examine their home for fire hazards, and also to make sure their fire-escape plans are known by everyone in the family.

    First, New York city fire officials say a lumbering pet turtle sparked a fast-moving fire in a a Brooklyn apartment after crawling out of its tank and knocking over the terrarium's heat lamp.

    The six-year-old African tortoise, about the size of a basketball, survived. But officials say one firefighter and three police officers suffered smoke inhalation. The reptile was housed in their owner's bedroom, an eighteen-year-old who was not home at the time, nor was his family.

    Fire officials say the heat lamp crashed to the floor, igniting a pile of art supplies, including thinner and paint. Within minutes, the fire spread through the third-floor apartment and caused some damage to surrounding units as well.

    Next, a space heater sparked a fire that damaged a single-story home in San Diego County, CA, and left at least one person without a place to live. An 89-year-old woman who lives at the home was taken to the hospital for smoke inhalation. Smoke and flames had already enveloped the rear part of the house by the time fire crews arrived, The fire started at around 12:30 p.m.in a bedroom, when a space heater was placed too close to sheets, pillows or curtains. Crews were able to keep the fire contained in the bedroom and extinguished the flames in 19 minutes. Structural damage to the home was estimated to be $200,000 and damage to content inside the home was estimated to be $50,000.

    Lastly, a large producer of box fans, which are used by many homeowners in windows or in doorways to cool a room rather than using air conditioning, has recalled thousands of its products due to a fire hazard within the box fans. The U.S. Consumer Product Safety Commission, in cooperation with Lasko Products, announced a voluntary recall of 4.8 million box fans.

    An electrical failure in the fan's motor poses a fire hazard to consumers, says the CPSC. Lasko has received seven reports of fires associated with motor failures, including two house fires and one barn fire, resulting in extensive property damage. Fortunately, no injuries such as third-degree burns or any other type of burn have been reported. This recall involves Lasko box fans with model numbers 3720, 3723, and 3733 and Galaxy box fans with model number 4733 that have date "2002-03" or "2003-04" stamped on the bottom of the metal frame. "Lasko" or "Galaxy" is printed on the front of the fan. The model number is either stamped or printed on the bottom of the fans.

    Consumers should immediately stop using the recalled fans and contact Lasko to receive a free fused plug safety adapter. It is illegal to resell or attempt to resell a recalled consumer product.

    March 31, 2011

    Alarming News About the Effectiveness of Smoke Detectors


    Researchers at Victoria University in Melbourne, Australia conducted a study among school-age children to see how effective a smoke detector was in waking them up in the event of fire. Unfortunately, the results were frightening, and a serious wake-up call for parents, firefighters, and to fire-safety educators alike.

    The study, whose results were publicized recently in the industry journal Fire and Materials, asked the parents in 80 families to activate the smoke detector in their home after their children had been asleep between one and three hours. The 123 children who were in the study were divided into two groups, based on which children had reached puberty and which did not. The reason for this: Levels of the hormone melatonin, which helps induce sleep, go down once children reach puberty. So it would seem that younger children would be deeper into sleep, and perhaps less likely to be awakened by an alarm.

    That proved to be true--but it did not mean that most of the older children heard the alarm, either. In fact,, 78 percent of all the kids that were studied slept through a smoke detector's alarm that was blaring for at least 30 seconds. What's more, parents reported that of the 22 percent of children who did wake up, only half of them identified the noise as a smoke detector, and just one-fourth of them even knew that a smoke detector's noise means to get out of the house immediately. And while the younger kids were likeliest to sleep through the alarm (87 percent of them!), 56 percent of the 11- to 15-year-olds also slept through the piercing noise.

    Such a study is a clear sign that parents have more responsibility to their families when it comes to fire safety than they might have thought. Specifically, not only must parents teach their children why a smoke detector makes that loud noise and what the kids need to do if they hear it, but parents must also have a plan for reaching their children quickly in the event that the smoke detector starts blaring.

    Here's why: The study shows that there is a strong chance that a child will not wake up from the alarm, so there is a real possibility that the child could become a victim of third-degree burns and/or smoke inhalation--both of which can happen in seconds, and are often deadly.

    One of the study's researchers put it this way: "Parents should not rely on their children waking to the smoke alarm in the event of a fire, and they should not assume that the children will immediately evacuate if they do wake up to a fire," says Dorothy Bruck.

    Interestingly, many fire departments are happy to make brief home visits to help parents teach children about the importance of the smoke detectors, and to create an evacuation plan from each room in the house. Because when it comes to a house fire, there might not be a way for parents to reach their children to lead them to safety. So kids need to know what to do once they are awakened by the alarm, or by shouts from their parents. Remember, kids tend to freeze when frightened, and this can have deadly consequences. But if they know what is happening and know what they should do, the chance of survival is much greater.

    March 29, 2011

    The Clothes Dryer: A Frequent Source of Fire and Severe Burns

    I was watching TV the other day when, believe it or not, a commercial caught my attention. (It seems that everyone else has a digital recording device, so they can skip the commercials. But I was glad that day that I don't have DVR, or I would not have seen this informative commercial.)

    Anyway, the commercial was for an insurance company that offers coverage for the home. In it, the actors stand in front of a giant ball of lint--the type of lint that comes from washing and drying your clothes--and then one of the actors lights the ball on fire. The ball, which was larger than the actors, becomes engulfed in flames almost instantly. Then one of the actors says, "Did you know that 15,000 fires start in clothes dryers each year?" That's a pretty big number.

    But as I thought about that a bit more, that number became even more terrifying. Why? Because most of the time, a clothes dryer is turned on and left alone for 45 minutes or more, until its timer runs out on its own. So that means that there are thousands of times each year where people go to sleep, or are doing things on the other side of their home, when the dryer is running. And if people are not diligent about cleaning out the lint trap frequently, it is very easy for the dryer to catch fire. What's more, the lint and the clothes inside the machine will go up in flames in an instant, and possibly engulf the room and the rest of the house before the occupants know what is happening.

    So the way to prevent a clothes dryer from causing fire--and prevent possible third-degree burns and smoke inhalation that can kill--is to clean the lint trap every time you use a clothes dryer. Also, never overfill a clothes dryer so that the unit and the clothes inside cannot overheat. Lastly, it would be smart to place a smoke detector on the ceiling near the clothes dryer so that if it does catch fire, the people in the building receive plenty of warning and can get out of the building.

    March 25, 2011

    Survivor Story

    In 1996 there was a devastating fire where a church deacon lost his life when his
    apartment was set on fire by suspected drug dealers. Jackie, his wife and her3 children survived, but were seriously injured. Jackie suffered severe smoke inhalation and burns to her arms. Her oldest daughter also suffered from smoke inhalation along with 2nd & 3rd degree burns to her arms and legs. The youngest daughter and son who was 3 years old miraculously managed to escape with minor injuries.

    After an extended period in the Burn Unit, Jackie and her daughter went home. However, the oldest daughter would require additional surgery at some point.
    Resilience, determination, motivation allowed this family to survive the ordeal of not only losing a husband, but losing all they had.

    It is now 14 years later, the two girls are now adults; the son is about to graduate from High School. There is a constant reminder when mom and daughter look at the scars that were left--not just the physical ones , but the emotional ones
    .
    The family has survived their ordeal. Of course it was a struggle trying to survive not only the physical impact, but the emotional trauma.
    It's like a container of milk that spills; you can't pick it up and put it back into the container

    March 24, 2011

    Smoking in Bed: Some People Don't Learn Until They Are Burned


    On March 20, the Chicago Sun Times reported that two people were injured when a fire started in an apartment at a Chicago Housing Authority senior citizens building. One person suffered minor smoke inhalation, but an elderly man suffered second- and third-degree burns, all because of a cigarette that touched a mattress and caused it to catch fire.

    Firefighters were called at about 1 a.m. to the 14th floor of the building at 1633 W. Madison St. The building is the Patrick Sullivan Apartments, a Chicago Housing Authority senior-living building, according to an address directory. While the first was small and contained only to the bedroom, the smoke was so thick that firefighters evacuated every apartment on the 14th floor.

    There are a few lessons to be remembered from this incident. First: Smoking in or near a bed is a terrible idea. If even a small ash lands on a mattress, it can ignite the entire bed in seconds, giving you no time to avoid being burned or having your clothes catch fire. What's more, mattresses generate a lot of smoke quickly, so someone can be overwhelmed in seconds by smoke that's inside a bedroom.

    Second: Elderly folks should be checked upon regularly to make sure that they are practicing safe cooking, safe smoking, and taking other precautions whenever it comes to a heat source or an open flame inside their homes. As people get older, their ability to see is diminished, and their memory tends to slip as well . As a result, food sometimes gets burned, boiling water is forgotten about, lit candles are forgotten about, etc.. In other words, the chance for fire or severe burns goes up as people get older, so a watchful eye from a family member, friend, or neighbor would help.

    Third: Smoke detectors are absolutely necessary in any home, but when it comes to older folks, that family member, friend or neighbor also needs to make sure that the batteries are still working in each detector.

    March 22, 2011

    Survivor Story: Face Transplant Gives Victim of Severe Burns Another Chance


    The Associated Press reported today that a Texas construction worker, whose face was completely disfigured by third-degree burns suffered when he fell into an electrical power line, successfully underwent the nation's first full face transplant in a Boston hospital last week.

    Dallas Wiens, 25, received a new nose, lips, skin, muscle and nerves from a recently-deceased person. The operation was paid for by the United States armed forces, which is trying to learn more about how to help soldiers who suffer disfiguring facial wounds.

    In March 2010, doctors in Spain performed the first full face transplant in the world on a farmer who was accidentally shot in the face, and could not breathe or eat on his own.

    Wiens will not resemble what he used to look like, nor will he resemble the unidentified deceased donor. The result will be something in between, said Dr. Bohdan Pomahac, a plastic surgeon who led a team of more than 30 doctors, nurses and other staff at Brigham and Women's Hospital in the 15-hour operation last week. As of today, Wiens was listed in good condition, and has even spoken to family members on the telephone already.

    Wiens' face was completely burned away after he came in contact with a power line while painting a church in November 2008. The transplant could not restore his sight, and some nerves were so damaged that he will probably have only partial sensation on the left side of his face and head.

    Wiens' grandfather said that "he could have chosen to get bitter, or he could have chosen to get better. His choice was to get better, and thank God that today he is."

    In fact, Wiens stayed motivated by the thought of being able to smile again, and to feel kisses on his face from his almost-four-year-old daughter. Wiens added that he also wanted the transplant because it gives hope to extremely disfigured people, rather than having to "look in the mirror and hate what they see," he said. Wiens also hopes to become an advocate for facial donations, and he publicly thanked the donor family for their selflessness

    The healing process is not even close to being over, however. Wiens will have to take medication forever to prevent rejection of the tissue that makes up his new face. He did not have insurance when he was injured, but Medicaid paid for the several surgeries before this one. Medicare will cover him from now on, under its disability rules.

    To see several videos of Wiens all throughout his ordeal, right up to the present, click here.

    March 21, 2011

    Radiation and its Effect on the Body and the Skin

    Damage to nuclear power plants in Japan caused by the earthquake and tsunami caused concerns and panic not only among the general public in Japan but also around the world including the people in the U.S.

    United States measures radiation dose by the REM unit (Roentgen Equivalent Man), the doses are commonly reported in millirem (mrem) which equals to 1000 of a rem. Japan measures radiation dose by the Sieverts unit (Sv) and doses are commonly reported in milliSieverts which equals to 1000 of a Sievert. Japan imposed a 12 mile evacuation zone around the plant as well as advising residents living within 18 miles to leave the area if they could or to stay indoors and make their homes airtight.

    Exposure to radiation can cause radiation sickness. Radiation sickness also known as acute radiation sickness and acute radaition syndrum (ARS) is defined as damage to the body when the body is exposed to a high dose of penetrating radiation often received over a short period of time, the severity of the symptoms depend on the amount of radiation absorbed by the body.

    Symptoms of radiation sickness:

    Symptoms of radiation sickness may appear within a few minutes to days after the exposure depending on the level of radiation, the symptoms may come and go, they may include:

    1. Fatigue.
    2. Nausea.
    3. Vomiting.
    4. Diarrhea.
    5. Headaches.
    6. Appetite loss.
    7. weight loss.
    8. Sore mouth and throat.
    9. Swollen, red, itchy skin.
    10. Skin burns.
    11. Hair loss.
    12. Anemia.
    13. Increase risk of infections.
    14. damage to internal organs.
    15. Sterility.
    16. Increase the risk of cancer.
    Treatment of radiation sickness:

    You should seek medical attenson if you have symptoms of radiation sickness:

    1. Remove clothes and shoes.
    2. Gently wash the skin with soap and water.
    3. Medications.
    4. Antihistamines.
    5. Rest.
    6. Fluids including intravenous fluids.
    7. Nutrition.
    8. Iodine.
    • Cells lining the stomach and intestine and the bone marrow cells are the most vulnerable to radiation.
    • Radiation therapy for cancer involve highly controlled doses and specifically targeted at small area of the body.
    • Oral Potassium Iodide (KI) should be given to people who are exposed to radiation as soon as possible. What happens normally is that the thyroid gland uses iodine very actively, and by giving potassium iodide, the thyroid gland will use that instead of the radioactive iodine that can be libirated in radiation accidents. Children are more liable for for thyroid damage because their thyroid is active and they are still growing.
    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.


    March 17, 2011

    Severe Burns from Radiation: Lessons from Cancer Treatments


    With Japan suffering through a national health scare over the leaking of radiation from its tsunami-damaged nuclear power plants, the topic of radiation sickness and radiation burns has made it front and center in the newspapers and TV news programs.

    But the most common sources of radiation burns are the sun, and treatments for cancer. First, repeated sunburns means repeated radiation exposure, which damages skin cells so much that the possibility of getting carcinoma, melanoma, or other skin cancer is significant among people who do not take precautions to protect their skin from the sun.

    Ironically, for people who have breast, cancer, colon cancer, and other types, radiation therapy is often used to stop malignant tumors from growing and spreading, and eventually killing them. But this treatment often results in radiation burns.

    Here are a few things patients can do to help speed healing, and alleviate the pain of these burns--which actually hurt more than third-degree burns that destroy nerve endings.

    -Hyperbaric oxygen therapy is used to treat severe radiation burns because of the increased need for nutrients and the need to generate healing quickly because of possible surgery to remove a malignancy. Hyperbaric oxygen therapy works as the pressure within the hyperbaric tank presses upon the vessels and saturates the plasma in the blood. This causes an increased amount of oxygen flow and increases the healing process. It also generates new skin cells.

    -Intravenous therapy is used for severe radiation burns because the body can easily become dehydrated. This loss of fluids is due to the exposed, burned skin that cannot hold in moisture, and increased body temperature. Fluids are pumped into the body to help keep the patient hydrated and to speed recovery.

    -Cool compresses as well as careful skin care will be needed for a radiation burn site after therapy for a malignancy. Cool compresses are applied to the affected areas to help the healing process and to relieve some of the burning feeling patients may experience.

    -Because radiation-burned skin commonly becomes dry, red and flaky, and thus becomes itchy and irritating, applying aloe vera, a gentle moisturizer, to the skin can help ease flakiness and help promote burn healing. Aloe vera presents an ideal radiation burn moisturizer, since it is is gentle on the skin and should not cause further irritation. Aloe vera gel does not contain oils or fats, which act to seal heat into the radiation burn and slow the healing process. But remember that the American Cancer Society cautions that patients with allergies to onions, garlic or tulips may have adverse reactions to its use.

    -Pain medications are necessary to ease discomfort from a radiation burn. Anything from ibuprofen to morphine may be administered, depending on the severity of the burns. Lesser burns may be treated with over-the-counter drugs, but doctors may prescribe more serious pain medications for higher levels of pain.

    -Debridement of the radiation burn site as well as antibiotic therapy will be used to treat the radiation burn area. Infection also may occur with radiation burns and needs to be treated to prevent further complications from the radiated burn site.

    Lastly, consider this: If you do obtain severe burn injuries from a medical treatment, you might want to consult with a person-injury law firm such as Kramer & Pollack LLP in Mineola, NY, to see if the medical provider was negligent in applying the treatment.

    March 15, 2011

    Inspiration and Hope Comes from a Victim of Severe Burns


    From a story that makes most good people wonder why there is such evil in the world comes a lesson that anyone who is burned, injured, or otherwise ill can look to as hope for themselves.

    In South Florida back in February, a 10-year-old boy named Victor was deliberately doused with chemicals by his adoptive father and left to die. Fortunately, the boy was spotted in the front seat of his father's pickup truck by a passerby, who called police. Victor had third-degree burns from the chemicals, and it did not seem likely that he would live.

    He spent weeks at Jackson Memorial Hospital in Miami, at first barely conscious but over time responding to treatments and making progress. Almost as important, his mental state was aided by the bonds he made with other patients--and in return, those bonds also aided the psyche of each patient who interacted with Victor while he was in the hospital.

    "The boy's about God. The first thing he told me is, 'God gave me another chance to live,'" a patient who was in the hospital room a few doors down from Victor told a WSVN television crew. "He also asked me, 'Why did God put us in this position?' I told him, 'It's not God. It's some people who do evil things.' Then victor asked, 'Why do people do evil things?' I said, 'I don't have the answer to that, but everything that you're going through, you have to pray.' And then, the next day, he came up to me and said, 'I prayed,' and I said, 'Just keep praying.'"

    The patient says that he and Victor became friends quickly, in part by doing card tricks together. Victor also asked the man if he played football. "I said, 'Yeah, I used to play football in college.' He replied, 'You're a big guy.' And then, one of the nurses came by and said, 'You could be Victor's bodyguard.'" This made Victor smile.

    Many in South Florida have been praying for Victor's recovery, and the video that WSVN obtained shows a small glimpse into his life as he recovers from the abuse he suffered. In the cell-phone video shot by another patient, Victor can be seen rolling on a skateboard down a hallway in the hospital. Victor is trying to make friends and find normalcy in the midst of the continuing medical treatment and other chaos in his life, now that he is out of the hospital.

    But Victor's positive spirit has helped not just him, but those around him. "I think that God put me in the hospital for a reason to show me that somebody else could have something worse than you in your life," said the patient who befriended Victor. "I think the abuse was horrible because he's so innocent. Why would somebody do something to this young boy that is so loving? All Victor did was make me smile."

    To read more about this story, and to see the video of Victor, click here.

    March 10, 2011

    Here's Another Good Source for Preventing Fires and Third-Degree Burns at Home


    While we writers on this blog always try to give useful lessons on everything from preventing second- and third-degree burns, smoke inhalation, and other injuries that come from fires, hot liquids, hot surfaces, and even the sun, we sometimes come across other really good sources of information that we want to pass along to you.

    For instance, I saw an article this week on www.SafetyAtHome.com about making your home safer not only by being more aware of fire hazards and possible obstacles to escape, but also by teaching your children about fire prevention and what they should do if a fire starts in the home without their parents' knowledge.

    This topic is especially relevant as the entire nation mourns the loss of 7 small children in a house fire in rural Pennsylvania this week. The children were in the house while the mother was in a nearby barn, milking cows. By the time one of the kids ran to get mom to tell her about the smell of smoke in the house, the mother was unable to get the other children out of the house because of the speed of the fire. It's a truly terrible story.

    To read the article on fire prevention and teaching children, click here. And to read another article on that same web site about clothes dryers and how to keep them from starting a fire--which happens more often than you might think--then click here.

    March 8, 2011

    Smoke Alarms Can Prevent Death from Third-Degree Burns or Smoke Inhalation

    Two deadly fires in the past week are perfect examples of why working smoke detectors are literally life-saving items that every home or apartment should have.

    First, a fire in a high-rise apartment building in Philadelphia left two firefighters hospitalized, one in serious condition. The fire department responded to the early-morning blaze at an 18-story Philadelphia Housing Authority building and cleared scores of residents out. Smoke and flames poured from windows on the building's eighth floor before the fire was doused.

    The American Red Cross of Southeastern Pennsylvania helped about 150 residents with shelter, clothing, and food. The good news is that the worst outcome for any of the tenants was damage to their apartments and property--but nobody suffered bad smoke inhalation or third-degree burns.

    But if the fire department did not arrive so quickly, this situation could have been an absolute disaster. Because smoke and heat rise, the people who lived on the ten floors above the eighth-floor fire were in mortal danger. The possibility of rapid, deadly smoke inhalation is much greater on floors located above a fire--a tall building acts like a chimney would on a fireplace, funneling the smoke upwards! And after just a few seconds of breathing in smoke, people succumb to the poisonous elements and they pass out, and just moments later could be dead, even if the fire is still far away from them.

    So the point is this: People who live in apartments should always make sure that the superintendent regularly checks the smoke and fire alarms in the hallways to make sure they are working. Also, inside each apartment there should be at least one smoke detector as well as a carbon-monoxide detector. And if you notice a fire on a floor below you, get to a stairwell that is away from the source of the fire and get down those stairs. It is this simple: If you get below the fire, you probably live. If you get trapped above the fire, you likely die.

    Remember, smoke detectors help so much because it's not just what goes on in your apartment that you have to worry about--it is also the actions of your surrounding neighbors that can affect your health and safety.

    In a second tragic fire this week--this one in a neighborhood outside Dallas--six young adults were killed in a fire at a mobile home shortly after a birthday celebration that lasted into the early-morning hours.

    The blaze broke out at about 5:30 a.m. in a manufactured home. Three people escaped from the burning home. A neighbor called 911 after a woman ran to the door begging for help. One of those who escaped, 18-year-old Cody Rubalcaba, said he was able to help some of his other friends out of the home, but the blaze then became too strong. "When they told me that six were dead, I started bawling. I tried to save as many as I could, and I couldn't even get the other six out."

    Rubalcaba said he and friends had gone to bed after partying, but he awoke early Monday morning coughing and seeing flames coming from the master bedroom. He broke a window, cutting his arm, and crawled out to safety. He then tried to go back in to save his friends. "I was like, 'Follow my voice, there is a window I busted open, go underneath the pool table and I will be right here waiting for you,'" he said.

    He was able to help get two friends out safely, but said he couldn't help the others. "I called for their names, but no one would respond back to me," Rubalcaba said. "All you could hear were flames burning."

    "It's just a shock to see a house totally engulfed," said neighborhood resident Paul Woods. "Especially when the people are still inside. There's nothing you can do; literally nothing. The flames are pouring out and here's no way you can get anywhere close to the house."

    Shirley Culberhouse, who lives about seven houses down the street from the home that burned, told The Associated Press that it "was a group of boys who had moved in, and they were having a party." Another neighbor, auto mechanic Michael Brennan, said the party woke him up. "About 2:15 a.m., the noise woke me up," he said. "There was shouting. Then there were cars pulling out, and I was sort of waiting for the sheriff to show up when the fire happened."

    In this case, if the homeowner--whose daughter was having the party without the homeowner present--had working smoke detectors in the home, it is quite possible that more of the victims could have gotten out of the house before it was too late.

    So please take these two examples to heart, and make sure your smoke detectors are working in your home.

    March 3, 2011

    A New Way to Regenerate Skin for Victims of Third-Degree Burns


    Before I get to the topic in the headline, here's a quick story: As I've written about in past blog entries, even the most mundane situations inside the home can result in third-degree burns. Another example came to light this week in Worthington, VA, where a routine cooking accident severely burned a man and damaged much of the home.

    It was this simple: A visitor to the home accidentally splashed oil from a deep fryer onto the stove and onto the floor. Unfortunately, the oil landed on the visitor's hands and feet, instantly causing second- and third-degree burns that required treatment at the West Penn Burn Center across the state border. Furthermore, the splashed oil also caused the window curtains to catch fire. Fire crews from four towns had to respond to the fire. The family now lives in a hotel temporarily, thanks to the American Red Cross.

    Now for the good news that this blog's title refers to. The web site InHabitat.com reported this week that scientists from the Wake Forest Institute for Regenerative Medicine are advancing in their goal to regenerate more of a person's own healthy skin to repair burn damage on another part of the body. Inspired by, of all things, the typical office printer and its ink cartridge, the research team believes it could soon "print" human skin.

    Speaking to CNN, Dr. Anthony Atala, director of the institute, said that the project starts with duplicating a burn victim's healthy skins cells in a lab. Then, "the next step is to put the cells in the printer, in a cartridge, and literally print on the patient." The bio-printer is expected to be a converted office printer, but with the addition of a three-dimensional "elevator" that builds on damaged tissue with fresh layers of healthy skin. The printer is placed over the wound, allowing the flat-bed scanner to "move back and forth and put cells on the victim," Atala said. The cells then harden, mature and grow into new skin.

    The team believes that this treatment could be a reality within five years. The project is currently in pre-clinical phases. Among the first victims who likely will test the treatment are wounded soldiers returning from combat. According to the Armed Forces Institute of Regenerative Medicine, burns account for between five and 20 percent of combat-related injuries. As a result, the Wake Forest institute will receive approximately $50 million in funding from the US Department of Defense.

    It is not just the Wake Forest Institute that is working on this procedure. Other universities, including Cornell University and the Medical University of South Carolina, Charleston, are also working on similar projects and announced their research at the American Association for the Advancement of Science conference this month.

    And the next challenge for these scientists: Creating new organs from this same process.

    March 1, 2011

    A Terrible Month for Fires and Third-Degree Burns due to Carelessness

    Unfortunately, it seems that the month of February 2011 can be used by fire-prevention experts as a useful lesson in how human error and carelessness can bring devastating consequences, in the form of third-degree burns and smoke inhalation, from fires.

    First, in New York City on February 24, candles used in a bedroom caused a fatal five-alarm fire after they tipped over and ignited bed sheets. The fire left an elderly woman dead and also injured 20 firefighters and three residents. The occupant of the apartment where the fire began had placed the candles on the floor around her bed. At some point, they tipped over, and a guest doused the flames with water.

    But then the guest made a terrible mistake--he opened a window to clear the smoke from the room, which allowed fresh air to feed the fire again. The fire department said this actually created a "blowtorch effect" that whipped through the open window and pushed the fire all the way through the apartment. Then, as the occupants were fleeing through the apartment, they left the bedroom door and the front door open, which allowed the fire to spread all the way into the building's hallway and quickly engulf the rest of the building.

    "Time and time again we respond to tragedies that could have been so easily prevented," Fire Commissioner Salvatore Cassano said. "This fire had so many of those elements. Hopefully others will learn from this tragedy."

    That same day in Houston, four toddlers died in a fire at a day-care center simply because a pot filled with oil had been left unattended on a stove. In fact, the day-care provider was not even in the house at the time the fire started. Such carelessness is so egregious that local police have arrested the women running the day-care center.

    Earlier in the month, a man in Ontario, Canada was found in his bedroom, dead from smoke inhalation, after a fire gutted his mobile home. The reason he could not escape a fire in such a small building? He collected too much furniture in the home, so that when the fire started he could not find his way around all those obstacles--the blinding and choking smoke overwhelmed him too quickly. While the fire might not have been preventable, the man apparently did not consider how his clutter would prevent his escape in case of fire. This mistake cost him his life.

    Finally, in Allentown, PA, five people died in a natural-gas explosion and fire that enveloped a neighborhood here, marking the third major blast in the U.S. since September 2010 and heightening worries about aging gas pipelines that crisscross the nation. The late-night blast was so large that it leveled two homes and damaged 30 others.

    UGI Utilities Inc., which provides natural gas to the neighborhood where the blast erupted, said a routine safety check the day before had turned up no sign of problems with the 12-inch-diameter cast-iron pipe that exploded.

    The National Transportation Safety Board is set to hold hearings in the coming weeks on the recent blasts and consider improvements in pipeline safety. The review comes amid a growing consensus that the U.S. has a problem with aging infrastructure, particularly underground pipelines that are hard to inspect. The pipe that blew in Allentown had been in service since 1928.

    In a Philadelphia gas explosion in January, utility workers were trying to shut off a leaking gas main after residents reported a strong smell of natural gas. The pipe that failed there was a 12-inch-diameter gas main made of cast iron dating from the 1940s. And another explosion in San Bruno, CA in September was likely caused by poor welds in a 60-year old pipeline made of steel.

    Another explosion in Allentown in December 2006 happened when an inexperienced contractor unscrewed a plug on a gas meter, filling a nearby home with gas. That home and two others were destroyed by a blast and others were damaged, though there were no injuries The Pennsylvania Public Utility Commission last year approved a $160,000 settlement, including pledges by UGI to improve its procedures and training.

    In winter, "gas lines are like water lines," said a UGI Utilities supervisor. "As the ground freezes and thaws, it tends to shift. Sometimes that cracks the pipes. And if gas is leaking out under the street, it's going to follow the path of least resistance. So it could seep in the ground, into your home, and any ignition source inside the home could create an explosion."

    So the last lesson to take from these terrible stories is this: If natural gas is used in your home or office, always be alert for the smell of gas, and have the phone number of the utility company handy so you can call quickly, before there can be an explosion. Even a small spark can ignite natural gas that's in the air.