Burn Injury Resource Center

We hear the warnings all the time, but too many of us do not listen to them: Smoke detectors are absolutely necessary inside homes. Night-time fire can kill the occupants of a home while they sleep; the carbon monoxide, hydrogen cyanide, and other poisons that enter our bodes from smoke inhalation can kill a person within seconds.

Unfortunately, lack of smoke alarms or faulty smoke detectors caused two terrible tragedies in the past few weeks. First, In Charleston, WV, in mid-March, a fire tore through a two-story home that had no working smoke detectors, killing eight family members--including six children.

Charleston Mayor Danny Jones said he believed it was the city's deadliest fire in at least six decades. Jones said only one smoke detector was found in a cabinet, and it was not working. The Mayor said he was "devastated" by the news when he got a phone call after the fire was reported around 3:30 a.m.

"I walked up there and caught a glimpse of some of the fatalities, and it's something that's hard to grasp. The fact that there are [six] dead children, it's unimaginable." In addition, one child was on life support at a hospital and not expected to survive, the mayor said.

Neighbors indicated there had been a birthday party at the home a few hours before for one of the adults. An adult female from the home went to a neighbor's house to report the fire overnight. The home was engulfed in flames when firefighters arrived.

The fire chief said that firefighters knocked down the flames quickly. But when they got inside the house, they found five victims and "started realizing there were a lot of people in this house, a lot of children." The fire seems to have started in the middle of the home's main level. The cause is under investigation.

And in Jacksonville, AR the same week, the bodies of a mother and her four children were found inside a duplex apartment, and authorities believe they were killed by smoke inhalation from an overnight fire that had actually died out before firefighters arrived.

A maintenance worker found the bodies around 7 a.m., about an hour after firefighters first knocked on the door to follow up on a neighbor's report of smelling smoke. At the time, nobody answered the door and the firefighters could not detect any sign of a fire from outside, so they left without entering, said the fire chief.

Firefighters had three engines deployed to another house fire nearby, and they believed that was the source of the smoke. After firefighters returned to the scene following the discovery of the bodies by the maintenance worker, they determined that a fire burned overnight and smoldered itself out, causing a lot of smoke to build up in the duplex.

The 31-year-old mother died in her sleep, along with her four children: ages 11, 9, 7, and 4. The maintenance worker found the bodies in their bedrooms and saw extensive smoke damage in the kitchen. "The damage around the stove and the cabinets beside the stove," said the fire chief. "Evidently, something was cooking and caught fire."

A police spokeswoman said there was smoke and soot damage throughout the duplex and in the ventilation system, but no fire damage to the outside of the duplex.

"I got the call this morning and I couldn't believe it," said a family friend, who was godfather to the family. "The last thing I heard the son say was that we were going to get together this weekend and go to the park."

Authorities say a smoke alarm is being tested as part of the investigation. They say smoke detectors in the duplexes do not send signals directly to the fire department and that the detectors do not require regular battery replacement because they are hard-wired into the complex. It is not known at this time if the building's fire alarms were working properly. If they were not, then the complex might have legal liability for injuries that caused the deaths of the occupants.

If you or someone you know suffers an injury such as third degree burns or smoke inhalation, you should call Kramer & Pollack LLP in Mineola, New York so that the personal injury attorneys in that firm can determine whether another party has legal liability for injuries suffered, and if the injured party has a strong legal case.

Since the start of April, there have been more than a dozen deaths around the United States from smoke inhalation during fires in houses and other buildings. This is a clear indication that smoke from fire is even more dangerous to people than the flames themselves. Why? Because it only takes one or two breaths of smoke to cause a person to become unconscious, and become unable to escape a burning building. And just a few more breaths of the hydrogen cyanide and carbon monoxide in the smoke can kill a person.

Here is a grim example from just last week: In Northeastern Pennsylvania, a four-month-old girl was killed by smoke inhalation in a fast-moving fire in a trailer home. The county coroner said that the girl died of carbon monoxide poisoning from the smoke, although all other occupants got out safely or were rescued by neighbors. The infant was not able to be rescued in time from her bassinet. Three boys and a woman were treated at Geisinger Community Medical Center in Scranton and released, while a man was admitted in stable condition.

The local fire chief stated that the trailer was engulfed in flames when he arrived. He and a state police fire marshal said the cause is unknown, but the fire is not believed to be suspicious.

And in Fitchburg, MA, last week, a police officer was taken to the hospital to be treated for smoke inhalation after responding with firefighters to a kitchen fire. The officer, whose name was not given, entered the building believing there was a child inside the house, because a woman there made statements indicating her 3-year-old baby was inside. But the woman was actually referring to her dog, who made it out of the fire. Firefighters were on scene about 45 minutes after the blaze was reported. It appeared to have started with unattended food and spread into the kitchen cabinets.

In case of fire, it is important that adults find children immediately and get them to safety. The best thing to do is for everyone to then drop the floor and then crawl towards a door or window. Remember that smoke rises, so the only breathable air during a fire is right down at the floor.

If you or someone you know suffers an injury such as third degree burns or smoke inhalation, you should call Kramer & Pollack LLP in Mineola, New York so that the personal injury attorneys in that firm can determine whether another party has legal liability for injuries suffered, and if the injured party has a strong legal case.

Zane Wetzel spent 47 days in a coma, and awoke to the realization that he was involved in a life-changing accident. But with the love of his wife and unwavering faith and optimism, he and his wife have gotten to a place where they can actually help other burn victims too.

It has been a little more than two years since the 27-year-old apprentice lineman for Maine Public Service Co. in Presque Isle, Maine suffered a flash burn to 50 percent of his body while working at an electrical substation. His chest, back, arm and neck suffered third degree burns in the accident.

Wetzel was standing on a scissor lift with several other co-workers when a charge of electricity arced and touched the corner of the lift. The electricity traveled to the ground and bounced back, burning him. Safety equipment prevented Wetzel from being fatally electrocuted. And no one else around him was injured.

Wetzel was in a drug-induced coma for 47 days in the intensive care unit at Brigham and Women's Hospital in Boston. He has endured a dozen surgeries, including several operations to place skin graft from his legs onto his burned areas. After seven weeks, he was transferred from Brigham and Women's to Spaulding Rehabilitation Hospital in Cambridge, Massachusetts. He spent two weeks in that hospital and remained in Boston for outpatient therapy before coming home at the end of January 2011. For several months, he spent up to 2½ hours a day, five days a week, at County Physical Therapy in Presque Isle working with therapists on exercises to increase his range of motion and mobility and improve his quality of life.

After Zane was released from the hospital, he and his wife Courtney began receiving invitations to speak at churches, Christian schools and other venues about the accident and its aftermath. They now have traveled all over New England and also spoke in Zane's home state of Ohio.

"We always tag-team during these engagements because he doesn't remember the first month after the accident and we had two different challenges," said Courtney. "Mine was that I didn't know if my husband would live. His was waking up and realizing the condition he was in."

Wetzel still has virtually no memory of the accident. At the emergency room, "I remember being scared and confused, and then I heard my mother-in-law's voice and I calmed down," he said. "I remember whispering, 'Tell Courtney I love her.'"

When Courtney arrived at the Boston hospital a few hours after the accident, she repeatedly asked doctors and nurses if Zane would live. They just stared in silence. "I really just had to put it in God's hands," she said. "I turned it over to Him."

Zane's family traveled to the hospital from Ohio to join Courtney and her loved ones. As they watched, he struggled. Feverish and thirsty, he thought he was being held captive in Mexico, the constant sedation leading him to believe that his captors were drugging him. His loved ones watched him kick and flail in his hospital bed, with Courtney humming "Amazing Grace" to him every night before she left.

The doctors assured her that one day Zane would just emerge from his sedation and start talking to her. That day was six weeks after the accident. Although he was still on the feeding tube, he began eating his first real meal of peaches and ice cream six days later. To the amazement of his family and caregivers, he was well enough to make a trip home for Christmas 2010.

Wetzel's last operation was surgery on his neck in June 2011 and he will have additional neck surgery soon. He also may be facing a procedure on his thumb. "But hopefully, that will be the last one," he said.

His physical therapy has decreased to three days a week and he is now lifting heavy weights. He has gained mobility and strength. He can lift weights over his head now, something he could not do a few months ago.

The biggest change, however, has been the public speaking. The Wetzels are strong in their faith. The couple said they've had unbelievable reactions when they tell their story in public. "I always people that your strength doesn't come from you, God gives you the strength to get through," said Courtney. "Things happen for a reason, and you have to be strong."

During each session, Zane unbuttons his shirt and shows the audience his chest, which was the most severely burned in the accident. "I am not ashamed of my scars," he said. "And we always get a positive reaction when we speak -- lots of tears and people telling us how inspired they were by our story."

Zane adds that "I do want to go back to work. I will talk to the doctors to determine what sort of job duties I can perform."

Since he can't expose his skin to sunlight for very long and has poor circulation in his hands, which makes him more susceptible to frostbite, he cannot go back to his position as a power lineman. Still, he wants to return to work in some fashion and has kept in contact with his colleagues, who he called "very supportive."

The couple said they have amazing support from family, friends, and the community. They credited medical staff at both hospitals in Massachusetts as well Zane's team at County Physical Therapy for his recovery. They now are back to making plans both personally and professionally and looking forward to their next steps after the long journey home.

If you or someone you know suffers an injury such as third degree burns or smoke inhalation, you should call Kramer & Pollack LLP in Mineola, New York so that the personal injury attorneys in that firm can determine whether another party has legal liability for injuries suffered, and if the injured party has a strong legal case.

On April 1, the National Highway Traffic Safety Administration announced an investigation into the cause of fires in the Chevrolet Cruze, General Motors' best-selling passenger car. According to complaints made to NHTSA, there have been at least two incidents in which the small sedan has caught fire while in motion. What's more, General Motors confirmed that it is researching warranty claims involving fires for at least 19 Cruzes. NHTSA is also investigating incidents of fire in the Jeep Wrangler sport-utility vehicle.

In one incident, a driver said that his 2011 Cruze Eco - a model with a special factory-installed set of options that increases the sedan's fuel economy - caught fire when the car had about 11,000 miles on the odometer.

The driver first complained of a slight smoke smell whenever he brought the vehicle to a stop. In one instance, flames appeared out of the hood and the car was completely engulfed with fire within five minutes. The owners said that a warning light appeared on the dashboard only after the first flames appeared.

In the other case reported to NHTSA, a driver was waiting at a stop light when a driver in a nearby car started shouting that the Cruze was on fire. The vehicle also was quickly engulfed in flames.

Car fires are very dangerous because there are so many flammable liquids and other parts that can burn. Also, smoke can fill the passenger compartment of a car very quickly, to the point that the occupants might not be able to get out of the car before they are overcome by deadly smoke inhalation.

So if you are in a car and see or smell smoke coming from the car, park the car, shut if off immediately, move away from the car, and then call 911. DO NOT attempt to open the hood--this will the fire fresh air, and result in a flare-up of flames that can cause third degree burns to you or others around you!

The Cruze probe began only two months after NHTSA ended a similar investigation into fires that broke out following safety tests of the Chevrolet Volt, GM's plug-in hybrid vehicle. GM fixed the problem by adding structural reinforcement that better protects the Volt's battery pack from punctures or a coolant leaks if the car crashes.

But that issue affected sales of the Volt, and proved embarrassing to GM, which promotes the Volt as a technical achievement and a sign of the the firm's rebound from bankruptcy in 2009. Having to deal with another fire issue in a different car model could hurt Chevrolet's image. The typical Cruze buyer is "someone who is very practical, and safety will be a concern," said one auto-market analyst.

With sales of almost 232,000 last year, the Cruze became one of the nation's most popular small cars, outselling rivals such as the Honda Civic and Ford Focus and only narrowly trailing the Toyota Corolla. It is selling well in 2012 as new car buyers gravitate to more fuel efficient vehicles in light of rising gas prices.

The agency also has received eight reports alleging fires that originated in the engine compartment of the 2010 model year Jeep Wrangler vehicles. Seven of those complaints allege that the fire began while the car was moving.

No injuries or accidents have been reported with the fire incidents in both the Jeep and Chevrolet vehicles.

If you or someone you know suffers an injury such as third degree burns or smoke inhalation, you should call Kramer & Pollack LLP in Mineola, New York so that the personal injury attorneys in that firm can determine whether another party has legal liability for injuries suffered, and if the injured party has a strong legal case.

A recent article from the Institute for NanoBioTechnology discussed the developments that Johns Hopkins researchers have made in creating a jelly-like material for burn wound treatment which, in early experiments on skin damaged by severe burns, seemed to regenerate healthy tissue with no sign of the previous burn scars.

In a mid-December report from the National Academy of Sciences, the researchers reported their promising results from tests using mouse tissue. The new treatment has not yet been tested on human patients, but the researchers say that the procedure, which promotes the formation of new blood vessels and skin, could lead to greatly improved healing for victims of third degree burns.

The treatment involved a simple wound dressing that included a specially designed hydrogel: a water-based, three-dimensional framework of polymers. This material was developed by researchers at Johns Hopkins' Whiting School of Engineering, working with clinicians at the Johns Hopkins Bayview Medical Center Burn Center and the School of Medicine's Department of Pathology.

Third degree burns typically destroy the several layers of skin right down to the muscle tissue. They require complex medical care and leave behind significant scars. But in the journal article, the Johns Hopkins team reported that its hydrogel method yielded much better results than typical outcomes. "This treatment promoted the development of new blood vessels and the regeneration of complex layers of skin, including hair follicles and the glands that produce skin oil," said Sharon Gerecht, an assistant professor of chemical and biomolecular engineering, who was principal investigator on the study.

Gerecht said that the hydrogel could form the basis of an inexpensive burn wound treatment that works better than currently available clinical therapies, adding that the product would be easy to manufacture on a large scale. Gerecht suggested that because the hydrogel contains no drugs or biological components to make it work, the Food and Drug Administration would most likely classify it as a device. Further animal testing is planned before trials on human patients begin, but Gerecht said that "it could be approved for clinical use after just a few years of testing."

John Harmon, a professor of surgery at the Johns Hopkins School of Medicine and director of Surgical Research at Bayview, described the mouse study results as "absolutely remarkable...We got complete skin regeneration, which never happens in typical burn wound treatment," he said.

Gerecht says that the hydrogel is constructed in such a way that it allows tissue regeneration and blood vessel formation to occur very quickly. "Inflammatory cells are able to easily penetrate and degrade the hydrogel, enabling blood vessels to fill in and support wound healing and the growth of new tissue," she said. For burns, Gerecht added, the faster this process occurs, the less there is a chance for scarring. After 21 days, the gel is harmlessly absorbed, and the tissue continues to return to the appearance of normal skin.

If the treatment succeeds in human patients, it could address a serious form of injury. Harmon, a co-author of the NAS journal article, pointed out that 100,000 third degree burns are treated in the U.S. every year in burn centers.

If you or someone you know suffers an injury such as third degree burns or smoke inhalation, you should call Kramer & Pollack LLP in Mineola, New York so that the personal injury attorneys in that firm can determine whether another party has legal liability for injuries suffered, and if the injured party has a strong legal case.

Earlier this year, a man in Portage, Indiana, was placed into an induced coma after an industrial accident at the steel mill where he worked left him with third degree burns over 55 percent of his body.

The accident happened one evening at the ArcelorMittal Burns Harbor plant, when a high-pressure steam hose ruptured from where it was connected to an oxygen furnace. Gabe Rocha, a salaried foreman who transferred from the firm's Inland Steel plant to the Burns Harbor facility about six months ago, was checking pressure lines that are part of the cooling system when the hose ruptured.

At the time of the accident, workers were investigating an alert that a steam pressure line had stopped working properly. While Rocha was looking into the situation, the hose ruptured with such force that it threw him about 200 feet, dousing him with steam.

Rocha, who is in his 50s, was airlifted to the burn center at Loyola University Medical Center in Maywood, where he was placed in the coma. Rocha is expected to be in the medically induced coma for about a month, he added. "His hands, neck, back and legs suffered severe burns," said a union spokesman. Fortunately, he was initially listed in stable condition.

The plant workers' union and the steelmaking firm have launched a joint union-management investigation into the accident to determine the exact cause, and determine if the incident could have been prevented. "We want to make sure this doesn't happen again," said the union spokesperson.

If you or someone you know suffers an injury such as third degree burns or smoke inhalation, you should call Kramer & Pollack LLP in Mineola, New York so that the personal injury attorneys in that firm can determine whether another party has legal liability for injuries suffered, and if the injured party has a strong legal case.

In August 2011, Randy McAllister suffered third degree burns while trying to save equipment from a fire in wheat field. Today, he says that when he goes for his burn treatments, "it gets me to the threshold where I can't stand it, but then I find out it can hurt even more," says the 60-year-old farmer. During five weeks at the Oregon Burn Center at Legacy Emanuel Medical Center in Portland, Oregon, McAllister needed repeated rounds of burn wound care to remove dead tissue from his extensive burns. "It's more painful than the fire."

Then a nurse told him about SnowWorld, a computer game designed to help burn patients escape from agonizing pain by distracting their minds during burn treatments. During his next wound care session, McAllister wore headphones and looked through virtual reality goggles. He found himself floating through an icy canyon rendered almost three-dimensional by the wrap-around goggles. By tapping on a computer mouse, McAllister fired snowballs at animated penguins, snowmen and dolphins in the canyon to a soundtrack of upbeat music. And the virtual world made his real-world pain less overwhelming.

It's one of the most successful examples of non-drug pain management techniques to emerge from the work of psychologists and neuroscientists. The search for non-drug options has gained urgency amid a worsening epidemic of overdoses linked to prescription opioid pain relievers such as oxycodone and hydrocodone, which killed 14,800 Americans in 2008 - more those killed from heroin and cocaine overdoses combined.

In clinical trials, burn patients using SnowWorld reported 35 to 50 percent reductions in pain. The system was developed at the University of Washington by research scientist Hunter Hoffman and psychologist David Patterson, with input from burn care experts at Harborview Burn Center in Seattle.

Virtual reality therapy isn't a substitute for opioids and other pain-relieving medications, but it can boost the effectiveness of drugs - and possibly reduce the dosage. Researchers who developed the technology say it might also help people with chronic pain syndromes, although those clinical trials are incomplete.

Theresa McSherry, burn and wound care coordinator at the Oregon Burn Center, says burn patients need more options. Pharmaceutical research has provided safer and more effective anesthetics and opioid pain relievers, but drugs have limits.

"You can't safely give burn patients enough medication to provide adequate pain relief," says McSherry, a registered nurse who has worked with burn patients for more than 10 years. A grant from the Legacy Foundation allowed the Oregon Burn Center to buy the $66,000 virtual reality system in August. About a dozen are being used worldwide.

Preventing pain not only relieves immediate suffering, but also seems to help burn patients weeks and months later. Patterson, the UW psychologist, says the amount of pain during treatment is a stronger predictor of depression, anxiety and distress six months to a year later than the extent of burns or the length of hospital stay. "If you can control more of the acute pain, it can result in better long-term outcomes," he says.

Scientists have known for decades that the human brain can interpret the same signal transmitted by a pain receptor as painful or not, depending on what a person is thinking. Mood and expectation also play a big role. German researchers recently showed that a sad mood consistently makes people experience more pain. In another recent experiment, tricking people to think time passed more quickly reduced perception of pain.

Entering a rich, three-dimensional, sound-filled virtual reality might use so much of the brain's attention resources that less is available to process pain. "We're taking advantage of the malleability of human perception to deliberately divert mental resources away from the pain," Hoffman says.

Burn patients come to associate the sights and sounds of the wound treatment room with excruciating pain so that just entering the room can amplify the suffering, Hoffman says. Putting on headphones and goggles blocks the anxiety-stirring sights and sounds.

But distraction of attention appears to be the main way that virtual reality reduces pain. Hoffman's team has compared differing gear and found that the more realistic and "immersive" the gear, the greater the reduction in pain reported.

That matches McAllister's experience. His burned fingers made it difficult to hold the computer mouse during his SnowWorld experience. When the mouse slipped from his hand and he lost engagement with the snowball throwing, the pain of the procedure immediately intruded.

McAllister expects to continue intensive physical therapy for several months to regain more use of his fingers and hands. He may need additional surgery to remove scar tissue and increase joint mobility. But he's optimistic about returning to work next year.

Patterson believes virtual reality can help treat chronic pain as well. The UW researchers also developed a virtual reality program that induces hypnosis. The goal is to use post-hypnotic suggestion to change the way the brain handles chronic pain signals long after therapy sessions.

If you or someone you know suffers an injury such as third degree burns or smoke inhalation, you should call Kramer & Pollack LLP in Mineola, New York so that the personal injury attorneys in that firm can determine whether another party has legal liability for injuries suffered, and if the injured party has a strong legal case.

It is a life threatening medical emergency in which the heart is unable to pump oxygen rich blood to the vital organs of the body and can cause many organs to stop working.

Causes:

Hypovolemic shock happens due to decreased blood volume, losing about 1/5 or more of the normal amount of blood in the body causes hypovolemic shock. It is caused by:

1. Blood loss from bleeding, it can be bleeding from a cut, or internal bleeding.
2. Loss of blood plasma due to severe burns, this happens due to loss of skin and damage to the blood vessels.
3. Dehydration ie, diarrhea or vomiting (loss of a lot of body fluids may lead to a drop in the amount of circulatory blood).

Signs and symptoms:

1. Anxiety or agitation.
2. Cold, pale skin.
3. Confusion.
4. General weakness.
5. Low blood pressure.
6. Rapid pulse.
7. Decreased or no urine output.
8. If severe it can lead to unconsciousness.

• It is usually diagnosed based on the clinical features and physical exam, blood tests and other diagnostic methods might be needed to determine the exact cause of shock if it is not clear.

Treatment:

• It is a medical emergency, call 911 or take the person to the emergency room.
• While waiting for medical help:

1. Ensure that the airways are open and the person is breathing.
2. Place the person on his back and elevate the legs 6-12 inches unless there is a suspected back or neck injury where the person should be immobilized.
3. Keep the person warm.
4. Try to stop bleeding from an obvious bleeding site by applying direct pressure.
5. If the person is vomiting or there is bleeding from or around the mouth, place the person on their side or back with head turned to the side to avoid suffocation unless there is a head or neck injury.

• Hypovolemic shock is treated by replacing the fluid and/or blood, usually done through an IV line, in addition to treating the cause.
• The more severe the burn is, the higher the possibility that hypovolemic shock will occur.

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.

In mid-January, BMW began a recall of 89,000 Mini Coopers in the United States for the same sort of problem that led to earlier recalls of BMW and Rolls-Royce luxury cars.

The problem, in all the recalls, is that a computer circuit board controlling a turbocharger cooling system can fail. The result: an overheating and smoldering water pump and, in some cases, a fire in the engine compartment.

The turbo cooling system in the Mini Coopers operates differently from that in the BMW and Rolls-Royce cars, according to a letter BMW sent to the National Highway Traffic Safety Administration. Nevertheless, some turbocharged Mini cars have caught fire in the same way the larger cars did.

BMW is still investigating whether the cause of the problem is related or just coincidental. Germany's BMW AG owns and operates all three car brands.

Worldwide, the Mini recall covers a total of 235,535 cars. Cars being recalled include some model year 2007 through 2011 Mini Cooper S hatchbacks and convertibles; Mini Cooper Clubman S (the longer three-door Mini); and Mini Cooper Countryman S (the larger, four-door SUV Mini); as well as John Cooper Works high-performance versions of the Mini Cooper.

Mini Cooper dealers will replace auxiliary water pumps on the recalled cars. Non-turbocharged Minis are not involved in the recall.

There have been 81 cases of water pump failure in turbocharged Mini Coopers globally so far, including four engine compartment fires. No accidents or injuries have been reported as a result of this issue, however.

Nonetheless, the lesson that people should take from this news is that cars burn quickly because are made up of many flammable parts and hold combustible fluids. And because of this, when they malfunction it is possible that they produce fire and smoke conditions that can quickly overcome the occupants of the car, resulting in severe burns or smoke inhalation. In fact, several people die in car fires each year because they are unable to simply open the door and get out of the car in time!

So if you see or smell smoke coming from your car, do not wait to get to a gas station or a repair shop. Instead, stop the car and turn it off immediately--and then call for help.

If you or someone you know suffers an injury such as third degree burns or smoke inhalation, you should call Kramer & Pollack LLP in Mineola, New York so that the personal injury attorneys in that firm can determine whether another party has legal liability for injuries suffered, and if the injured party has a strong legal case.

The aim of physical therapy is to improve the movement and function of the affected area and to prevent and minimize scarring (hypertrophic, Keloid) as much as possible. Once the patient has sustained a burn injury such as a second or a third degree burn, the rehabilitation phase should begin as soon as possible.

Physical therapy usually starts at the time of admission; the patient will be assessed by a team of therapists who are part of the burn care team and rehabilitation will start accordingly.

Physical therapy may include:

• Body and limb positioning.
• Exercises: they are either active exercises done by the patient himself or passive exercises done by the physical therapist moving the area involved.
• Splints: splint will be fitted by your therapist and need to be worn as instructed, if you develop an allergic reaction such as redness, blistering, itching, numbness or abnormal sensation when wearing the splint than you have to remove it and contact your therapist immediately.
• Orthotic devices: some patients may need to use orthotic devices.

Physical therapy may be hard in the beginning because of the pain that is associated with the burn and surgeries, the sensitivity of the skin and the fear that the patient have. In children doing physical therapy may be harder; parents play an important role with the team in encouraging the child, helping him/her with their therapy and praising them.

Some patients will be transferred to a rehabilitation center after discharge from the burn center to continue their rehabilitation, the duration and type of therapy will depend on the condition of the patient and the severity of the burn.

Patients may be discharged home with instruction to continue physical therapy at home; compression garments may be given and used with exercising.

For some a physical therapist will be assigned to them making home visits, if exercises are given to you by your therapist, it is important to do these exercises and increase your home activities as advised by your therapist.

Make sure to follow all the orders and instructions given to you, it may be hard in the beginning, you may get tired and frustrated but you have to remember that it is for your benefit and will become easier with time, the aim of the therapy is to restore the normal daily activities as much and as soon as possible and to prevent any deformities.

Make sure to attend all outpatient follow up appointments with the burn clinic as your physicians and therapists will monitor your progress and adjust what needs to be adjusted for you.

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.

In late February, two Prince George's County, MD firefighters were critically injured when a wind-fueled fireball blew through a burning house. They will survive, but the two members of the Bladensburg Volunteer Fire Department will face long, painful recoveries.

Ethan Sorrell, 21, sustained respiratory burns "through his esophagus and down to his lungs," and Kevin O'Toole, 22, suffered second and third degree burns over 40 percent of his body when a basement fire suddenly turned a small house into something resembling a blast furnace.

O'Toole underwent skin graft surgery shortly after, and will be in the burn unit at the Washington Hospital Center for six weeks. He then faces six months of rehabilitation beyond that.

Doctors won't know the full extent of the damage to Sorrell's burned airway until they remove a breathing tube. His father, Vann -- a volunteer firefighter in Buies Creek, NC -- welled up when asked about his son's bravery. "When you go into it, you know the dangers," Sorrell said. But the Sorrells "just have that need to serve," he added.

His son is unable to speak but has been communicating with a pen and paper. He seems to be in good spirits, said the local fire chief. "The first thing Ethan wrote to me on a pad was [that] the medic who transported him was attractive."

Five volunteer firefighters were treated and released for burns and other injuries suffered in this incident, which as been called by fire officials a "freak occurrence."

One of the injured was Michael McClary, who returned to the hospital two days after the fire with bandages wrapped around his hands, and his heart heavy. "He's still upset that he got to go home and his brothers didn't," said his mother, Cheryl.

Michael, she said, wasn't up to discussing publicly what happened at the house, where wind gusts apparently shot a column of flame up the stairs, through the first floor and out the front door.

The fire was extinguished quickly, said a fire commander who was directing a group in the basement at the time of the fireball.

If you or someone you know suffers an injury such as third degree burns or smoke inhalation, you should call Kramer & Pollack LLP in Mineola, New York so that the personal injury attorneys in that firm can determine whether another party has legal liability for injuries suffered, and if the injured party has a strong legal case.

Last week, a small fire at a high-rise hotel in the main tourist district of Bangkok, Thailand caused the upper floors to become filled with smoke, killing at least one foreign tourist and injuring 23 others.

When firefighters arrived at the 15-story Grand Park Avenue Bangkok hotel last Thursday evening, they saw people screaming for help from the upper floors. The smoke had risen so quickly and had gotten so thick that "people were panicked and some of them wanted to jump from windows. We had to tell them to wait and we sent cranes in to help," said a local fire chief.

One foreign woman who suffered from smoke inhalation was unconscious when taken from the building and later died at a Bangkok hospital. It can take just two or three breaths of smoky air that contains carbon monoxide and hydrogen cyanide to cause permanent injury to the brain, heart and lungs, and even death.

The other victims included two Thais and 19 foreign tourists, most of whom suffered from smoke inhalation.

Investigators were still trying to determine the cause of the fire, which started on the building's fourth floor shortly before 10 p.m. and was quickly extinguished, but sent suffocating smoke to the upper floors at a time of night when most people were in their rooms.

Dozens of people were evacuated and rescue teams treated at least 12 people at the scene to clear their lungs of smoke.

The three-star hotel, formerly known as the Grand Mercure Park Avenue, has 221 rooms and is located in a tourist and residential district popular with foreigners.

The lesson to be learned from this incident is that hotel guests should locate the fire exits on the floor they're staying on as soon as they arrive. As the victims who were trapped in this hotel found out, even a small a small fire needs only a few minutes to cause choking smoke that will rise through a building, just like in a chimney. This can cause death and injury to people who are located far away from the actual fire. In a hotel fire situation, every second counts, so knowing where the exits are located before an emergency happens could mean the difference between life and death.

If you or someone you know suffers an injury such as third degree burns or smoke inhalation, you should call Kramer & Pollack LLP in Mineola, New York so that the personal injury attorneys in that firm can determine whether another party has legal liability for injuries suffered, and if the injured party has a strong legal case.

Several weeks back, a few unattended candles sparked a fire that caused about $130,000 in damage and caused more than 40 people to be evacuated from an apartment building in Seattle, Washington.

The fire started at just before 4 a.m., according to the Seattle Fire Department. Firefighters responding to the scene had to use a ladder to rescue a woman who had already become trapped in her second floor unit. Once she was rescued, it took them another 30 minutes to knock down the fire.

The evacuated residents waited inside a city bus as the firefighters fought the blaze. By about 6 a.m., all but two of them were able to return to their homes. Those two residents, a man and a woman, were being helped by American Red Cross.

The fire caused about $100,000 in damage to the building and about $30,000 in damage to its contents. Fire investigators determined that the blaze was started by unattended candles.

A Seattle Fire Department spokesperson said that this fire should serve as a lesson about the danger of using candles indoors, especially at a time when many people might be using candles to save money on their electric and heating bills. In short, it is dangerous to leave candles burning when you leave the room, even for a minute or two. Candles can fall over easily, which means they could ignite carpet, furniture or curtains and quickly cause a much larger fire.

If you or someone you know suffers an injury such as third degree burns or smoke inhalation, you should call Kramer & Pollack LLP in Mineola, New York so that the personal injury attorneys in that firm can determine whether another party has legal liability for injuries suffered, and if the injured party has a strong legal case.

In mid-February, the following product safety recall was voluntarily conducted by Bosch Security Systems of Fairport, NY, in cooperation with the U.S. Consumer Product Safety Commission. Consumers should stop using this product immediately unless otherwise instructed. It is illegal to attempt to resell a recalled consumer product.

The name of the Bosch product is the Fire Alarm Control Panel. The fire alarm panel is a locking red wall box with dimensions of 22.7 inches high by 14.5 inches wide by 4.3 inches deep. The status, date and time can be seen through a glass screen on the panel door. The word BOSCH is printed on the right corner of the panel and the model number FPA-1000-UL is printed on the bottom left below the glass screen. The alarm panels featured software versions 1.10, 1.11 and 1.12, which can be determined by installers. These units were designed to be used in small to medium-sized facilities, in both public and residential buildings. These were sold at authorized distributors and installers nationwide from May 2009 through October 2011. They were manufactured in China.

About 330 units are being recalled because when the "alarm verification" feature of the system is turned on, the control panel could fail to sound an alarm if a fire occurs. In addition, on systems with 50 or more reporting stations, a delay in sounding an alarm and reporting a fire might occur if the loop for the alarm system is broken.

As part of the remedy, all distributors and installers of these fire panels are being sent two technical bulletins. One provides instructions for how to implement a software change that will correct the verification feature. The second contains instructions for how to handle warnings from affected systems with 50 or more stations. Those who have not received the bulletins should contact Bosch.

No injuries have been reported due to the possible faults of these fire alarm systems. But the recall is being done to ensure that nobody who is inside a building that uses such a system suffers severe burns or smoke inhalation as a result of not being notified of a fire by the system.

To obtain instructions on how to download software to update the control panels or otherwise address the problems, contact Bosch Security Systems at (800) 289-0096 between 8:00 a.m. and 8:00 p.m. EST, or visit the "service and customer care" section on the Bosch website.

If you or someone you know suffers an injury such as third degree burns or smoke inhalation, you should call Kramer & Pollack LLP in Mineola, New York so that the personal injury attorneys in that firm can determine whether another party has legal liability for injuries suffered, and if the injured party has a strong legal case.

Diagnosis:

The diagnosis of DVT is made by physical examination and testing, the tests may include:

• Doppler ultrasound exam of the suspected limb.
• Blood tests: which include D-dimer, other blood tests may be done to test if there is increased blood clotting.
• Leg venography: it is an X-ray done to show the veins in the leg.

Treatment:

• The standard treatment is using medications called blood thinners (anticoagulant), such as Heparin which is given intravenously and Warfarin which is given orally and used for long term treatment, Warfarin needs time to be fully effective and that is why it is given while the patient is still on Heparin. When the patient is started on Warfarin, Lab tests will be needed to check the thickness of blood.
• Thrombolytic therapy: this is done by injecting drugs that lyses the clot.
• Catheter directed to remove the clot.
• Placement of a filter in the inferior vena cava (largest vein in the body) to prevent the clot from traveling to the lung.

You should seek medical help immediately if you have a history of DVT and develop symptoms such as chest pain, breathing difficulty, fainting, coughing blood or other symptoms.

Prevention:

• Stop smoking.
• In any condition that requires long time sitting ie, long plane trips or long period of time lying in bed, the person should try to move his/her legs to avoid stagnation of blood which increase the risk for developing DVT.
• Blood thinners, these medications decrease the thickness of blood and decrease the incidence of clot formation; they may be prescribed for Patients who are at high risk of developing deep venous thrombosis.
• Pneumatic compression device: these are devices that may be used to decrease the incidence of deep venous thrombosis. They are prescribed for patients in the hospital who are at risk of developing deep venous thrombosis. The sleeves of the device are attached to the calves of the patient. The sleeves periodically squeeze the calves preventing blood from stagnating. A blood clot may occur if the blood is stagnant. If you leave the bed ie, to walk or visit the restroom, you have to make sure that the device is reconnected when you return to your bed as these devices should be worn all the time.

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.