April 24, 2012

Septic Shock and Third Degree Burns (part II)

Diagnosis of septic shock:

  • History and physical exam.
  • Observing characteristic symptoms.
  • Tests including blood tests, blood cultures ( may not become positive for several days after the blood has been taken), urine, sputum and spinal fluid test, organ function tests, X-ray, CT scan and others.

Treatment of septic shock:

  • Septic shock is a medical emergency, the treatment is started even before diagnosis through lab conformation.
  • Admission to the intensive care unit is essential.
  • Mechanical ventilation and oxygen administration.
  • Treatment of infection with antibiotics.
  • Intravenous fluids and medication administration to raise blood pressure and restore blood volume.
  • Support of organ dysfunction,
  • Surgery.

Out come of septic shock: the outcome depends on:

  • The age of the patient.
  • The underlying health condition of the patient.
  • The causative microorganism.
  • The number of organs that have failed as a result of the septic shock ( the lesser the better outcome).
  • The timing of the start of treatment (the sooner the better outcome) and the method of treatment.
Prevention of septic shock:

Although some causes can not be prevented, immediate treatment of bacterial infections, wounds or burns decrease the incidence of septic shock.

  • Take care of any infection that you get ( see wound infection) and contact your doctor or go to the emergency department if you develop symptoms of septic shock.
  • If you are taking care of a patient with burns in a hospital, contact the treating staff if you notice any symptom of septic shock on the patient.
  • If you are a care giver of a burned patient at home, contact the treating physician if you notice any symptoms of septic shock on the patient ( see burn wound care at home).
  • Due to the increase of elderly patients and the increase in the invasive medical procedures and devices along with the increase in immunocompromised patients in recent decades, the rate of death from septic shock has increased.

Kramer and Pollack, LLP; are VERY well versed in all aspects of representing burn injury victims. They have handled a multitude of burn injury cases ranging from hot water scald burns, to stove tipping cases to explosion cases. They are competent, experienced and very thorough

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 24, 2012

Huge Workplace Fire at Oil Company Creates Possibility of Dangerous Smoke Inhalation for Miles

In Pike Township, Ohio, last week, firefighters from dozens of departments needed six hours to get control of a massive fire at an oil company. The damage from the fire, smoke, and hazardous materials that leaked will require an extensive environmental cleanup in the area.

More than 50 agencies responded to the workplace fire. The blaze produced flames that shot 200 feet into the air, and black smoke could be seen several counties away. The clouds of smoke could even be seen on weather radar. The oil company supplies diesel fuel, heating oil, gasoline, racing fuel, bio-diesels and lubricants.

Ohio Environmental Protection Agency officials at the scene determined that oil spilled into a tributary of Donnels Creek, which feeds into Mad River. Officials used vacuum equipment and other techniques to remove environmental contaminants. "We pushed hard to protect the environment," said a local fire chief. "We should have things back to normal in a couple days."

Public and private hazardous materials teams contained petroleum-based contaminants to no more than a quarter mile downstream, said another fire chief who is a member of the county's hazardous materials team.

Firefighters ramped up the use of water and foam to quench the flames after the fire spread throughout the entire facility. One firefighter was treated for a minor leg injury, and all 15 employees at the company's plant were accounted for. Homes in the surrounding area had minimal to no damage.

The fire started about 11 a.m. as the oil company's crews loaded a tanker truck. The cause of the fire is still under investigation, but fire officials believe it ignited while workers transferred a fluid from one tank to another. It was not immediately known what type of fluid was being transferred.

After about 45 minutes, firefighters ordered first responders and company employees to get back as the blaze spread. Electric transformers exploded and electric lines fell on the scene a short time later, forcing firefighters back even more. And as the fire spread, the building began to collapse.

Before the fire spread, oil company employees were able to salvage all computer servers and some files. But once the flames began advancing and the possibility of severe burns and smoke inhalation became higher, people were told to evacuate.

At the time of the fire, the company said it only had lubricants at the site. However, a fire chief said the fire involved several petroleum products and fuel oil, including 55 gallon drums of petroleum product. There might be legal liability on the part of the company if any employees or local residents were injured in this incident, or afterwards as a result of environmental contamination.

Some oil was found in the stream near the facility. One official said that this tributary was "running orange-red." Veolia Environmental Services of Dayton, Ohio had booms in the tributary to try to stop the flow of the oil.

Michelle Simmons, environmental manager for the Dayton Water Department, said her department recommended that the Mad River intakes be closed overnight as a precaution, even though the Ohio EPA does not expect any impact to the Mad River surface water from runoff. Any possible runoff will have passed the water supply intakes by morning, she said.

The city of Springfield's water well taps an aquifer along Mad River. It also has a ridge line along it, creating almost a confined pond that provides more protection. Fortunately, "we are upstream of their problem," said one city official.

Runoff of contaminated surface water is a common concern in fighting fires near hazardous materials. "When you knock down a fire of any size, you're going to have the water you use picking up contaminants," said one fire chief.

The Ohio EPA likely will monitor the stream and other water sources for the foreseeable future. Residents near the fire have well water, and several horse farms in the area rely on the stream, so they need to monitor the quality of their water.

This chemical fire posed numerous risks. One fire chief said that firefighters have to be aware of numerous risks when fighting a fire of this magnitude. The chemicals can seep into the clothes and skin of first responders, contaminate the air, and when mixed with water can create a slurry that will create an environmental hazard as it seeps into streams and waterways. Some surrounding homes were evacuated and people with farm animals had been advised to keep them away.

Having enough water to keep flames under control was a challenge. Without hydrants, fire crews trucked water into the site, including from schools and a local water tower. Firefighters used 5,000 to 6,000 gallons of water a minute, said a fire chief.

Firefighters handling the blaze went to Springfield's distribution district and filled up tankers with water from the city's hydrants. As crews worked to keep a steady supply of water on hand, officials remained concerned about the potential for explosions. There were many large explosions during the first several hours of the fire -- a large boom followed by a ball of flame and a heat wave that spread across the area. Soot and ash rained down cross the scene, raising the possibility of dangerous smoke inhalation.

The Clark County Sheriff's Office advised people in the immediate area to close their windows and turn off air conditioning. The advisory was issued about 1 p.m. and lifted about 6 p.m.

Clark County Health Commissioner Charles Patterson said his agency worked closely with incident commanders on the scene, as well as the Regional Air Pollution Control Agency. Brian Huxtable, of the Regional Air Pollution Control Agency, advised people to avoid the smoke if possible but said as far as he knows, it's not a serious inhalation hazard if people stay far enough away. "It may cause coughing... Just try to avoid going outside in it." People with prior breathing problems like asthma would probably be affected most, he said.

The two air pollution monitors in Clark County picked up any smoke by mid-afternoon, probably due to their placement in relation to the smoke plume. Officials closed ventilation systems at local schools anyway.

Kelly Phares lives across from the scene of the fire, and said that "I heard some pops and literally my house shook," she said. "I'm concerned that something flammable could fly over, but we don't have any trees or anything (that would catch fire)." She said black debris from the fire is in her yard.

"I just happened to look outside and I thought it was getting cloudy," she said. "But then I saw (the fire) before the fire trucks got here. It's pretty scary."

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.

April 19, 2012

Hydrogen Cyanide Plays a Large Role in Fire Deaths from Smoke Inhalation

A recent article in the trade publication EMS World discussed how the newer materials being used in home construction are actually making the homes more dangerous in the event of a house fire. And it is not the flames that make fires in new and recently built homes so dangerous, but rather it is the danger of smoke inhalation, which kills many more people in fires than do third degree burns.

With the number of smoke inhalation deaths between 5,000 and 10,000 each year in the U.S., experts looked at possible factors in those numbers being so high. And what they found is that because of lightweight construction materials and the increased use of synthetics in buildings and furnishings, a house fire is likely to reach "flashover" in a shorter period of time in the past. Reduced flashover time means there is a reduced time for firefighters to intervene, and it also means that potential smoke inhalation victims have much less time to escape from the fire. And the levels of toxic gases in the fire smoke also increase dramatically. All that adds up to increased potential for becoming incapacitated from smoke inhalation, and thus more possibility of death.

So it is important to know about the materials that were used to build the house or apartment you live in, so you can figure out how much time you would have to escape in case of a fire.

You see, fire smoke contains particulate matter as well as heated gases such as hydrochloric acid, sulfur dioxide, ammonia and carbon dioxide. It also generates toxins including hydrogen sulfide and hydrogen cyanide.

Recent research from independent studies about smoke inhalation victims may very well change the treatment protocols. More evidence now suggests that victims of smoke inhalation also suffer significantly from cyanide poisoning. Cyanide kills quickly by disabling the blood's mechanism for carrying oxygen. Cyanide in a fire comes from natural substances such as wool, silk, cotton or paper. Synthetic substances, such as plastics and other polymers, also produce cyanide.

Two studies in different countries were designed to assess the role of cyanide in fire-related mortality. In both studies, blood samples were drawn from smoke inhalation victims as close as possible to the times of exposure to smoke.

In one study, blood was collected by the first-arriving medical squads to residential fires. A total of 109 fire victims were studied - 66 who survived and 43 who died. The data was compared against 114 control individuals - 40 with drug intoxication, 29 with carbon monoxide poisoning and 45 with major trauma. The study showed that in some victims who died, blood levels of cyanide were in the potentially lethal range while blood levels of carbon monoxide were in the non-toxic range.

These results were directly opposite the thinking that smoke inhalation victims die only from carbon monoxide. Instead, the study showed that cyanide and carbon monoxide were both important when determining mortality risk associated with smoke inhalation. Other results of the study showed that cyanide concentrations were directly related to the probability of death, and that cyanide poisoning may have been the leading cause of death in some fire victims, and that cyanide and carbon monoxide may have possibly helped the toxic effects of one another.

The other study collected blood within eight hours from victims exposed to smoke. The study compared 144 smoke inhalation victims who arrived alive over a two-year period at the University of Texas Health Science Center emergency room against 43 smoke inhalation victims who were dead on arrival at the Dallas County Medical Examiner's Office during the same period.

The study found that the average blood cyanide concentrations in victims arriving alive at the emergency room were lower than concentrations in victims who were dead on arrival. The Dallas County study concluded that elevated cyanide concentrations were more present among smoke inhalation victims. It also concluded that cyanide concentrations were directly related to the probability of death, and cyanide poisoning may have been the leading cause of death over carbon monoxide poisoning.

And in a study using monkeys, researchers found that even sub-lethal concentrations of cyanide in a fire can still cause death because it rapidly brings on unconsciousness, thus preventing escape from the fire and permitting more exposure to fatal concentrations of other toxins.

As a result of these studies, it is easy to conclude that cyanide plays an important role in causing death and incapacitation in fires. Further, medical providers and firefighters should suspect cyanide poisoning in any person exposed to smoke from a fire in a closed space and any other smoke inhalation victims with soot in the mouth, an altered mental status and low blood pressure.

Obviously, the difference between life and death of a smoke inhalation victim is dependent upon the concentration of exposure and the time between exposure and treatment.

The current treatment of smoke inhalation victims is to administer pure oxygen and stabilize vital signs.

Some fire departments and ambulances carry cyanide antidotes kits specifically for smoke inhalation victims, called Cyanokit. By protocol, if a victim has soot in the nose or mouth and suffers an altered level of consciousness, the Cyanokit is used.

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.

April 18, 2012

Septic Shock and Third Degree Burns (part I)

One of the complications of severe burn injuries such as third degree burns is septic shock. Septic shock is a serious medical emergency that result from bacteremia ( bacteria in the bloodstream) leading to sepsis which is a systemic immune response to the bacterial toxins, this will lead to a dramatic drop in blood pressure leading to decrease tissue perfusion and decrease oxygen and nutrient supply to the tissues. Septic shock is the number one cause of death in intensive care units and the 13th most common cause of death in U.S (Parrillo, 1990 and US CDC). The mortality rate may reach up to 50%.

Septic shock can cause multiple organ dysfunction syndrome (multiple organ failure) including respiratory system failure and may cause death. Sepsis can be caused by other infectious microorganisms other than bacteria such as fungus and viruses. Septic shock occurs most often in children, elderly and immunocompromised individuals as their immune system is weakened and can't effectively with infection. Infection can be localized to a particular site but when the immune system is weakened or compromised, the infection can spread to the blood stream causing systemic infection, sepsis and septic shock.

Risk factors for septic shock may include:

  • Severe burns (second and third degree burns) and severe injuries.
  • Diabetes mellitus.
  • Aids.
  • Advanced cancer.
  • Pneumonia.
  • Genitourinary tract infections and diseases.
  • Liver cirrhosis.
  • Infections of the abdomen.
  • Indwelling catheters that are kept in place for a long time.
  • Patients using chemotherapy.
  • Prolonged use of antibiotics.
  • Recent surgery, organ transplant or medical procedure.
  • Recent infection.
  • Recent use of certain steroid medications.
Symptoms of septic shock:

Septic shock can affect any organ of the body, symptoms may include:

  • High temperature (fever) > 100.4 degree F or low temperature (hypothermia) < 96.8 degree F, chills.
  • Rapid heart rate (tachycardia) > 90 beats per minute.
  • Palpitation (awareness of the heart beats).
  • High respiratory rate ( hyperventilation) > 20 breaths per minute.
  • Low blood pressure.
  • Pale and cool body extremities.
  • Skin rash or discoloration.
  • Little or absent urine out put.
  • Shortness of breath.
  • Dizziness, lethargy, agitation, disorientation, confusion or coma.
  • Organ failure such as respiratory failure.
  • Gangrene that may lead to amputation.

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 17, 2012

Mayor of Newark, NJ Saves Neighbor From Severe Burns and Smoke Inhalation in House Fire


On April 12, Newark Mayor Cory Booker saved a neighbor from a blazing house fire -- a dramatic rescue that he admitted was absolutely terrifying.

The dramatic rescue began at around 9:30 p.m. that night, when Booker and two officers from the Mayor's security team spotted a fire at a house on Hawthorne Avenue belonging to Booker's neighbor. They went over to investigate.

On the first floor, they found a couple, who told them that the woman's daughter and a man were trapped upstairs. Booker and Newark Detective Alex Rodriguez then went to the top of the stairs, where the home's kitchen had erupted in flames.

They first saw a man trying to douse the fire, and told him to get out. Then they heard Zina Hodge, 47, yelling for help from somewhere beyond the burning kitchen.

"This woman is going to die!" the mayor recalled saying at that moment.

"It was very scary, and I consider myself very lucky," Booker said. "There was a time I got through the kitchen and was searching for her, and I looked back to see the kitchen in flames. It was really a frightening experience for me. I didn't think we'd get out of there."

Despite the flames, Booker was determined to get Hodge, whom he has known for six years and considers a good friend. "When I come home from a really tough day, she's there to tease me," he said. "She's just a really good human being."

Rodriguez, however, tried to stop his boss because the fire was getting worse. "Something exploded [in the kitchen], and at that point, my security men did what they're trained to do, which is get me out of danger," Booker said. "So Detective Rodriguez and I had a bit of an altercation. He was literally pulling me by the belt. Finally, I whipped around, we had some words, and he relented. In the end, I am his commanding officer."

Booker said he had to crawl on his hands and knees to get to the bed where Hodge was lying, because the rising smoke was so thick that he would have passed out from smoke inhalation if he did not get down on the floor. In a smoky fire, the cleanest air can be found near the floor, so the correct thing to do is to crawl to safety.

Booker put Hodge over his shoulder and carried her back through the kitchen -- where fire was shooting up the wall and flaming embers were showering down around them. At this moment, Booker said he feared for his life.

"Honestly, at that point, I did not feel bravery -- I felt terror," he said. "It looked like I couldn't get back from where I came from. And I couldn't breathe." But he eventually got back to Detective Rodriguez, and they both took Hodges out of the house.

"She didn't have many clothes on, so she sustained more severe burns than I did," Booker said. "I was holding her and my clothes got burned, but my hand was the only part of my body that got burned."

Two days later, as Hodge was treated for a few third degree burns plus other second degree burns, her mom, Jacqualin Williams, showered Booker with praise. "I think he's Super Mayor," she said. "He should stay mayor and then become president." Booker said he didn't feel like a hero, and balked at being called Super Mayor. "I think that's way over the top. There are people who do this every day," he said, referring to police officers and firefighters.

But Hodge's family feels that Booker was a real hero. "That was great," said Hodge's brother, Roderick Lucas, 38. "My uncle tried to get into the burning house, and my nephew too. Neither one of them could get through, but the mayor did."

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.

April 12, 2012

Smoke Inhalation During Night-Time Fires is Often Deadly--Smoke Detectors Are Absolutely Necessary

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.

April 10, 2012

Smoke Inhalation, Not Severe Burns, Is Most Deadly Aspect of House Fires

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.

April 5, 2012

Severe Burn Victim's Survivor Story Inspires Others

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.

April 3, 2012

Two Car Models Investigated for Possibility of Fire That Can Cause Severe Burns to Driver and Passengers


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.

March 30, 2012

New Skin Grows Over Third Degree Burn Injuries, Thanks to Hydrogel


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.

March 27, 2012

Workplace Accident Causes Severe Burns for Steel Plant Employee


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.

March 24, 2012

Burn Victims Can Reduce Pain Through Virtual Reality Games

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.

March 23, 2012

Hypovolemic Shock

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.

March 20, 2012

Recall of Mini Coopers for Fire Hazard Reminds Us That Cars Can Cause Severe Burns and Smoke Inhalation Injury


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.

March 20, 2012

Physical Therapy and Third Degree Burns

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.