Burn Injury Resource Center

A family in Clinton, Iowa is teaming up with firefighters around the midwestern U.S. to turn a terrible tragedy into an educational program that will probably save many people from suffering deadly smoke inhalation or severe burns due to house fires.

Four members of the town's Molitor family--two young boys, their mother, and their grandmother--all died of smoke inhalation after a chair caught fire in their Clinton home two years ago. The most heartbreaking aspect is that this was a small fire, which started in a chair. Unfortunately, the burning chair generated a lot of smoke quickly, and the family members who stayed too long in the house (rather than evacuating immediately and calling 911 from outside) were overcome by smoke, fell unconscious, and died. It takes just one or two breaths of smoky air to make a person pass out. In fact, 70 percent of all fire deaths are from smoke inhalation, not burns.

Furthermore, "there was not a smoke detector in the house, and there wasn't even a heat detector," said one family member recently. "There was nothing to alert some of them until it was too late. That is the worst part about it--this tragedy could have been prevented."

But since the fire, the family and the Clinton Fire Department have found a way to use this great loss to help save others. "The best thing we could do was get that information out to the public so it doesn't happen to anyone else," says one local fire official. So the Clinton FD created the "smoke detector project" just days after the fire. They will provide a smoke detector to anyone who needs one, for free--they'll even install it.

In the last two years the Clinton FD has installed more than 2,500 smoke detectors, and their program is now being instituted across the state. Also, Iowa firefighters are working to create a national smoke detector project.

The best part: The local smoke detector project has already saved a number of lives, which makes the Molitor family's terrible loss a little easier to bear. "If one life was saved, that is more than enough for them to use our last name in publicizing the program," said one Molitor family member. "If a thousand lives can be saved, I'll say that my family members' lives were not lost in vain."

Iowa's Smoke Detector Project is organized by fire marshals from around the state. Other states around the country also have free smoke detector programs. For information on obtaining a free smoke detector, call your local fire department or type in the words "free smoke detector" plus the name of your state into www.Google.com.

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.

Here's a story that provides a very good lesson for all of us on the need to think about fire safety not just at home, but also when walking around in stores, malls, and other public places.

In early January in Peterborough, Ontario, Canada, four people had to be treated for smoke inhalation after a fire broke out in a store. A clothing shop caught fire at about 8:15 p.m. on a Friday night, and firefighters were called away from a small fire in another neighborhood to fight the shop fire.

On arrival, fire crews found the fire was already extinguished. But even so, there were people in need of medical treatment, so paramedics were called in. Two ambulances and a rapid response vehicle were sent to treat three females who suffered smoke inhalation. They were taken to Peterborough City Hospital for further care.

Now, it is unlikely that many people think about where the nearest public exits or emergency exits are located when they enter a store, or a mall, or a sports arena, or another public place. But if you do not know where the exits are located, you have shortened the amount of time you have to escape and survive if a fire does break out.

So, always find the nearest public exit or emergency exit as you enter any building. Why? Because fire smoke spreads quickly, and is so poisonous with carbon monoxide and hydrogen cyanide that inhaling just one or two breaths of fire smoke can make a person unconscious and unable to escape. And even if an unconscious person is rescued by someone else, damage to the lungs, heart and brain from smoke inhalation can be permanent, forever changing a person's life.

If you or someone you know does suffer 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.

Winter is the time of year when home fires are more prevalent, and the Elgin, Illinois Fire Department offers excellent tips on how to stay safe as people try to stay warm in their homes.

"Winter storms can interrupt heating and electric service, and many times people attempt to heat their homes using alternative means, increasing the risk of fire," said Elgin Fire Chief John Fahy. "What's more, even cooking or trying to generate additional heat from traditional sources can also increase the risk of fire."

The United States Fire Administration reports that each winter, more than 108,000 residential building fires occur in the United States, resulting in 945 deaths, 3,825 injuries and about $1.7 billion in property loss.

Cooking is the leading cause of residential fires, followed by heating. And space heaters account for about one-third of home heating fires, plus about 80 percent of deaths from home heating fires, according to the USFA. And nearly 70 percent of these deaths are from smoke inhalation, and not from severe burns. Even a small kitchen fire that is contained to the stove top can produce enough smoke to kill occupants of the home--one or two breaths of poisonous smoke is all it takes!

Fahy recommends the following to keep you and your family safe this winter:

-If you are cooking anything on the stove, do NOT leave the kitchen while it cooks. Using the stove to fry, grill, or broil food creates an opportunity for something to catch fire. If you must leave the kitchen, turn off the stove!

-Give a space heater some space--keep anything that can burn at least three feet away from a space heater.

-Check electrical cords for cracks or exposed bits of wire, and replace those cracked or damaged electrical or extension cords. Do NOT try to repair them!

-Never use your oven or stove-top to heat your home. This is a fire hazard because they aren't designed to heat a home, and the carbon monoxide gas emitted from the burning gas could kill people or pets.

-Don't leave Christmas trees, wreaths, or cut flowers too long. Do NOT keep these items in the house longer than two weeks. And keep the tree stand or the flower vase filled with water. Dried-out trees, wreaths, and flowers burn very easily and quickly!

-If you use candles, place them in a sturdy candle-holder with a wide base, and which will not burn. Do NOT leave a room that has a burning candle in it--if you must leave the room, blow out the candle!

-If you smoke cigars, cigarettes or pipes, smoke outside the house and make sure all ashes and embers are extinguished by pouring a small amount of water on top of them. Many times, using your foot to put them out does NOT work!

The fire chief also made this very important point: "Most fires are preventable."

For more information about fire safety, go to the USFA website (see link above) and also visit the National Fire Protection Association.

If you or someone you know does suffer an injury such as severe 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 our last blog post, we wrote about five family members who died of smoke inhalation during a house fire in Connecticut. The fire raged so quickly through the wooden house that investigators still do not know if there were smoke alarms in the house that alerted the occupants.

But consider this: if these fire investigators think that people could have died in a fire even though there might have been smoke detectors in the house, how can anyone think that they could escape a fire when they do NOT have working smoke alarms in their house? Smoke inhalation kills people so quickly that even one or two breaths of air contaminated with smoke and carbon monoxide and hydrogen cyanide can render a person unconscious, and cause them to die even if they are rescued before suffering any third degree burns.

Here is just one recent example of such a situation: A woman died from smoke inhalation in Washougal, Washington in large part because the smoke detector in her apartment had been disconnected. The 28-year-old woman's apartment caught fire not while she was asleep, but right in the middle of the day! And the fire was not very big--it was contained to an upper-floor apartment and did not spread to the lower floor, and was extinguished within a few minutes. But the woman was found unconscious in a bedroom, and there were no other occupants in the apartment. The Clark County Fire Marshal's Office said a few days later that there was not a working smoke detector in the apartment--it had been disconnected.

"It's tragic, that is for certain," said the property manager. "We've done our best to reassure the other residents that there are no structural problems in the building. It appears that this was an anomaly. As far as we know, there are no electrical, structural or mechanical problems with the unit that would be of concern to the other residents." In other words, this fire might have started from something as simple as a pot or pan left on the hot stove and then forgotten.

If this tragic story does not convince you to install smoke detectors near the kitchen and the bedrooms of your home, and also to check the batteries and the working status of these smoke alarms regularly, then you are simply risking your life and the lives of others who come through there.

Lastly, if you or someone you know does suffer a smoke inhalation injury or severe burns, 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 solid legal case.

When it comes to extinguishing a fire, there is nothing to say except this: DO NOT try to do it yourself--call the fire department and let them fight the fire when they arrive.

In the event of a fire or a smoke condition, the only concern you should have is getting yourself and others away from the situation so that nobody suffers severe burns or smoke inhalation that can result in death.

You need some proof of how easy it is to become injured or killed by small fires? We have plenty:

1. In Foxboro, Massachusetts recently, a 15-year-old boy was taken to an area hospital suffering from smoke inhalation after trying to put out a bathroom fire in his home, one of two blazes that kept town firefighters busy Sunday afternoon.

Fire broke out around 3:30 p.m. in the first-floor bathroom of a three-family home, according to a local fire captain, He said that the teenager, who was later taken to Norwood Hospital for treatment, tried to douse the flames himself, but was unable to extinguish them.

There was heavy smoke and soot damage to the first floor of the home, leaving a family of four looking for somewhere to stay for the night.

"They're displaced, at least for the night," said the fire captain, adding that the American Red Cross had been notified. Luckily, the other tenants of the three-story house were able to stay there.

The call for the bathroom fire came into the fire department shortly after firefighters returned from battling a garage fire in another part of town. That fire, said the fire captain, was started when a pile of ash from a fireplace was put outside in a careless manner.

"The wind must have picked up," the fire captain said, adding that the embers from the ash must have re-ignited and blew towards a nearby wooden-framed, two-story detached garage. Most of the damage, estimated at about $10,000, was to the outside of the garage, with some smoke getting inside. Fire crews were there for a whole hour, but reported no injuries.

2. In Brick, New Jersey last week, a firefighter and a police officer were treated for smoke inhalation after responding to the report of a fire at a home. Upon arrival, police discovered a female homeowner outside--and her husband inside trying to douse the flames with a garden hose!

The homeowner told police that the fire started in a sun room at the rear of the house, and that her husband was still inside the now-engulfed house. One policeman entered the home through the garage and found the male homeowner at an inner doorway to the kitchen area, attempting to fight the spreading flames with a garden hose. The officer led the homeowner out of the structure. Firefighters then doused the flames that engulfed the not just the sun room but also kitchen area.

Both homeowners were treated for breathing difficulties at the scene by an EMS crew. The policemen and a firefighter were taken to Ocean Medical Center where they were treated smoke inhalation.

3. In Mankato, Minnesota, an autopsy found that a former county commissioner died two weeks ago of smoke inhalation while trying to contain a grass fire at his farm. The medical examiner found that the 77-year-old succumbed to carbon monoxide poisoning as he used a tractor in an apparent attempt to dig a ditch to stop the fire from spreading. The fire was reported by a neighbor, and when authorities arrived, the man's body was found slumped on his tractor.

4. In northern Indiana last week, an 87-year-old man died after he was burned trying to burn a pile of leaves near his home with gasoline. The man added gasoline to a pile of leaves but the fire got out of control, leaving him with burns to more than 90 percent of his body. He was pronounced dead at Loyola University Medical Center a few hours later.

If these four stories--all of which happened in the past few weeks--don't convince you to simply get away in the event of a fire or smoke condition and then call the experts for help, you are making the wrong decision.

On the other hand, if you or someone you know does suffer a severe burn injury or a smoke inhalation injury, 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 solid legal case.

In Fort Peck, Montana in late October, a fire destroyed a historic landmark restaurant in eastern Montana and the owner was hospitalized after suffering smoke inhalation.

Fort Peck's Gateway Inn Bar and Supper Club, built in 1933, caught fire at about 11:30 a.m. on a Saturday, just as the lunch crowd was coming in. An assistant fire chief said that several customers were in the building at the time, but were able to escape.

A local sheriff also said that the restaurant owner made a near-fatal mistake by running back into the building to get some keys--that's when he suffered smoke inhalation. Although he was listed in good condition just one day after the fire, the owner's actions were very risky.

There are two lessons you should take from this story. First, anytime you go to a restaurant--or into any public building--you should locate all the exits you could possibly use in case of fire. At a restaurant in particular, a fire in the kitchen is not such a rare occurrence, and can spread very quickly because of grease and other flammable items located in a restaurant kitchen. The speed of such a fire might mean you will not have time to look for an exit once you realize there is an emergency, and you could suffer severe burns or smoke inhalation even before you reach a nearby door or window.

Second, once you escape from a building that has fire and smoke inside, NEVER go back inside to retrieve items. A burning building has become a death trap, and you can easily be overcome by smoke in just a few seconds. And once you become disoriented or unconscious from smoke inhalation, your odds of survival go down to almost zero because of the hydrogen cyanide, carbon monoxide, and other poison gases in the smoke--even if you get out of the building.

If you or someone you know suffers a burn injury or a smoke inhalation injury, you should call Kramer & Pollack LLP in Mineola, NY 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 solid legal case.

On October 6, 2011, the Fire Smoke Coalition launched the first Smoke Inhalation Treatment Database for use by EMTs, first responders and medical professionals throughout the world.

In the United States, residential fires are the third leading cause of fatal injury and the fifth most common cause of unintentional injury death, yet the majority of fire-related fatalities are NOT caused by severe burns--they are cause by smoke inhalation.

Despite the amount of fires in the U.S. decreasing each year, the amount of civilians dying in fires is actually increasing. For example, in 2009, 1,348,500 fires were attended by public fire departments, a decrease of 7.1 percent from the year before; however, 3,010 civilian fire deaths occurred, which is an increase of 9.3 percent.

In fire smoke, hydrogen cyanide can be up to 35 times more toxic than carbon monoxide, an underappreciated risk that can cause severe injury or death within minutes. In a review of major fires over a 19-year period, cyanide was found at toxic or lethal levels in the blood of approximately 33 percent to 87 percent of fatalities.

While many fire department medical directors and physicians have altered treatment protocols to consider cyanide as a deadly poison in smoke inhalation patients, thousands still have not. Until cyanide is presumed to be responsible along with carbon monoxide, especially in victims removed from closed-space structure fires, people will continue to die of what is actually a complicated illness. It cannot be assumed that carbon monoxide is the only poison requiring treatment, or that it is the sole cause of death.

The Coalition is requesting all medical providers and physicians to enter data following treatment to smoke inhalation victims. Information collected will be available to all medical professionals, day or night, and will hopefully provide insight into "new" treatment practices that include consideration of an antidote for cyanide poisoning associated with smoke inhalation--more than just hyperbaric chamber therapy that forces high amounts of oxygen into a patient to cleanse the lungs of carbon monoxide. There are only two FDA approved cyanide antidotes in the United States--the Cyanokit®, also known as Hydroxocobalamin, is one of them.

In April, the Congressional Fire Services Institute (CFSI) passed a resolution noting that there is mounting proof, obtained through atmospheric monitoring on fire grounds throughout the U.S., that hydrogen cyanide (HCN) is a predominant toxicant found in fire smoke. The resolution calls for educating the fire service about the dangers of smoke inhalation--including those of HCN--through support of a national education program, the development of HCN poisoning treatment protocols for all local and state emergency medical services (EMS), and efforts by the Centers for Disease Control and Prevention (CDC) to establish a national database of smoke inhalation injuries, medical complications and deaths linked to HCN.

If you or someone you know suffers a burn injury or a smoke inhalation injury, you should call Kramer & Pollack LLP in Mineola, NY 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 solid legal case.

Paramedics in the Buffalo suburb of Tonawanda, NY have a new tool to help them save victims of smoke inhalation.

In late August, the paramedics announced that their ambulances will now carry supplies of the drug Cyanokit, which works to help those suffering from smoke inhalation by counteracting the chemicals in toxic gases and smoke. Other ambulance units around the country will likely do the same thing over time.

Paramedics are calling it a life-saving treatment. "It's to benefit the citizens of our town and the firefighters who put their lives on the line, should anyone be overcome by smoke and the toxic effects of cyanide that's in smoke," said one paramedic.

The drug has been used in France since 1996 and has recently been FDA approved.

Cyanokit (hydroxocobalamin) is a form of vitamin B-12. It is used as an antidote to cyanide poisoning. Cyanokit works by helping cells in the body convert cyanide to a form that can be removed from the body through urination.

Cyanokit is given as an injection through a needle placed into a vein, most often in an emergency situation. The medicine must be given slowly through an IV infusion, and can take about 15 minutes to complete.

Cyanokit is usually given only once. However, you may receive a second dose if needed.
Cyanide poisoning can occur if a person is exposed to smoke from a house or industrial fire, if they swallow or breathe in cyanide, or if they get cyanide on the skin.

Cyanokit is usually given in an emergency, so you may not have time to tell your caregivers about any drugs you take or medical conditions you have. However, you will need follow-up medical care after receiving this medication. Tell your doctor if you have high blood pressure, heart disease, or congestive heart failure.

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

You may develop an acne-like skin rash from 1 week to as late as 4 weeks after you were treated with Cyanokit. This rash should go away without treatment. Call your doctor if you have a rash that does not clear up on its own.

This medication can cause you to have unusual results with certain medical tests. Tell any doctor who treats you that you have recently received a Cyanokit injection.

Even though barbecues are enclosed units and are used outside, the chance of suffering severe burns from careless use of them is high. The following story is prime evidence of that: According to the Naples Daily News in Florida, a 71-year-old woman was rushed to a Tampa hospital in early May with burns over almost 30 percent of her body after an outdoor grill caused a gas explosion at her home. She was very fortunate, however; by the next day she was recuperating at home.

An emergency call came in around 7 p.m. to the local fire department, and fire engines from the city of Naples Fire/Rescue Department reached the home less than seven minutes later. The responders found the patient seated and covered in wet towels.

A brief fire was caused by the gas explosion, but was out by the time responders arrived. They were able to cut off the gas supply to the grill. The woman was transported as a precaution by ambulance to the Tampa General Hospital Regional Burn Center, with first-degree burns reported on 22 percent of her body, and second-degree burns on five percent of her body, largely to her neck and her face.

Here is the careless part: According to one fire official, the woman reported that she had been smelling gas for the previous couple of days. The official said an investigation found that gas had been leaking into the cabinets located above and below the grill, and when the woman went to light the grill, the lower cabinet exploded, emitting a fireball that engulfed her legs and traveled up to her face. Her shirt caught fire, and fed the flames, allowing them to come into contact with her skin.

A fire chief said he visited the home with a fire marshal the day after the incident to further investigate the cause of the fire, and determined there was either a leak in the liquid propane piping or in the grill itself. He said the liquid propane is contained in an underground tank that supplies the entire house, including the kitchen stove and pool heater.

The moral of this story is that if you smell gas for more than a minute or two in or around an area, you must find out exactly where that gas is coming from, or call a professional to come in and locate the source. It is NOT a normal occurrence to smell unlit natural gas for longer than a few seconds. If so, it probably means that there is a leak somewhere--and the slightest spark can cause an explosion that could hurt you or others far worse than the very fortunate woman in Naples.

Lastly, any barbecue that is in use should be kept far away from the house or an indoor porch, because any buildup of smoke in an enclosed area can lead to smoke inhalation that can damage the lungs, as well as carbon monoxide poisoning.

So please think carefully every time you fire up the barbecue this summer. Click here to go to a web site with excellent safety tips for using a barbecue or grill.

Carbon monoxide is a colorless, odorless, tasteless gas. It is also flammable and is quite toxic to humans and other oxygen-breathing organisms. Carbon monoxide poisoning happens when enough carbon monoxide is inhaled.

CO is found in combustion fumes, such as those produced by cars and trucks, small gasoline engines, stoves, lanterns, burning charcoal, burning wood, and gas ranges and heating systems.

Breathing carbon monoxide fumes decreases the blood's ability to carry oxygen. Low levels of oxygen can lead to cell death, including cells in the vital organs such as the brain and heart.

Symptoms:

Symptoms vary from person to person. Those at high risk include young children, the elderly, persons with lung or heart disease, people at high altitudes, and smokers. Symptoms may include:

• Headache.
• Nausea, vomiting (often seen in children).
• Dizziness.
• Fatigue.

• Confusion, drowsiness.
• Rapid breathing or pulse rate.
• Vision problems.
• Chest pain.
• Convulsions, seizures.
• Loss of consciousness.
• Cardiac arrest.
• Respiratory failure.
• Death.

Treatment:

• Immediately leave the area and get fresh air, immediately remove the victim from the site of exposure.
• Call for medical help.
• If the victim is unconscious, start CPR.
• Depending on the severity of the poisoning, 100% oxygen may be given as soon as it is available.
• Hospitalization may be needed and further treatment will be given depending on the condition of the victim.
• In severe cases hyperbaric oxygen therapy may be used.

Prevention:

• Install a carbon monoxide detector on each floor of your home.
• Check the battery once per year.
• Inspect and properly maintain heating system, chimneys and appliances.
• Use non electrical space heaters only in well ventilated areas.
• Don't use gas oven or stove to heat your house.
• Don't burn charcoal inside your home, garage, or tent or camper.
• Don't leave cars running inside the garage.
• If you are using a kerosene heater indoors, make sure there is good ventilation.

Prognosis:

Carbon monoxide poisoning can cause death. For those who survive, recovery is slow. Prognosis depends on the amount and length of exposure to the carbon monoxide.

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.