Published on:

When the skin is burned, it may heal by forming scars depending on the severity of injury. The more severe the injury (third degree burns), the more likely to develop scars and contractures.The aim of occupational therapy is to prevent or minimize the scars and deformities that may result from the burn injury. (See preventing and dealing with scars)

Occupational therapy is a skilled treatment that helps individuals achieve independence. OT may be started while the patient is still in the hospital and may be continued after discharge.

Occupational therapists evaluate the patient’s need for a splint, positioning (sitting, comfort in bed) and exercises. They institute diversional activities, teach activities of daily living, provide a home program of splinting and exercises before discharge and home visits (if the patient needs them) after discharge.

The patient plays a major role in the recovery process. It may be difficult in the beginning with the pain and stress associated with the exercises, but with time it will be easier. The more time spent following the program, the faster the healing process and the less scaring and deformities.

Occupational 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 may experience. With children, doing occupational therapy may be more difficult. Parents play an important role 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 Occupational therapy at home; compression garments may be given and used with exercising.

Make sure to attend all outpatient follow up appointments with the burn clinic. Your physicians and therapists will monitor your progress and make adjustments as needed.

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.

Published on:

A study by researchers at Loyola University Chicago Stritch School of Medicine generated some surprising findings about the response of the immune system in victims of severe burns and smoke inhalation.

Contrary to expectations, patients who died from their injuries had lower inflammatory responses in their lungs than the patients who survived. “Perhaps a better understanding of this early immune dysfunction will allow for therapies that further improve outcomes in burn care,” researchers reported.

The study was published in the January/February issue of the Journal of Burn Care & Research. First author of the study was Christopher S. Davis, MD, MPH, a research resident in the Loyola Burn & Shock Trauma Institute. Assisting him was Elizabeth J. Kovacs, PhD, director of research of the Burn & Shock Trauma Institute.

Researchers followed 60 burn patients in the Loyola Burn Center. As expected, patients with the worst combined severe burn and smoke inhalation injuries required more time on a ventilator, in the intensive care unit, and in the hospital. They also were more likely to die. Also in line with expectations was this finding: Patients who died were older and had larger injuries on the whole than patients who survived.

But the immune system findings were not expected. Researchers measured concentrations of 28 immune system modulators in fluid collected from the lungs of patients within 14 hours of burn and smoke inhalation injuries. These modulators are proteins produced by white blood cells and other cells such as those that line a person’s airway. Some of these modulators recruit white blood cells (leukocytes) to areas of tissue damage, or activate them to begin the repair process within damaged tissue.

Based on studies conducted at Loyola and other centers, researchers had expected to find higher concentrations of modulators in the fluid of patients who died, because sicker patients tend to have greater inflammatory responses. However, researchers found the opposite: Most patients who died had lower concentrations of these modulators in their lungs.

The question is this: Why do some patients mount robust immune responses in the lungs after smoke inhalation and burn injuries, while others do not? The reason may be due to a few things working together: age, genetics, differences in patients’ pre-existing health conditions, or anything that might disrupt the balance between too much and too little inflammation.

Survival of severe burn patients has significantly improved since the 1950s, due to advancements such as better wound care and treatment and prevention of infections. But progress has somewhat stalled in the last 10 years.

The immune response to lung injury from smoke or burns “remains not completely understood, and additional effort is required to improve survival of burn-injured patients,” researchers wrote.

The study was presented at the 2011 meeting of the American Burn Association, where it won the 2011 Carl A. Moyer Resident Award for the best study submitted by a resident physician. The study was funded by grants from the National Institutes of Health, Department of Defense, International Association of Fire Fighters and the Dr. Ralph and Marian C. Falk Medical Research Trust.

Loyola’s Burn Center is one of the busiest in the Midwest, treating more than 600 patients annually in the hospital, and another 3,500 patients each year in its clinic. It is one of only two centers in Illinois that have received verification by the American Burn Association.

The study is among the results of research over the last several years conducted in Loyola’s Burn Center and its Burn & Shock Trauma Institute, the latter of which is investigating the lung’s response to burn and inhalation injuries.

Published on:

Burn injury may be severe and may involve any part of the body including the face. Facial scars are considered in general as a cosmetic problem, whether or not they are hypertrophic. There are several ways to reduce the appearance of facial scars. Often the scar is simply cut out and closed with tiny stitches, leaving a thinner less noticeable scar.

If the scar lies across the natural skin creases (or lines of relaxation) the surgeon may be able to reposition the scar using Z- Plasty to run parallel to these lines, where it will be less conspicuous.

Some facial scars can be softened using a technique called dermabration, a controlled scraping of the skin using a hand held high speed rotary wheel. Dermabration leaves a smoother surface to the skin but it won’t completely erase the scar.

After scar revision:

With any kind of scar revision it’s very important to follow your surgeon’s instructions to make sure the wound heals properly. Although you may be up and about very quickly, your surgeon will advise you on gradually resuming your normal activities.

As you heal, keep in mind that no scar can be removed completely; the degree of improvement depends on:

  • The size of the scar
  • The direction of the scar
  • The nature and quality of your skin
  • How well you take care of the wound after the operation.

If your scar looks worse at first, don’t panic because the final result of your surgery may not be apparent for a year or more.

As there are different methods of facial scar removal and each has its benefits and risks, you will want to schedule an appointment with a practitioner that specializes in facial scar removal before having the procedure completed because they will explain all these risks and benefits. You might also want to do your research on the practitioner that you choose because some are more experienced than others and you will want to choose the one that will provide you with the best results.

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.

Published on:

The death of a Chicago woman who stepped off an elevator in her apartment building–and into a blazing inferno–highlights the need for fire sensors in all elevators.

Shantel McCoy, 32, who was returning to her 12th-floor apartment on Lake Shore Drive, died from third degree burns to her skin plus lung burns after the elevator doors opened and she was hit with 1,500-degree air heated from gas and fire fumes coming from another apartment, according to a Chicago Fire Department spokesman. The fire apparently began inside an apartment on that floor–but although the residents managed to escape the apartment, the front door did not close behind them. This allowed the fire to spread into the hallway and heat the air throughout the floor to deadly temperatures. Nine other residents were injured in the blaze as well.

But the elevator accident never should have happened, says one longtime elevator-industry consultant. Charles Buckman notes that the United States’ engineering safety code requires elevators to have fire sensors on every floor and in the motor room. But in this building, Buckman speculates that “they must not have been fitted with sensors.”

In fact, the 21-story building, among Chicago’s older high-rises, was not required to meet safety codes that were established in 1975, according to the city’s building department spokesman. The high-rise was built sometime in the 1950s.

Chicago’s city council recently voted to put off until 2015 the deadline for all buildings to comply with a new ordinance requiring building-wide alarm systems that automatically trigger elevators to descend to the ground floor and shut down.

Buckman, who works for consulting firm Doherty and Buckman of New Bern, North Carolina, says that even older buildings should be equipped with fire sensors that automatically shut down all elevators. “The elevator should not have been available to this lady” once a fire started, he says. “The elevators should have closed their doors, returned to the first floor and shut down so that no one could use them” once the sensors detected fire.

Having testified in numerous personal injury cases involving faulty elevators, Buckman has a harsh judgment this time: “In this case, somebody committed murder,” he alleges.

The building’s management company did not respond to requests for comment.

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 injury suffered, and if the injured party has a strong legal case.

Published on:

PTSD is a psychiatric disorder that may occur after the exposure to a traumatic event. People differ in their reaction to trauma; some will return back to normal after an exposure to a traumatic event, others will experience symptoms of post traumatic stress disorder. PTSD develops differently from one person to another. Symptoms of PTSD most commonly develop in the hours or days that follow the traumatic event , but can also happens weeks, months, or even years after the incident.

PTSD is some what common. It can affect those who personally experience the trauma, those who witness it, and those who pick up the pieces afterwards, including law enforcement officers and emergency response workers. In the United States, 60% of men and 50% of women experience a traumatic event during their lifetimes. The diagnosis of PTSD was developed by studying soldiers from war, and it was originally called “shell shock syndrome.”

Many events and life situations may lead to the development of PTSD, these include:

  • Exposure to severe burns such as third degree burns.
  • Military combat.
  • Sudden death of a loved one.
  • Sexual assault or physical attack in childhood or adulthood.
  • Exposure to terrorist attack.
  • Exposure to natural disasters such as earthquake.
  • Exposure to a serious accident.

PTSD can happen in adults as well as in children. The symptoms may rise suddenly, gradually or come and go over time. In adults, the symptoms may include:

  • Any reminder of the traumatic event will produce upsetting memories and intense physical reactions like rapid breathing, palpitation, nausea, sweating and muscle tension.
  • Having flashbacks, bad dreams (Re-living the events).
  • People try to avoid situations and things that trigger the traumatic event.
  • People isolate themselves from others and may feel emotionally numb, they may be less interested or lose interest in activities that they used to like.
  • People feel irritable, anxious, have anger outbursts.
  • Feeling that they are in constant danger.
  • Having difficulty in concentrating.
  • Having sleep difficulty.
  • Having nightmares.
  • Having depression.
  • Having suicidal feelings and thoughts.

Children may show symptoms of PTSD depending on their age, young children may have nightmares, sleeping problems, fear and upset if the parents are not nearby, regression in a previously trained child such as bed wetting, and toilet training trouble.

Some people will develop PTSD after a trauma while others won’t; people will have increased the risk of developing PTSD if:

  • The person was seriously injured as a result of the trauma.
  • The person was the one who was exposed directly to the trauma.
  • The trauma was long lasting.
  • The person was not in control during the event.
  • The person had a previous mental issue.
  • The person had a history of prior severe trauma.
  • The person doesn’t get that much help and support after the trauma.


  • Counseling (talk therapy): this is one of the methods of treatment in which the person can get help and discuss his/her feeling that will help to get to normal life activities. Cognitive behavioral therapy (CBT) is a type of treatment that helps is promising and is the most effective in counseling. Family therapy may be effective too as PTSD not only affect the patient him/herself but those who are close to the patient, this therapy help the family understand what the patient is going through and communicate better with him/her.
  • Medications: in the form of antidepressant medications.

Other diseases and conditions may occur with PTSD such as depression, panic attacks, drug and alcohol abuse.

  • The earlier the treatment, the better the outcome as symptoms of PTSD may get worse.
  • Seek medical help if you or your child has symptoms of PTSD.
  • Seek help and support from your family or your close friends, they may be able to help and support 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.

Published on:

Back in August 2011, a grandmother’s summer holiday at a luxury seaside hotel in Great Britain ended in tragedy when she was scalded to death in a hot bath.

Unfortunately, severe burns from scalding hot water happen too often among children and seniors alike. The worst part is that these incidents are almost always preventable.

Evelyn Cowley, 88 years old, was enjoying her annual family holiday when she took a bath in her hotel room. But for some reason, she immersed herself in water that had a temperature of more than 120 degrees Farenheit. As a result, she suffered third degree burns to half her body, mostly to her lower limbs and her back and arms.

Cowley was no ordinary senior citizen. She was a decorated RAF officer, who served during the Second World War. She died in the hotel room’s bath at some point between saying goodnight to her two sons and breakfast time the next morning. Her son came to wake her in the morning and heard the bathtub water still running, then found her dead in the tub.

The water coming into the tub had been heated in the hotel’s boiler to 140 degrees-which is much too hot for human contact–and the water came out of the tap at around 125 degrees, said a hotel spokesperson. But he added that heating the water to that temperature was a precaution to stop the spread of Legionnaires’ disease–an often deadly form of pneumonia caused by a specific bacteria that grows quickly in stored hot water.

Two days after Cowley’s death, an investigator recorded a temperature 130 degrees from water running from the bath’s tap. He said: “I could only hold my hand under for about two seconds.” The investigation also found that there was not a warning sign for the hot water posted in the bathroom. The hotel did note, however, that this was not a legal requirement.

An autopsy showed Cowley died as a result of extensive burns, which could have been caused as a result of her dementia. The local coroner said: “She died accidentally, and dementia could have caused her misjudgement of immersing herself into the water.”

The coroner also said it was possible that she suffered a mini-stroke when she entered the hot water, but tests were inconclusive.

The lesson here is that seniors and the elderly, as well as children, must be closely monitored when they are going to use hot water to bathe or to cook. It is very easy to spill scalding hot water onto the skin when handling it, and the burns can be so severe that skin graft is necessary to heal the wounds–and death is certainly possible too.

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 injury suffered, and if the injured party has a strong legal case.

Published on:

Infection remains the most common complication of burn wounds, it’s a major cause of death among burned patients. It can happen in the hospital or at home; it can be local (at the site of burn) or systemic (the spread of infection to other areas of the body).

As the skin plays an important role in protecting the body against infection and acts as a barrier that prevents Microbs from entering the body, the risk of infection increases when a burn injury happens.
Risk factors of developing a burn wound infection many include:

  • The extent of burn, burns exceeding 30% of the total body surface area (TBSA) are at higher risk.
  • The depth of burn, full thickness burns (third degree) are at higher risk.
  • The location of burn, burns in the perineum are at higher risk of infection.
  • The age of the patient, extremes of age are at higher risk because of lower immunity.
  • The general condition of the patient, amonge conditions that increase the risk of infection are immunosuppression, obesity, diabetes and malnutrition.
  • The type of organisims, their number and virulence.
  • The quality of wound care provided for the patient.
  • Duration of hospitalisation and number of days ventilated.

The incidence of infection and its mortality has significantly decreased due to the improvements in the techniques of burn wound care and infection control mesures. When infection happens, it can cause the wound to progress from a partial thickness (e.g second degree burns) to a full thickness (e.g third degree burns), can prevent or delay healing, can encourage scar formation and can result in septicemia and organ failure.

Burn wounds should be inspected daily for signs of infection especially in pediatric age group as they sometimes can’t express their feelings of being unwell.

Warning signs of infection may include:

  • Increased or persistant pain.
  • Increased redness in or around the wound.
  • Increased swelling in or around the wound.
  • Increased drainage from the wound.
  • Change in the color of drainage (green discharge or puss).
  • Foul smell from the wound.
  • Increased warm feeling from the wound.
  • Bleeding from the wound between dressing change, or soaking the bandage with blood, unless there has been a trauma (remember that bleeding at the time of dressing change itself may be expected).
  • Chills or fever greater than 101.4 degrees. Burned patients should check their tempreture daily.
  • Complete loss of appetite.
  • Persistent vomiting or diarrhea.

Helpfull tips in preventing wound infection:.

  • Keep the burned area clean.
  • Look for any signs or symptoms of infection during dressing change.
  • Follow a strict sterile protocol during wound dressing change (see home wound care).
  • It’s important in infants to observe any change in the appearance of wound or change in activity level (not playful, fails to hold eye contact, lethargic) children can’t express what they feel. Contact the doctor immediately if you observe any sign or symptom of infection.
  • Topical antibiotic ointments may be prescribed as a prophylactic (preventive) measure in burned patients.
  • Infection delays wound healing, encourages scarring (as a result of collagen deposition in reaction to the infection) and may result in bacteremia and organ failure (systemic infection).

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.

Published on:

Itching occurs with healing and newly healed burned areas. Itching can be a major problem for some children when they are in the hospital as well as after being discharged home. Itching is caused by the overlapping tissues formed by the scar itself. This tissue lack the nerve endings that is present in normal skin but due to the surrounding normal tissue that still has nerve endings, they become stimulated by scar tissue thus the characteristic itch kicks in. Itching should decrease as scar tissue matures. Itching can disturb or even prevent your child’s sleeping. Although it’s hard, try to prevent your child from scraching the burned areas as these areas are still raw (immature) and may bleed easily or get infected with continous or vigorous scraching.
Among the things that help in decreasing your child’s itching are:

  • Keeping the burned area lubricated by applying cream and massage the burned areas on a regular basis.
  • Wearing loose clothes made of natural materials such as 100% cotton with light colors.
  • Avoiding clothes or elastics over the clothes like waistbands.
  • Avoiding your child of prespiring and becoming hot.
  • Encourage your child to wear compression garments as prescribed. Compression (pressure) garments must be worn 23 hours a day and taken off only when bathing your child.
  • Clip your child’s fingernails regularly, there are certian gloves that your child can wear to prevent him/her from scraching the burned area.
  • Tell your child whenever possible to elevate the affected area.
  • If itching becomes severe or prblematic for your child, please call your doctor as he/ she may prescribe medications that can help with itching.
  • Applying lotion or cream:
    Healing burn wounds as well as skin grafts, donor sites and scars all require creaming on a regular basis to prevent these areas from becoming dry, becoming sore and cracking. The reason for that is because the healing and newly healed skin is unable to lubricate itself in the same way as the normal skin does.

    These are some helpful tips regarding applying lotions or creams on your child’s affected areas:

  • Apply the lotion or cream as often as needed, follow the instructions given to you, this should be repeated 2-3 times a day. It may be needed more often if the your child’s skin is particularly dry.
  • Use enough lotion or cream to lightly lubricate your child’s skin. Gently rub and massage the cream until it disappears, the skin shouldn’t feel greasy after putting the lotion rather it should feel moist and soft.
  • Massage involves firm pressure in circular waves over the scar.
  • Avoid using lotions or creams recommended by your friends or family, also avoid using lotions or creams containing chemicals or perfumes as healing and newly healed skin is very sensitive and can be damaged by the wrong lubricant.
  • It’s important that you cleanse your child’s skin every day as the build up of lotion or cream may cause skin irritation and clog the skin pores. Excessive lotions or creams can also damage pressure garments
  • 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.

    Published on:

    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.

    Published on:

    Burn injuries are not only devestating for the patient but for the whole family. A common question the parents ask, is for how long their child will be hospitalized in the hospital. When the time comes, the Burn team will begin planning for discharge. The case manager or the social worker assined to the patient will assist with coordinating discharge plans. Among the things discharge plan deal with is, caring for the child at home, potential complications , follow up appointments and refferals if the child need them.
    Caring for your child at home involves the following:

    Mnay burned children are discharged home with several medications. Before leaving the hospital make sure to ask any question you have about the medication of your child, you should know how to give these medications, when and for how long, what are they used for, and what are the side effects that may happen as a result of using these medications. Continue giving these medications as described by the treating physician even if you think that your child is feeling well and if you have any concern or question, don’t hesitate to call the treating physician.

    A well balanced diet with a lot of fluids is necessary for the healing process. Start your child with small frequent meals. See also nutrition and burns.

    An important part of well being and recovery is to help your child engage in light activity as soon as possible. It’s normal for your child in the begining to feel weakness and fatigue as he/she has been in the hospial for a period of time without using the muscles but this will improve with time. Activity help in increasing the circulation (blood supply), decrease scaring, improve contractures, and prevent the loss and improve muscle strength. Follow the instructions given to you by the burn team. Some chilren may need to be reffered to physical therapy and/or occupational therapy as needed, they may get these services at home. Make sure that your child aviods all strenuous activities and contact sports until cleared by the treating physician. See preventing and dealing with scars.

    Changing dressings:
    An important part of the burn care is dressings as they protect the burn wound from injury, keep ointments or creams on the wound and absorb any fluid or discharge drawn out of the wound. You play an important role in observing dressing condition and dressing change. The burn team before discharge will teach you how to change your child’s dressing, how often and for how long. Dressing change may be frightening and painful for your child, it’s better to give pain your child pain medication 30 minutes before dressing change.

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