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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.

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After being discharged home from the hospital, a new phase of wound care starts at home. The new healing skin needs special care and consideration in which you play a major role.

Bathing: the first thing to be done before getting into a shower or a tub is to test the temperature of the water as your new skin is sensitive to extreme cold or extreme hot water and can be injured easily. Make sure that the area where bathing is taking place (shower or tub) is clean. Always look for signs and symptoms of infection of infection especially in children as they may not be able to speak. Gently wash with a clean soft towel instead of vigorously rubbing as this will lesson any discomfort associated with bathing. Use your medications as described before washing the wound if you have any open area. Continue to wash these area as directed according to the instructions that you have been given and with applying medication as directed.

Scarring: it’s very difficult to tell how much scarring will be perminant in the beginnig. People vary in their tendency to scar, some people have a greater tendency to scar than others and it’s difficult to determine how much scarring each patient will have as the amount is determend depending on the depth of the burn as well as individual basis. There are 2 types of scars, Keliod and hypertrophic scars.

A keloid scar is a type of scar that results in an overgrowth of tissue at the site of healed skin injury due to aggressive healing process. This type of scar grows and extends beyond the site of injury unlike hypertrophic scar. They occur as a result of the body’s continuous production of collagen which is a fibrous protein after the healing of the wound. They often appear red or pink in color as compared to the surrounding normal skin. They are firm, rubbery lesions; they may appear shiny or as fibrous nodules. Keloid scars may be accompanied by severe itching, pain and may limit mobility if they are extensive. They may vary in size and some types may increase in size. They may occur anywhere on the body although some areas are more susceptible to form keloid scars such as the deltoid region. They occur more often in darker skinned patients.

A hypertrophic scar is an elevated scar that appears red, thick and raised as a lump on the skin, hypertrophic scars usually feel firm to the touch, and they may be sensitive to changes in temperature or texture. They don’t grow beyond the injury site or incision (unlike a keloid scar which grows beyond the original site of the injury). Hypertrophic scars usually start to develop within weeks after the injury and often improve in appearance with time, which may take few years.
Treatment of scars is not easy, scars have the tendency to re-occur and multiple treatments may be required. Treatment may include compression garments, steriod injuction, cryotherapy, surgical therapy and laser surgery.

It’s important to follow your doctor’s instructions. if you have been prescribed compression garments, it is important to wear them for 23 hours a day (taken off only when bathing), as they can minimize scarring. If you were taught any exercises than you have to do them as they will minimize the scarring.

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.

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Wound care at home is one of the important factors in the continuation of wound healing. You may be discharged from the hospital with unhealed wound areas that still require wound care. Before being discharged, the social worker will have a meeting with you to discuss your discharge arrangement. According to your burn severity and your needs, you may be sent home or to a rehabilitaion facility were you will be provided with services according to your needs such as Physical therapy (PT), Occupational therapy (OT), and Speech therapy (ST).

Being discharged home after a lengthy hospital stay is one of the exciting moments for a burned victim. Your healing skin requires special attention and care. Some of the facts that you should pay attention to include:

  • Skin dryness: when the skin is burned, the oil producing glands in the skin (Sebaceous glands) will be damaged or destroyed and your skin will appear dry and scaly. Until the time some of these glands will begin functioning again, lubricants are needed. Avoid using lubricant that contains chemicals or alcohol as they may lead to skin irritation and blister formation. Use the lubricants as directed by your treating physician.
  • Blisters: blisters occur in grafted or healed skin. Bumping against objects, friction and rubbing with linen can cause blisters. As the new skin matures and thickens, the tendency to form blisters decreases. Contact your burn clinic or treating physician when blisters when blisters form to take instructions on how to take care of them.
  • Exposure to sun: you should protect your new skin from the effect of sunlight as the new skin is more sensitive and takes shorter time to burn. Direct contact with sunlight should be avoided at all times. Protection from sunburn can be done by: limiting exposure to sun specially in the peak hours (10am-3pm), Wearing sunscreens with a sun protective factor (SPF) of at least 30, Applying sunscreen 30 minutes prior to sun exposure (to allow skin to absorb it); sunscreen absorbs ultraviolet light reducing the amount that reaches the skin, Wear sunscreens when swimming in an outdoor pool, Wear hats, protective clothing and sunglasses with UV protection, Use lip balm with sunscreen to protect lips from burning, Look for shady areas, An ounce of prevention is worth a pound of cure.
  • Exposure to cold: the new skin is thinner and with time it will mature therefore it will be more sensitive to cold. When the weather is cold, slight numbness and tingling may be experienced especially in the feet and hands, this sensation will decrease with time. Wearing warm cloth and avoiding cold exposure help in decreasing the discomfort.
  • Itching: the new skin is dry and scaly due to the destruction of the oil producing glands which take time for some of these glands to function again. Itching is usually associated with healing, dry and scaly skin. Vigorous scratching should be avoided as this may lead to a break in the healing skin as well as a superadded infection. Use lubricants (mineral oil, lotions) as needed. Contact your physician in case of severe itching as he/she may prescribe medications for that purpose.
  • Skin discoloration: skin discoloration that may be noticed in the healing area is a result of the normal healing process. The color may vary from light to brown or even gray in color as the discoloration varies depending on the natural color of your skin. The time needed for the skin to return to its natural color depends on the severity of burn as it may take several months in superficial and some second degree burns while others may take a longer time, some skin discolorations may be permanent in severe burns such as third degree burns.

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.

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It seems that winter has come early to the Northeast, and surely there are many people in that region who have already started using firewood and other sources of fuel to heat their homes.

However, it is very important to think and take precautions before using a fireplace or other heating unit, because it is very easy to have an accident that causes a small fire to grow out of control, and possibly cause severe burns or swift, deadly smoke inhalation because the fire is in an enclosed space–a den or some other room.

Here is just one recent example of a person being careless and causing a life-threatening situation: In mid-September in Brooklyn Park, Maryland, fire investigators determined that a man who was burned a few days before in the basement of his Brooklyn Park home had poured gasoline on wet wood inside his fireplace.

The 41-year-old man was attempting to light his fireplace, but the wood was too wet to ignite, said a local fire spokesman. But as the man poured gasoline on the wood to get it to burn, the gas erupted in a large flash (which is not unusual for gasoline) and engulfed and burned the man. He was taken to the Johns Hopkins Bayview Burn Center with both second degree burns and third degree burns across his legs. Fortunately, there was no damage to the house or injuries to any other people.

You simply must think about safety before using a fireplace for the first time this season, or a kerosene heating unit, or other heating units that require you to add fuel. Otherwise, you could end up with severe burns or poisonous smoke inhalation and suffer permanent physical damage.

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.

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In our last post on Wednesday, October 26, we talked about the many services offered at the new Grossman Burn Center in Phoenix, Arizona. But once a burn victim is released from a burn center like Grossman, there are still many challenges to deal with for the rest of their lives. But burn survivors can gain the confidence to move forward in their lives with the help of burn camps. In fact, every state in the U.S. has a burn camp.

Here is one example: In August 2011 a 10-year-old named Elizabeth Watson attended a burn camp in Utah, and came home feeling energized and able to better handle the complications in her life. When Elizabeth was younger, she hated the burn scars that wrapped around her legs, arms, feet and part of her head, thinking that they were so ugly. But over time, Elizabeth learned that the burn scars suffered from a propane accident when she was just 5 months old do not define who she is or how she looks. They are simply, as she says, “a part of who I am.”

Elizabeth attended the annual University Health Care Burn Camp at Camp Tracy in Mill Creek Canyon in Utah, along with 40 other young burn victims. They rode horses, went swimming, made music, and created arts and crafts over four days. All of this helped them build confidence that they can do whatever they want, and that their burn injury and scars won’t hold them back..

“Burn survivors go through a lot of different phases in their healing. It’s sometimes difficult for them to feel good about the way they look after suffering severe burns and to have positive self-esteem,” said camp co-director Brad Wiggins, a clinical nurse coordinator at University Health Care Burn Center. “The camp’s purpose is to facilitate interactions with other burn survivors and teach them how to move past their burn injuries.”

Asked what her favorite activity was during these burn camps, 6-year-old Chloie Workman just smiled and said, “Everything.” Chloie also got to talk with other people for the first time about her burn injuries, caused by an accident when she pulled a rice cooker onto herself. “I learned about other people and how they got their burns too,” she said.

For kids under age 12, the paid for by the Professional Firefighters of Utah, the union that supports more than 15 municipal departments in the state. Firefighters also volunteer at the camp by becoming counselors, doing cleanup and cooking for the children. The Greater Salt Lake Council of the Boy Scouts also donates the use of Camp Tracy.

“In the past, firefighters have kind of lost track to what happens to [burn survivors], and what this burn camp gave us is a chance to follow up and see how well they’re doing,” said camp co-director Ron Fife, who also is a Salt Lake City fire division chief. “It’s a great opportunity that firefighters have and something they really support.”

Ten-year-old Elizabeth said she would just like to go to burn camp without having the scars. Yet she says she has accepted what happened and just wants to move forward. “I used to picture my life like it was put into a book,” she said. “But then I realized that without my scars, I wouldn’t know what my story was about.”

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.

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In October 2011, Grossman Burn Centers announced the official opening of its new burn center in Phoenix, Arizona, at St. Luke’s Medical Center. The eight-bed unit is the fifth Grossman Burn Center, and the second outside the state of California.

GBC Medical Director Dr. Peter H. Grossman commented that “It is a privilege to partner with St. Luke’s Medical Center to bring additional state-of-the-art burn care services to Arizona. Our facility will complement Phoenix’s existing burn center by making more beds available to Arizona’s growing population, and by providing patients and referring physicians with more options for their burn treatment regimen. This is a very positive development for the Grossman Burn Centers, for St. Luke’s, and for Arizona.”

The Grossman Burn Center at St. Luke’s Medical Center provides a comprehensive suite of burn care services, from acute and reconstructive burn care, to rehabilitation and post-treatment emotional and psychological support. The center is under the direction of GBC Medical Director, Dr. Peter H. Grossman. It is managed on a day-to-day basis by Dr. Robert Bonillas and Dr. Anthony Admire, and staffed by physicians on the medical staff at St. Luke’s Medical Center trained in restorative burn care.

The Grossman Burn Centers have been involved in the treatment of second degree burns and third degree burns for four decades. GBC’s approach to burn care focuses on more than just patient survival. Its surgeons and health care professionals seek to restore patients to as close to their pre-injury status as possible in terms of physical ability, cosmetic appearance, and emotionally.

Besides California and Arizona, the company also has a Louisiana burn center.

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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.

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A few weeks ago in Kinston, NC, a utility worker was injured badly after 7,200 volts of electricity traveled through his body when he came in contact with an underground power wire. The worker, whose name was not released at press time, was working to fix a power outage when the incident happened. He was taken to the burn unit at UNC Hospital in Chapel Hill because he suffered second degree and third degree burns. One city official said the worker has second degree burns to his face and chest, and third degree burns to his arms and legs. The employee is a lineman who’s been with the city for 25 years. He was working on an underground primary line in a ditch when he was shocked.

That same week in Lake Katrine, NY, a faulty propane gas line caused a home fire that severely burned an elderly couple. The fire left the unidentified woman hospitalized in critical condition at Jacobi Medical Center in New York City, with burns over 90 percent of her body. The man was taken to Westchester Medical Center in Valhalla with burns on about 40 percent of his body. Neighbors trying to help the couple also suffered burns that required medical treatment.

Officials investigating the fire say it is likely that there was a leak in the line between an outdoor propane tank and the stove inside the home, which caused an explosion.

These two incidents are prime examples of how common elements within a home can be dangerous, and even deadly. Electric and gas service are things we take for granted, but we must never forget to be careful when dealing with them. Exposed wires, loose or ungrounded plug outlets, and plug outlets near water faucets are prime areas where someone can be badly burned–or have their heart stopped– by electric shock. In fact, more people die from burns received by electric shock, rather than from a heart stoppage.

And anyone who lives in a home that uses propane or natural gas should always be aware of the smell the gas creates–if you can smell it even though it is not being used for cooking or heating at that moment, then you have detected a gas leak, which can cause an explosion from the smallest spark! So if you do smell gas, leave the house right away and call the local fire department to come and inspect the house.

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.

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In Las Vegas in early October, a casino employee was lucky to have survived after suffering smoke inhalation after a fire started inside his restaurant’s grease duct.

Firefighters quickly doused the fire a little before 9 a.m. on a Sunday at the Wynn Las Vegas Resort, and damage was confined to a small mechanical room. And the local fire chief credited the design of the duct system for containing the fire. The Wynn resort is about 10 years old, so it has a very modern design that helps with fire prevention so that a small fire cannot spread easily and become a large fire that threatens any more lives.

On the other hand, many older restaurants around the country are not designed in the same way. As a result, they have a much higher chance of being engulfed in a rapidly-spreading fire if their grease ducts and air ducts are not cleaned regularly. Restaurant managers have an obligation to make sure this cleaning happens enough so that there is only a small chance of a grease fire growing out of control.

Here’s another lesson to be learned from this story: Restaurant patrons should always locate the fire exits in a restaurant before they sit down at a table. Even a few seconds can make a difference between life and death when evacuating from a fire, so know where to go if a fire does break out.

Fortunately, once the fire was discovered in the back of the Stratta restaurant at Wynn Resort, employees evacuated customers from their breakfast tables, and also from the adjacent casino areas, while firefighters vented smoke through a hotel skylight.

Things do not always turn out so well with kitchen fires, though. In Kansas City recently, a restaurant employee turned out to be not as lucky as the one in Las Vegas. Now, he has finally come home from the hospital to continue healing after he suffered severe burns that came from hot grease.

Gary Cifuentes, 22 years old, almost never complained while in the hospital for over a month, receiving painful treatments for burns that covered more than 50 percent of his body. Doctors released him from the burn center at the University of Kansas Hospital in early October. “The truth of it,” he said about his survival, “is that it has been a miracle.”

In late August, the restaurant worker was critically burned by a vat of grease that spilled on him when a car slammed into the side of the restaurant he worked at in Olathe, KS.

Cifuentes spoke to media through an interpreter Friday just before his release to stay with family in Kansas City, KS. He spoke from a wheelchair, his arms and hands in special wraps. There will be many more painful dressing changes and trips to the hospital, but doctors expect him to make a full recovery. “They tell me to keep working hard and keep moving forward,” he says. He also thanked God for being alive, thanked medical staff and thanked family and friends, who almost never left his side in the hospital. Kansas workers’ compensation is paying for his care, but it is unclear whether the fund will cover all of the costs.

Again, the lesson here is this: Kitchens are among the most common places for people to suffer severe burns and smoke inhalation. Therefore, everyone should think ahead of time and take precautions when in the kitchen, to avoid being injured.

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In late September, a 13-month-old girl received severe burns from an accident at a Starbucks Coffee shop in Stuart, FL.

According to the local sheriff’s office, witnesses saw the mother of Lourdes Marsh place the infant in a clip-on tabletop chair that had been manually attached to the table. The chair has no legs that touch the ground, and such a chair is meant for children who are about Lourdes’ age. But for some reason, the weight of the child placed into the chair caused the table to fall over, sending a large cup of very hot coffee and another large cup of hot tea onto Lourdes.

Lourdes received second-degree burns to her face and upper torso. Witnesses said that skin was steaming, red, and coming off her body. A fire/rescue spokesman said the burns covered 20 percent of her body. For a child that small, 20 percent is a dangerously large portion of the body. What’s more, blistering of the skin from burns is a dangerous situation–not only does it require immediate professional medical care, but it makes it possible that the child will have permanent scars. While the child was being taken by helicopter to Jackson Memorial Hospital in Miami as a precaution, she was alert, which was a positive sign. And after a few days, Lourdes was recovering at home, although the extent of any permanent scarring will not be know for some time.

It should be noted that Starbucks did not provide the infant seat to the Marsh family. The seat was brought into the Starbucks by Lourdes’ mother. An alert was issued by the Consumer Product Safety Commission, warning parents about potential danger with these seats. So legal liability might rest with the maker of the child seat, although Starbucks could be named in the lawsuit as well, because the table was not able to hold a seat that is made specifically to attach to it. Also, the liquid in the two cups was so hot that it might have been an unreasonable danger.

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.