Burn Injury Resource Center

Published on: February 9, 2011

Third Degree Burns and Smoke Inhalation, gas explosion

A woman was home in her apartment with her 4 children (all under the age of 5) when an enormous explosion occurred. The fire Marshall determined that the gas line in back of the stove had corroded and cracked. Gas escaped through the crack. From a physics standpoint the concentration of gas within the apartment had to fall within a very tight parameter in order to pose a danger of explosion. If the concentration of the gas was to little there would be no explosion. Conversely, if the concentration was too great there would be no explosion.

As it turned out the family had recently moved into the apartment. They were not familiar with the neighborhood. They did not speak English and therefore they did not go out of the apartment. It had been unseasonably warm. They were using a device that blew air across ice to cool the apartment. The windows had been closed. With the windows and doors closed the gas accumulated in the apartment. Once the concentration of the natural gas in the apartment reached the combustible level all that was required was a spark. Merely turning on a light, using a cell phone or the pilot light was all that was necessary to ignite the ticking bomb.

Fortunately we (Kramer & Pollack, LLP) were retained within a few days after the explosion. We had a team of cause and origin experts in the building 10 days after the explosion. We hired investigators to canvas the neighborhood, interview tenants of the building and obtain statements of anyone with any knowledge of the incident. No expense was spared. What we found through our investigation was that there had indeed been complaints to the gas company as well as the super and management of the building prior to the explosion. We found a building tenant who said that the gas company had been in her apartment 3 times in 2 months. Despite the 3 visits from the gas company she still smelled gas in her apartment (which was 2 floors above our client’s apartment).

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Published on: February 8, 2011

A Bad Week for Fires, but Good News Arrives for Victims of Severe Burns

By Larry Kramer

The cold weather blanketing much of the United States in this first week of February is causing many incidents of fire as people try to keep warm. For instance, in suburban New York, five firefighters were hospitalized with smoke inhalation after battling a basement house fire. One of those firefighters was in critical but stable condition and undergoing hyperbaric chamber treatment before going into the intensive care unit.

A local fire marshal said the blaze was not suspicious; the fire broke out around lunchtime and took about an hour to get under control. The firefighters were injured while in the basement, where there was a sudden eruption of flames, said one police detective. A fire chief added that “the fire at one point flared up on them,” probably from a rush of oxygen that came into the basement from a door or an area of wall being opened to the outside. See a video of the fire here.

The lesson here: If you have a fire in your home, it is best to simply close the door to the room where the fire is burning and immediately go outside your home to call the fire department — do not try to put out the fire yourself! In fact, closing a door or window as you leave will actually help to starve the fire of the fuel it needs to burn — oxygen.

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Published on: February 4, 2011

Biobrane and Third Degree Burns

By Larry Kramer

Is a temporary skin substitute that is man made. It is a white stretchable dressing that is made from a silicone layer and a nylon fabric to which collagen has been chemically bounded. Biobrane is used to cover the site of a burn wound like second and third degree burns and can also be used to cover the skin graft donor site. Before it covers the burn wound, the burned area is washed and all the burned skin is removed, after placing Biobrane on the burned area, it’s wrapped with a bulky gauze and an ace wrap dressing. The dressing stays in place for 24-36 hours.

How to care for Biobrane in the first 24-48 hours:

Keep the dressing dry, avoid removing the dressing, move the area covered by the dressing only as needed and avoid extra movement.

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Published on: February 3, 2011

Smoke Inhalation from Unusual Fire Sources

By Larry Kramer

In a blog post about ten days back, I talked about the need to check your home for potential fire hazards on a regular basis. Red flags that come to mind right away are extension cords on carpets, space heaters too close to furniture or clothing, and candles left to burn for too long at a time.

Of course, almost immediately after posting that blog, I see an example of a fire hazard that most of us would never have thought of: lint in the clothes dryer. On January 26, two residents of Rochester, NY had to go to the hospital and receive oxygen therapy quickly to stave off potentially fatal effects of smoke inhalation–even though they were involved in what the local fire department considered a minor house fire, and had suffered no second- or third-degree burns.

Just after 7 a.m. that day, the clothes dryer caught fire in the basement of the house, probably because its lint trap was overly full. Although the residents noticed the smoke and left the house to call for help, and it took firefighters just 15 minutes to control the fire (which was contained to the basement) the two people told emergency responders that they did not feel well and were taken to the hospital as a precaution. Because smoke rises, the entire house sustained damage from the smoke. What’s more, there were no working smoke detectors inside the house, though local firefighters installed detectors in the house right after the fire, as a courtesy. But if the fire started while the residents were asleep, the lack of smoke detectors could have produced a tragic outcome.

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Published on: February 2, 2011

Third Degree Burns, Stove Tipped

By Larry Kramer

A family moved into an apartment that contained a free standing oven with a stove cook top. When they moved into the apartment the oven was filthy. The super of the building refused to clean the oven. An 11 year old girl decided to help her mother by cleaning the inside of the oven. Her life changed that day forever.

She opened the door of the oven and wiped down the door. She then reached into the oven to clean the inside of the oven. While reaching in she leaned on the door causing the oven to tip over. Her mother, meanwhile had been boiling chicken on the stove top. When the oven tipped, the pot of boiling water fell. The 11 year old girl suffered third degree burns on approximately 20% of her body. She was frightened and in a great deal of pain.

At first glance one might say why would the landlord be responsible for this tragic accident? Through good fortune the family retained Kramer & Pollack, LLP. We immediately set out to investigate the circumstances of this tragedy. We learned that the super of the building installed the oven. The oven, when shipped contained an anti-tip device along with instructions for proper installation. The anti tip device is essentially a small L bracket that gets mounted to the bottom of the wall and when you slide the oven into place the oven will not tip. With the bracket in place the door of the oven could support 250 lbs. The 11 year old weighed about 65 pounds. If the anti tip device were installed properly this accident would never have happened. The cost of the anti tip device about $3.79.

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Published on: February 1, 2011

Third-Degree Burns Can Happen in a Flash

By Larry Kramer

When the frightening possibility of receiving a 3rd-degree burn enters into most people’s minds, they tend to think that such a severe burn can only be gotten from having a flame touch the skin for several seconds or more. But the possibility of getting a burn that penetrates and does damage beyond all the layers of skin in one area of the body–which is the simplest definition of a 3rd-degree burn–is greater than simply being exposed to a flame.

Take the recent case of a Fort Lauderdale man who was severely burned by an unusual source. One recent morning, the man decided to have a cigarette, but he lit up while sitting next to a medical oxygen tank that he used to help his breathing. Unfortunately, because there was a stream of oxygen flowing through the mask–and oxygen is a very powerful accelerant of fire–the tank literally blew up in the room. In an instant, the heat from that explosion badly burned the man, even though there was no fire after the explosion.

It can be the same way with natural gas, which is used in many homes for appliances and for heating. If a source of natural gas is leaking in a home or any enclosed space, it does not even take an open flame to cause a huge superheated flash–just a spark from an appliance switching on could ignite the gas, causing a flash that can literally destroy all the layers of skin on any exposed body part, or even melt clothing onto skin that is covered! Larry Kramer, a partner in the law firm of Kramer & Pollack LLP in Mineola, NY, has had clients who received 3rd-degree burns from natural gas being ignited; these burns can happen in just a fraction of a second, and not necessarily from any fire afterward.

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Published on: January 28, 2011

Accommodating Workers With Burns (partII)

By Larry Kramer

Psychological issues that burn patients may deal with may include anxiety, depression, post traumatic stress disorder (PTSD). Employers and supervisors can provide support to the burn victims by:

Written job instruction provision.
Positive praise and reinforcement.

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Published on: January 27, 2011

Fast Treatment of Smoke Inhalation Critical to Recovery

By Larry Kramer

In a small town in England last week, a man was saved from his burning car by firefighters. But it was the fimmediate action of paramedics in getting the man fitted with an oxygen mask and breathing pure oxygen that just as likely saved his life too.

The man, who was suffering from shock as a result of the fire, was not able to tell paramedics if he had breathed in smoke, so the paramedics gave him pure oxygen as a precaution. This was wise, as it turned out that a later examination revealed that he did in fact breathe in the poisonous fumes contained in smoke.

Anyone who gets within close proximity of a fire should take oxygen therapy afterwards, because the damaging effects of smoke inhalation can present themselves over days, weeks, and months–even if a person feels okay right after a fire. And with children, who have smaller lungs than adults which will fill completely with smoke and become damaged more quickly, it is imperative they take oxygen even if there’s no evidence of first-, second-, or third-degree burns or other obvious physical ailments.

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Published on: January 26, 2011

Smoke Inhalation, Not Fire, Results in Devistating Injury

By Larry Kramer

A mother of 3 fell asleep, on the living room couch, with her infant in her arms. Her 2 other elementary school age children went to sleep in their room. While she slept, in the early morning hours, her 6 year old son played with either a lighter or matches. As a result the couch cought on fire. The son, petrified, ran back to his room. It did not take long for the fire to engulf the sofa and spread to the entire room. The mom woke up to a couch that was on fire and a home filled with smoke. She could not see anything (because of the smoke), but she could hear a neighbor yelling from the other side of the door. She was able to feel around through the smoke and get to the door. Unfortunately she was unable to open the door. As she made her way to the back of the apartment she was overcome by smoke. She passed out due to smoke inhalation. She was found by the fire department unconscious, near the childrens’ bedroom. She was hospitalized for 2 months during which time she was placed in a medically induced coma. She suffered 3rd degree burns that were treated but the reason for the lengthy hospital stay was the fact that she suffered from smoke inhalation. The infant that she was sleeping with on the couch did not survive.

Now at first glance you might think that the landlord could not possibly have any responsibility because the fire was started by a child playing with matches or a lighter. We (Kramer & Pollack, LLP) thouroughly investigated the case and we were left with some very pointed questions. Where did the matches or lighter come from? Why couldn’t the mother get out the side door? Well, the stove in the apartment would not light without using matches or a lighter. She could not open the door because months prior to the fire someone had attempted to break into the apartment through the side door. They did not break in, but they did break the lock. The mother had complained to the landlord that the stove did not work properly and that the door was inoperable. If the stove worked properly there would be not need for a lighter or matches. If the woman were able to open the side door escape would have been possible.

You can only imagine the sadness and grief not to mention the pain and suffering that the mom has endured. Even more compelling is the guilt that her son will contend with for the rest of his life.

Published on: January 25, 2011

Smoke Detectors / Smoke Alarms Prevent Deadly Smoke Inhalation–if They’re Working

By Larry Kramer

In one of my posts last week, I mentioned a fatal fire that started because an extension cord had shorted out and set fire to clothes that were laying on top of it. This is a very preventable type of fire–but it can be prevented only when people living in a house or apartment practice good fire safety. The best way to do this: Take two minutes every day to check around your house or apartment for situations that could start a fire, or cause a fire to spread, or block the escape path to a door or window.

Besides this, there is another very simple precaution that people can take. And even though this precaution cannot prevent a fire, it can do something even more important: it can prevent a fire from trapping victims and inflicting terrible third-degree burns and poisonous smoke inhalation. What is that precaution? Installing a minimum of one smoke detector on the ceiling of each level of the house, preferably in the hallway near the bedrooms. It is advisable to put a smoke detector in each bedroom as well.

Sure enough, the blaze that was started by the shorted-out extension cord, which killed a mother and her three children who were asleep at the time, took place in a home that did not have a smoke alarm. So even though the fire began in the living room, in an electrical outlet that was also being used to power a stereo system, a computer, and other appliances, the lack of a smoke detector meant there was too little time to escape once family members woke up and realized there was a fire. The fire had engulfed much of the first floor and created dark, choking smoke that rose up and filled the rooms of the second floor before any of the sleeping victims had a chance to escape. And believe it or not, many victims who die of smoke inhalation are not even awakened by the smell of smoke. Smoke can poison your lungs and cause unconsciousness so quickly that there is no time to wake up!

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