December 2009 Archives

Injury caused by fire is the second leading cause of death in the home. No single cause has a greater impact on that statistic than inhalation injury. The presence of an inhalation injury in a fire victim is a larger factor in patient deaths than the amount or severity of the external burns that victim sustains.

There are over 100 toxic substances in fire smoke. Inhaling these toxins cause internal injury that is often hidden or overlooked due to the distraction of more visible burn trauma. It has been estimated that 50-80% of all fire related deaths are caused by smoke inhalation not burns

Symptoms of smoke inhalation can appear immediately or gradually over the first few days following the fire. Aside from obvious burns to facial openings, other symptoms can include vomiting, nausea, confusion, sleeplessness and saliva mixed with soot. An individual with these warning signs must be evaluated by a trained medical professional immediately.

Smoke inhalation injuries create three major categories of complication. An immediate complication is a decrease in oxygen levels in the victim's tissues. Carbon monoxide instantly binds to hemoglobin in the blood cells. Hemoglobin that carries carbon monoxide can not carry oxygen. By decreasing the amount of oxygen carried in the blood, carbon monoxide poisoning causes tissue damage by hypoxia.

Another immediate complication of smoke inhalation comes from combustibles containing paper, wool, plastics and nylon components among other synthetics. When burned these materials produce cyanide. Cyanide acts in a similar manner to carbon monoxide. Cyanide bonds to ferric ions on the cellular level. This chemical bond blocks metabolism for the individual cells. The result is cellular asphyxiation and death without immediate treatment.

Thermal or heat damage to the upper airway is another common mechanism of injury. Hot gasses within the smoke will char mucous membranes that line air passages in the upper respiratory system. Thermal damage can swell these passages making breathing or clearing obstructions more difficult. Severe damage can cause respiratory failure and then death.

Another major complication is chemical injury to the lungs. Toxic substances in smoke and combustible materials can easily damage lungs. Wheezing and bronchospasms can narrow airways and increase the heart rate. Within a few days, smaller airways will slough off leading to obstruction and pneumonia.

Pulmonary irritation is the final major mechanism of injury to victims of smoke inhalation. Combustion also releases solid chunks of debris or minuscule particles into the air during a fire. These solid bits are then inhaled causing damage to the respiratory system. Inhaled material can physically damage the lungs. The body will also activate its immune system to combat the invasion. The natural inflammatory reaction that occurs can itself cause tissue damage. Increased lymph fluid production in the lungs can lead to respiratory congestion.

Many of the signs and symptoms of smoke inhalation injury are difficult to detect. Treatment by a medical professional after all suspected exposure to smoke inhalation is a prudent course of action. Smoke inhalation injuries are potentially life-long in nature.
From a legal perspective, burns may only be a prosecutable offense if they require hospitalization or if they prevent a person from living their normal life. Burns that require hospital treatment are third-degree and deep second-degree burns. The headline-making case of the 90's when a woman sued McDonald's and won happened because of the deep tissue damage and scarification caused by McDonalds' hot coffee. However, for the victim of a burn, it can be difficult to determine how serious his or her burn is. 

First Degree Burns 

First degree burns require the least amount of care, and usually go away on their own. The clinical definition for a first-degree burn is that only the outer layer of the skin, or epidermis, is damaged. The epidermis turns red, and occasionally the skin gets inflamed and sore. However, the top layer of skin doesn't burn through to the next. Treatment for first-degree burns involve putting a damp, cool cloth over the affected area and try to keep it from further injury. Never apply ice to a burn. First-degree burns usually disappear within a week. These aren't serious unless the burn is over the majority of a sensitive area such as the face, groin, hands, feet, or a major joint, which prevents the victim from living his or her normal life. 

Second Degree 

Burns Second degree burns are defined as burns that go through the epidermis to the second layer of skin, the dermis. These burns typically turn the skin a pinkish red and form blisters. When pressure is applied to the area of the burn, blotchy discoloratons form. These burns result in swelling and intense pain. Second degree burns typically go away after two weeks to a month. Depending on how deeply the dermal tissue is affected and how extensive the damage is, second-degree burns may or may not require hospitalization. If the burn is under three inches in diameter and the skin is red, it should be treated as a first-degree burn. If the skin turns white, secretes fluid, or loses sensation, it is a more serious burn that you should have a doctor look at, as it could cause hypertrophic scarring. 

Third Degree Burns 

 Third degree burns are the most serious class of burn, in which all three layers of the skin are damaged, all the way to the subcutaneous tissue. They are the most visually striking, often resulting in physical depression, charring, or a leathery appearance. Skin may fall off, and muscle or even bone can be damaged as well. Third degree burns should definitely be treated by a doctor as soon as possible. Even with medical treatment, third degree burns often result in irreversable nerve or tissue damage, and nearly always cause permanent scarring. Many require skin grafts or other reconstructive efforts to fully heal. They are often pain-free, as the nerves which receive pain have been completely burnt off and damaged. While waiting for medical attention, it is important to cover the burn with a cool, clean, damp sanitary bandage, cloth, or towel.

For more information on Burn Injuries please contact our law firm.

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This page is an archive of entries from December 2009 listed from newest to oldest.

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