Prevent Burns

Prevention is better than cure

Dr. Nikhil Panse

The efforts of compiling this booklet are dedicated to all the burn victims; whose burns could have been prevented

Prevent Burns
Prevention is better than cure

Dr. Nikhil Panse

Vimal Niwas, Sudarshan Society, Model Colony Shivajinagar, Pune 411016, India. Mobile: 91 9422314809 E-mail l nikhil.panse@rediffmail.com l drnikhilpanse@yahoo.co.in

Sketches : Mr. Prabhakar Diwakar 295/B,Shaniwar Peth,Pune 411030, India. Tel.: 91 020 24455296 Copyright 2011 : E Book - ISBN No.: 978-1-4660-6112-5

Dr. Nikhil Panse

M.S., M.Ch., DNB (Plastic and Reconstructive Surgery)

Any part of this booklet may be reproduced and copied for teaching and awareness purpose in any form or by any means, electronic or mechanical, provided proper citation is accorded. The author would be grateful to learn if you find this booklet useful and would appreciate any suggestions or comments for the betterment of this booklet. All reasonable precautions have been taken by the author to verify the information contained in this booklet. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader.

Design & printed by: VINS Graphic,

Tel.: 020 24250292/36

E-mail : info@vinsgraphic.com

Foreword:
It gives me great pleasure to be asked to write a few words of introduction and commendation for this marvelous book. For all those directly involved with burns either as healthcare professionals dealing with them or as relatives and patients living with them we know the nature of the enemy. For many others though, burns are injuries that you read about in newspapers and are distant and remote. This wonderful, illustrated book is designed for the latter group to remind them how ever ready the enemy is, just waiting to pounce. To inflict pain; destroy flesh and transform freedom and grace into disfigurement and disability through the medium of scar. And yet whilst this enemy is in every corner of our lives, it can be kept at bay by many simple and routine precautions. I define a burn as an injury to the tissues caused by a pathological flux of energy. To keep our homes safe for our children and elderly, to keep our workplace safe for ourselves it is essential to know where the potential hazardous energy might be lurking. Dr. Panse has revealed the dangers in such an excellent way. I do hope that families will look at this book. Mothers, fathers, sons and daughters sharing together to make their lives, our world, a safer place. Together we can banish this terrible insult from our homes and tame the beast. We need fire, hot water, electricity, chemicals for the good they can do. Respect energy and use it wisely and it will serve to warm, comfort, clean and cook. But always keep this energy under control. This is a message for young and old and delivered in such an informative way. Thank you, Dr. Nikhil Panse Andrew Burd Professor and Chief Division of Plastic, Reconstructive and Aesthetic Surgery Department of Surgery The Chinese University of Hong Kong Prince of Wales Hospital Hong Kong

Foreword:
'Burns' as a subject is of great concern not only to the common man but to every clinician and health administrator. Burns is a global phenomenon encompassing a wide array of psycho social problems with high morbidity and mortality. Hence dedicated and earnest efforts are required from all quarters to work towards Burn prevention. Not much has been and is being done in the field of prevention of burns. Lot of things can be done. But the foremost method is public education. This is an extraordinary work on a topic in which very few seem to be interested. I have gone through the booklet and the sketches. The booklet has material related to almost all types of burns which we see and some of the first aid too. They are good, meaningful and relevant. It is impressive to note that this booklet is freely available on net and there is attempt to distribute it among the masses. There are very few examples of voluntary involvement in such a gigantic task. I wish Dr. Nikhil Panse all the very best in his endeavors. Dr. Ajay Chandanwale Dean B.J Medical College & Sassoon General Hospitals Pune, India

Preface: Burns is the most devastating injury a person can suffer. No other condition is so painful and so debilitating for so long. Burns is a major public health problem globally. Absence of facilities in district and peripheral Hospitals combined with traditional unscientific household practices and lack of safety systems result in high mortality and disability from burn injuries. World over, PREVENTION is the only way forward for burns as treatment is prohibitively expensive and outcomes both in terms of morbidity and mortality are still so unpredictable. It is myth that Burn injuries are accidents; and accidents cannot be prevented. It has been proven beyond reasonable doubt that Burn injuries happen due to known facts in environment, and can be prevented to a great extent. Most burn injuries are preventable. In the present booklet, common causes of burn injuries and their prevention are discussed in pictorial format. The aim is to create awareness and achieve prevention of burn injuries in the long run by educating as many people as possible. Only knowledge is not important. Almost every smoker knows smoking is injurious to health, but how many actually quit smoking! Behavioral modification as per our knowledge will help us in prevention of burns. Greater application of burn prevention strategies globally would go a long way towards lowering the unacceptable burden of death and suffering from burns. Together we can make a difference. Nikhil Panse

Acknowledgements: I express my thanks and gratitude to Mr. Prabhakar Diwakar, who put in a lot of time and efforts for sketching the pictures again and again to perfection. Without his support and cooperation, this booklet would not have materialized. I wish to express my deep sense of appreciation to all the people who have been invaluable in completion of this book (In alphabetical order of names).

Dr. Atul Shah Dr. Mukund Thatte Dr. Parag Sahasrabudhe Dr. Sunil Keswani Dr. Surajit Bhattacharya Dr. Yogesh Bhatt While any acknowledgement in words falls short of my feelings, I am thankful to my family, especially my father whose constant support and encouragement helped me complete this booklet. For her enduring patience and understanding, I remain in love of my better half Smita. Nikhil Panse

INDEX
Sr. No. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Topic Kitchen Burn Safety Microwave Burn Safety Bathroom Burn Safety Electrical Burn Safety Chemical Burn Safety Firecracker Burn Safety Vehicular Burn Safety Lightening Burn Safety In Case of Fire In Case of Burns Page No. 1 9 13 16 18 20 25 30 31 35

l Cooking on the floor should be avoided as a rule.

l There

is an increased risk of toddlers coming near the stove and getting burnt. Some types of stoves, especially used in the developing world need repeated pumping which creates high pressure in the stove and has a very chance of explosion. These types of stoves should not be used for cooking purposes.

Prevent Burns

l While cooking, don't wear loose clothing's.

l Keep clothing from coming into contact with a flame or heating

element.
l Reaching

over the stove could cause garments to catch fire, especially the sleeves of robes, dresses, housecoats, etc. Wear snug-fitting or short-sleeved clothing. Pure polyester, nylon and wool are reasonably flame resistant.

l Preferably

wear kitchen aprons, which are relatively resistant to fire. Slide the sleeve cuff up to the elbow. Use a band to hold long or loose sleeves out of the way.

Prevent Burns

l Turn

handles of cookers, pans and water pots, etc away from the front side where little hands can reach and pull them.

l Store

sweets and other foods away from the stove area so no kids will be tempted to reach across a hot burner purposes.

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l A child's

curiosity is generally what causes him to play with matches, lighters and cigarette lighters. Keep these things away from the reach of children.

l For older

children, parents should agree to let their children strike matches and use fire when appropriate, but only in the presence of a parent or responsible adult and under safe conditions.

Prevent Burns

l When you cook, keep your child away from the stove.

l Never

hold a child in your arms when you are handling or serving hot food or a beverage like tea or coffee.

l Mark

and explain a kid free zone in the kitchen to your kids. Kids free area must be an area where it would be unsafe and dangerous and accident prone for the kids to play either in presence or absence of adults.

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l A tool

has a specific purpose and should be used only for that purpose. Teach your children that the match is a tool for adults and has a specific purpose, such as lighting candles, etc. It is not a game to be enjoyed.

l In general,

the average age to begin the "Match is a Tool" education is about five. However, parents should determine when their individual child is ready .You, as a parent, must set a good example in your use of fire. If you follow safe practices, your children will do the same.

Prevent Burns

use of fire includes teaching the safe way to light matches. The following teaching sequence is suggested. l Open package and remove match. l Close package. l Turn package over to the side with the striking surface. l Hold match in proper position and strike away from the body. l Hold match in horizontal position (after ignited) for 2-3 seconds. l Blow out flame and wait until match is cool to touch (5-10 seconds).

The proper l

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l Keep

hot foods and drinks away from the edge of tables and counters.

l Do not put them on a tablecloth that little hands can pull. l Pulling

of the table cloth causes the hot liquids to spill over the infant causing severe burns.

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l Properly

used, the microwave oven is safe and convenient for heating a variety of foods in a short time, but the microwave can cause scald burns if it is used improperly or unsafely.

l Be careful

when heating liquids in the microwave. Since the containers may feel only warm, rather than hot, they are sometimes handled less cautiously, resulting in the splashing or spilling of a scalding liquid.

l Use gloves or mittens while handling hot microwave utensils.

Prevent Burns

l As a

general rule, only those who have read and understood the directions should use the microwave oven.

l Generally,

children under the age of 7 may be at risk, unless they are closely supervised. Even children over 7 must be properly taught and supervised. The child's height is important to consider. Children should be tall enough that their face is not directly in front of the microwave heating chamber when the door is open.

l Young

children can be seriously scalded as they attempt to remove heated liquids from the microwave oven.

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10

l Food can heat unevenly in a microwave oven, which can cause

serious mouth burns. When heating foods or milk for a young child, check the temperature by sampling the food before allowing the child to eat or drink it.
l Heating

baby formula or milk in bottles with disposable plastic liners may be risky, because the liner may burst.

l Holding

a child in your arms while removing items from the microwave may result in serious burns to the child.

l Keep children at a safe distance from the microwave oven.

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11

l Be careful

when removing a wrapper or cover from a hot item. Hot steam escaping from the container as the covering is lifted can cause a burn.

l Frozen

foods may be cold or only warm in one spot and scalding in another.

l If you

are heating a product wrapped in a cover, be sure to perforate the cover so as to prevent injury due to hot steam.

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12

l Always know where your children are and what they are doing.

Continuous and adequate supervision of young children is critically important.

l Put a

small slide-bolt latch on the upper half of the outside of the bathroom door.

l This

will prevent young children from entering the bathroom without supervision, and will also help control other risks, such as drowning in the tub, chemical burns, etc.

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13

l There are various types of tap systems available these days. It

should be understood that the taps must be closed in such a way, that whenever the tap is opened, cold water comes first.
l This

prevents accidental scalds due to high temperature to small children.

l Establish safe hot water temperature.

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14

l Check water temperature before placing child in tub or shower. l Instruct

carefully any older siblings who help bathe young children.

l Young children should never be left alone in the tub. l Generally

the water in a child's bath should not be hotter than 100 degrees F.

l Run

cold water into the tub first, and then add hot water to reach a safe temperature. This will prevent a scald burn if the child should fall into the tub while it is being filled.

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l In homes

where young children are present, consider using child-proof receptacles or receptacle covers.

l Limit your use of extension cords. l If you

have lots of cords lying on the floor, such as the cords coming from your Computer, you can fit all the wires into a flexible tube to keep your children and pets from chewing on the cords.

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16

l Education

about and respect for electricity are essential. Always use rubber slippers while handling electrical equipments.

l Making

sure that all electrical devices are properly designed, installed, and maintained helps prevent electrical injuries at home and work.

l Any electrical

device that touches or may be touched by the body should be properly grounded. Three-pronged outlets are safest. In case of electrical injury, pull the plug at the wall or shut off the current.

l Do not touch the victim while they are in contact with electricity.

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17

l All chemicals

should be stored out of the reach of young children - preferably in a locked cabinet.

l Avoid

mixing different products that contain toxic chemicals such as ammonia and bleach. The mixture can give off hazardous fumes.

l Avoid prolonged chemical exposure. Leave the labels intact for

easy identification and injury prevention.

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18

l Chemical eye burns usually occur when a chemical is splashed

in your eye.
l Chemical

burns to the eye are a medical emergency. Wash your eye with water immediately for at least 10 minutes. Do not rub your eyes. It may cause more damage to the already injured eye.

l The longer

a chemical is in your eye, the more damage will occur. After washing your eye, contact a doctor immediately.

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19

l Don't light crackers in your hands. l People

have a tendency of lighting the fuses by bringing the cracker to the candle or incense rather than bringing the candle or incense to the fuse. Moving the candle of the incense to the fuse is the recommended method. They may burst in your hand causing severe injury.

l Never throw firecrackers at a person or animal.

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20

l Avoid

picking up firecrackers that may have failed to explode (nagmintis or dud crackers) because these are likely to explode in the picker's hand or face. that do not explode should be doused with water

l Firecrackers

or with sand.
l Children

must be discouraged from picking up these types of firecrackers.

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21

l Discard used fireworks in a bucket of water or bucket of sand. l In this

manner you can avoid people from stepping on to and hurting their feet from used fireworks, which are thrown on the ground.

l Always use footwear while bursting crackers.

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22

l Bottle

rockets can fly into people's faces and cause eye injuries; crackers can damage your eyesight if they explode at a close range.

l Injuries

may result from standing too close to fireworks when they are lit up; for example, when someone leans over to look more closely at a firework that has been ignited, or when a misguided bottle rocket hits a nearby person.

l Light

crackers in open spaces. Light rockets preferably from terrace when there is not much wind.

l While

lighting the crackers stand at an arm's length from the cracker. 23

Prevent Burns

l Little

do people realize that in our increasingly populated and polluted cities, the temporary joy of watching the firecrackers is soon replaced by the intense air pollution caused by these.

l The toxic

substances used in the firecrackers release toxic gases that are harmful to the health of all living beings.

l The

high level of noise generated by the crackers cause immense suffering to birds and animals.

l Besides,

that, crackers are dreaded by the sick and the ailing. Crackers that make a noise of more than 125 decibels at four meters distance from the point of bursting are banned by the law. 24

Prevent Burns

l Common

burn-related injuries include burns from silencer contact, having the vehicle turn over, trapping a person and having gasoline spill on them, causing a chemical burn or igniting, and of course sun burns.

l To protect

from sun burns and silencer burns, wear proper clothing and footwear in addition to safety helmets. should be kept away from hot surfaces such as

l Children

radiators.

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25

l When

the radiator overheats, the temperature of the fluid increases drastically and pressure builds. When the cap is removed, the liquid boils or even explodes out, potentially causing serious burn injuries.

l In addition to scalds, radiator fluid contains antifreeze that may

cause chemical burns.

l Never

open a hot radiator cap! Allow radiator to cool before removing cap. Never look into or lean over the radiator opening. Carry a first aid kit in your vehicle.

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26

l Never

leave a child in a vehicle with the windows closed, especially in hot weather.

l If a child

has to be left in a vehicle, the child must always be accompanied by an adult for supervision.

l Teach children not to play in, on, or around vehicles. l Keep the vehicle doors and trunk locked at all times, especially

when parked in the garage or near houses. Children may become trapped while playing inside the passenger compartment or trunk of a car.

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27

l Use window shades in the front and rear windows. Place a light

covering or shading over seats to reduce heat buildup in the vehicle parked in the sun.
l Before

entering a car parked for a long time in the sun, run the air conditioner to help cool off the vehicle.

l Avoid

hot surfaces in your vehicle. (e.g. safety belt buckle and latch plates, vinyl or leather seats, dashboards and sides of vehicle) that can cause contact burns.

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28

l Do not smoke while refuelling the vehicle. l Cell phones

are asked to be switched off at petrol pumps as they are a potential ignition source to the flammable vapors in that atmosphere.

l This step

has been followed after realizing that there is risk of fire accidents due to ignition of batteries of cell phones.

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29

l Common

safety precautions during thunderstorms include remaining inside a closed car or in a building away from doors and windows, fireplaces, and metal objects such as pipes, sinks, radiators, and plug-in electrical appliances.

l When

outside and unable to find shelter, maintain distance from tall trees, hilltops, or other exposed areas. A person caught outside in the open without cover should crouch on the ground with his or her limbs close together. Dry caves, ditches, and valleys may provide some protection from lightning strike. Lightning can travel through water; thus, swimming, boating, and bathing should be avoided during a thunderstorm.

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30

l Always be prepared to face an unexpected fire. l Keep

a plan ready in case the fire erupts. Plan for ways to get out of the house and explain it to the children as well. Windows can be a source of emergency exit. Decide who will take charge of each child. Designate a meeting place at a safe distance outside the house.

l In case the fire erupts, don't waste time taking out baggage and

materialistic goods. Prioritize the safety of the family members.

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31

l If a fire occurs and the room door is CLOSED: l Get out of bed to the floor, Keep low. l Crawl to the door, as smoke is generally at a higher level. l Feel

the door. Use the palm of your hand to feel parts of the door to be sure it is not hot.

l Brace

yourself against the door and open it very slowly. Toxic gases or fire may be on the other side. If smoke or hot gases rush into the room when you open the door, quickly close it and seek another method of escape.

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32

l If a fire occurs and the room door is OPEN: l Get out of bed to the floor, Keep low. l Check for smoke and fire. l If it is

safe to leave, cover your nose and mouth with a moist cloth. Get low and get out quickly.

l If there is smoke or fire, immediately close the door. Shut off the

crevices and small openings below doors and windows with moist towels and use an alternate escape route.

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33

l Use stairs

to get from upper floors to ground level. Never use elevators; they can easily malfunction during a fire.

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34

l In case of burns, never panic and run around. l Running

around only provides more oxygen to the fire, and increases the fire.

l Stop, lie and roll to try and extinguish the fire. Always use water

or fire extinguishers to extinguish the fire.

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35

l In case

of burn injuries, pour ample of water over the burn wound till the burning sensation stops.

l Please

do not apply ink, toothpaste, Vaseline, Amla leaves or any other products over the wound before taking the patient to a doctor.

l Application

of these agents over the burn wound makes assessment of the depth of wound difficult

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36

l Make

sure the burned victim is breathing. If the victim's airway is blocked open the airway, and if necessary begin mouth to mouth resuscitation.

l In the event that someone is burnt, don't remove burnt clothing

(unless it comes off easily), but do ensure that the victim is not still in contact with smoldering materials.
l Remove

off the smoldering material gently by cutting it off with a scissor, and not by peeling it off. It causes further injury to the burnt skin.

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37

l In case of burns, please remove any constricting materials like

rings and bangles as soon as possible.

l After

burns, swelling of that particular area sets in, and it becomes difficult to remove these ornaments later.

l If not

removed early on, they can cause constriction and compromise the blood supply to a particular body part.

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38

l In the

event of burns, do not pour ice-cold water or apply ice over the burn area.

l This can lead to hypothermia, especially in case of children. l Try and

avoid friction over the burn wound. Try and shift the patient to a health care facility.

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39

l During

transportation, head end of the patient should be kept opposite to the direction of the journey.

l This prevents pooling of blood in the legs during motion. l It also

prevents temporary reduction of blood supply to the

brain.
l Blankets

and heaters must be provided to prevent hypothermia.

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40

References:
l Burn

prevention: Success stories and lessons learned; WHO library cataloguing- in publication data 2011. last

l http://www.ameriburn.org/preventionEdRes.php,

accessed 11.11.2011.

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About the Author

Dr. Nikhil Panse completed his M.Ch and DNB in Plastic and Reconstructive Surgery from Government Medical College, Baroda. He is currently working as Assistant Professor in Plastic Surgery at B.J Medical College and Sassoon Hospital in Pune, India. He has numerous national and international publications to his credit. Burn Prevention and Post Burn reconstruction are his areas of interest.

This book is also available online for free download at http://www.smashwords.com/profile/view/nikhilpanse