Fire accidents can result in catastrophic personal injury and devastating damage. Fire accidents can cause death not only from burns but also from smoke inhalation and toxic gases. The surviving casualties mostly have serious and extensive burns. Cases showing up with burns require immediate rescue procedures but these procedures cannot always be done with just the local resources. Smoke and gas, because of their suffocating action and their direct action on the airways, represent the other specific danger elements. People generally underestimate the danger of smoke and gas.
- A burn or a case of burns is often associated with other serious pathologies, such as wounds, fractures, electrocution, and blast or inhalational injury.
- Hypovolemic shock, a characteristic feature in the first phase of the burn illness, (as early as within three hours of the trauma), induces a state of tissue hypoxia, with irreversible damage to the various organs and systems. The time interval between the burns / fire accident and the initiation of resuscitation therapy must be less than two hours.
- Triage in loco of the victims must be carried out by specialists, as only experts are able to evaluate the immediate gravity of the burn and the measures to be taken.
- Rapid assessment and care for viable and potentially curable victims is paramount.
The operational rescue plan in a fire disaster cannot fail to take into account two points:
- The victim’s pathological picture: the presence of extensive burns, inhalation lesions and polytrauma.
- The type of intervention required: immediate care; medical rescue within three hours; use of specific equipment and the means for the rescue of the burns patient.
Role of rescuers in immediate care:
- Contain or reduce the fire
- Extraction and transfer of victims to open air surroundings
- Appropriate action when clothing is on fire
- Removal of burning clothing
- Emergency treatment of burned areas
- Knowledgeable action pending more complete relief
- Dealing with chemical burns
In a disaster with a great number of patients with burns and other casualties occurring in a rural or isolated area or the burns cases where the delay in the arrival of the first rescue workers is predictable, the persons present on the spot should mark out a safe place as an area for assembly of the injured. This area should be accessible to vehicles already in the vicinity or on their way (ambulances, helicopters, private cars, etc.). This will facilitate the task of the first rescue workers who arrive, as they will be able to proceed with their task immediately and perform the initial triage and the initial resuscitation procedure.
Medical/Paramedical personnel must carry out the first triage of urgent cases and the many polytraumatized patients.
Minor burns/noncritical sites [<10% Total Body Surface Area (TBSA) for children; <20% TBSA for adults]: dress wound; tetanus prophylaxis; out-patient care.
Prevention & Safety:
There are steps consumers can take to protect themselves from a fire:
- Keeping a fire extinguisher ready at home can help extinguish a small fire that could develop into a major blaze.
- Keeping portable heaters more than 3 feet from anything that could catch fire. Heaters should never be left on when the house is empty.
- Repairing or replacing frayed wires, electrical cords and old appliances.
- Keeping kindling matches and flammable items clear of fireplaces.
- Ensuring cigarettes are completely extinguished before throwing them into the trash and avoiding smoking in bed.
- Planning escape routes, and a place for family members to meet in the event of a fire.
- Installing and maintaining smoke detectors.