Unless it has happened to you or to a close friend, firefighters often don’t understand the nature and impact of a burn injury. Granted, a subset of our service is burn prevention; because of this, we have good baseline knowledge about burns through our training, and often work with various burn foundations. But upon closer examination, it appears that there remains an awareness gap in our overall understanding of burns—how they occur, their treatment and their long-term impact.
Types of Firefighter Burns
There are many ways to categorize firefighter burns. As they relate to personal protective equipment (PPE), there are five general categories:
- Compression burns occur when the PPE, especially when wet, is pressed tightly against the body (where the knees bend, SCBA straps, etc.).
- Steam burns typically result from fire streams being converted to steam. The most common areas for steam burns are the ears, wrist and face.
- Scald burns occur from exposure to hot liquids: these are likely to occur to the knees and hands from crawling in superheated water.
- Dry garment burns are typically found when there is no visible sign of damage to the PPE. We are still trying to understand how this happens.
- Inhalation burns occur when the SCBA mask is not worn, not worn properly, or the mask fails—especially the lens.
As stated earlier, there’s an awareness gap among firefighters (and even within the medical profession) related to burn injuries. This gap is most glaring when it comes to treating burn injuries. Doctors are either generalists and specialists. Many burn injuries require the treatment of a burn specialist—i.e., a burn center—and many generalists, by nature, do not understand the specific treatment needs of a burn patient.
Recently, two firefighters were treated and released from a local hospital emergency room and told they would be okay (no further treatment needed). The following day, both experienced complications and were immediately sent to a burn center. Their treatment lasted six weeks! The well-intentioned local hospital ER had no clue about the nature and treatment of burn injuries.
Following are some examples of when a firefighter should consider treatment from a burn center:
- 10% or more of the body with second-degree burns
- Any third-degree burn
- Circumferential burn
- Electrical burn
- Chemical burn
- Inhalation burn
- Burn over a joint
- Burn to face, feet, hands or genitalia
- Burn with additional trauma
- Firefighter over the age of 50
- Medical complications from a burn
Burn injuries can some of the most painful and difficult injuries to treat. The rehab and permanent scarring impact the firefighter, the family and the fire department.
To learn more about burns and PPE, be sure to attend the rapidly approaching 2013 F.I.E.R.O. Fire PPE Symposium. One of the presentations related to this subject will be from the D.C. Burn Foundation, which recently developed a program titled “Firefighter Burn Injury Awareness” funded by an Assistance to Firefighters (AFG) Fire Prevention and Safety Grant.
The Symposium will be March 4–6, 2013, at the Sheraton Raleigh (N.C.) Hotel. A highlight of the symposium will be a tour of the Textile Protection and Comfort Center (T-PACC) at N.C. State University. Details and online registration are available at www.fireppesymposium.com.