So, you are moving out on your own.  You are leaving high school and home to move into the adult world. When you finally get out on your own, you are on your own and it becomes your responsibility to check your new “home” for fire and burn safety.  Even if you are not going to college, this information will be helpful if you are leaving home to live on your own for the first time. (Bridge)   Those who developed this program have seen many tragic results of fires and burn injuries affecting this age group.   

Up to 4,000 people a year die from fire and burn injuries. Most die at the scene. Most of those with severe fire and burn injuries who do not die at the scene are transported immediately to one of the 125 hospitals in the U.S. with specialized burn centers. Physicians, nurses, therapists and other members of the burn teams at these centers treat over 25,000 such admissions each year. Burn specialists also care for many of the 600,000 burn injuries treated in hospital emergency departments each year. These patients are often referred to burn specialists after initial treatment at the hospital where they were first seen.

      Fires and burns are very often preventable, but they still cause thousands of injuries every year, all too often with fatal results.       People, especially young people, often cannot imagine being affected by fire. They are the age group least likely to have an escape plan in case of a fire where they live. If they can imagine it, they believe they can handle it, but almost every huge blaze started out as a small fire.

To help you understand the impact burn injuries can have on those who survive them, we will show you how the lives of these students were changed forever by a fire in their dormitory.

     The fire took place in a new freshman dormitory at Seton Hall University in northern New Jersey. The dormitory housed 600 of the university’s 10,000 students.       Three students died and 60 dormitory residents were injured. Two dorm residents allegedly caused the fire while playing around with matches. The fire alarms did go off, but their signals were largely ignored by the students. A large number of prank false alarms had sounded in the previous three months.

      This is the story of Dave and Bill (not their real names). Freshman roommates who did not know each other before being housed together, they forged a strong bond as a result of their ordeal.

       After this fire in January, 2000, Dave and Bill were two of the 60 students who were brought to The Burn Center at Saint Barnabas Medical Center in northern New Jersey. Dave and Bill were two of the most seriously injured survivors.

       The hydrotherapy room in the Burn Center is the first place burn patients go when they leave the Emergency Department. Here, the patient’s wounds are cleaned and the physicians do a full assessment to determine the severity of the burn.          Patients become quite familiar with this room. They are brought here every day for a bath and an assessment of their burn wound. The process is very painful.

      This is Dave in the hydrotherapy room, being bathed and shaved. He has sustained third degree burns over a large portion of his body, and he is on a ventilator because his airway and lungs were also affected.

      Bill winces in pain as he receives his daily bath. Although patients are given large amounts of pain medications before their bath, they cannot be given enough to go to sleep.

        Physical and occupational therapy is extremely important to burn patients. It helps prevent the development of scar tissue that otherwise would become very thick and tight, seriously limiting a patient’s range of motion.          Rehabilitation begins as soon as the patient is admitted. It can  continue for years after discharge. This process requires a great deal of work and commitment on the part of the patient, but it is vital in order for them to regain as much function as possible.

      Burn wounds being cleaned. It is painful for the patient but critically important to continually remove dead skin and keep the wounds clean. Otherwise, there is an increased chance that a potentially fatal infection will spread throughout the burned surface area, which no longer has the protection provided by normal skin.   

      The burn intensive care unit is a “controlled environment”, to which few outsiders are admitted. Since infection is the largest risk to a burn patient, access is strictly limited. In this picture Dave’s parents are visiting.   They are gowned, gloved and masked to avoid transferring germs to Al’s unprotected body. 

     Since third degree burns do not heal on their own, they require surgery. Here a burn surgeon is being gowned to perform a skin graft operation.

     Skin grafting involves taking skin from somewhere else and placing it over the burn wound. Ideally, the surgeon will use some of the patient’s own skin, because that will have the best result. In “autografting”, the surgeon takes the top layer of skin from a non-burned area of the patient and places it in a mesher, to prepare it for grafting.

      The graft is then placed on the burned area. 

      Patients are often placed on ventilators to assist with breathing and fed by a tube in the mouth. They may need multiple surgical procedures. 

      The sudden, dramatic change in their appearance and function can be devastating to burn patients, once it becomes apparent to them.  Severely injured patients often do not realize there has been such a significant change at first, because they are so critically ill, extensively bandaged and heavily medicated when they first reach the burn center.         The psychological component of burn care thus is much more intense than in many other areas of health care. All members of the burn team are usually involved in helping a patient come to terms with his or her injury.   

      Eventually it’s time for someone from the burn center staff to go into the patient’s room with a mirror.  Here, Dave is seeing himself for the first time.  

      As a patient starts to improve, their activity level increases. Eventually they are well enough to be transferred to the burn stepdown unit. Here, less intensive care is needed but rehabilitation continues.

         As patients contemplate leaving the hospital, they face a new set of challenges. This too is a difficult stage of their recovery.

      Bill’s recovery went much faster than Dave’s. He frequently returned to the burn unit to visit his roommate.

      Patients often wear skin-tight plastic face masks and pressure garments on other burned areas. This minimizes the scarring that can occur as a result of grafting and the uneven healing of burned surfaces.  Such masks and garments are frequently uncomfortable, and must be worn 23 out of 24 hours per day for up to 18 months.

        Things we take for granted become monumental hurdles, like trying to button a jacket or pick up a token off the floor. Bill worked intensely with physical and occupational therapists for many months to regain function in his hands.

      The physical and psychological toll a severe burn injury takes on a person can  be overwhelming.

      Severely burned patients may spend several months in a burn center. Along the way they frequently form strong bonds with other patients, helping each other along with their rehabilitation.

      Patients eventually are discharged home. Although they still go back to the hospital for doctor visits and physical therapy, they have to adapt to daily life without the assistance of the hospital staff. 

      As they return to life with family and friends, there are good days and bad.     

      The most difficult part of the transition to life outside the hospital, especially for adolescents and adults, is the reaction of others. People are often shocked by the scarring associated with a burn injury. Staring is commonplace.      (Bridge) Now that you have experienced the horror of surviving a fire with severe burns, allow us to share with you how you can help avoid such an ordeal.  Just how serious is the fire problem in on-campus and off-campus student housing?

In a recent year, 1700 fires were reported in dormitory and fraternity or sorority housing, where only one-third of all full-time students at four-year colleges reside. Another two-thirds live off-campus. Young people leaving home are increasingly drawn to lively urban campuses and their surrounding downtown neighborhoods, where space for campus expansion may be limited. When you are considering which college to attend, or where to live, find out about the housing scene both on campus and in the neighborhood where you may be looking in the future. Many students begin college life in a dormitory and move off campus later in their college career. Three-quarters of fires reported in student housing occur in rented houses and apartments off-campus. (Bridge) What questions should you ask college officials and off-campus landlords to learn more about your current and potential exposure to fire and burn injury?

Find out how well your college and its surrounding neighborhood accommodate students’ housing needs. Is the housing supply adequate and safe?  Do college officials have plans to improve the supply? The typical young adult has much more electronic equipment and other “stuff” than his parents did when they first left home. The combination of crowded living space, more “stuff” and youthful energy is an exciting, but potentially dangerous, mix. It can have serious consequences for fire safety. On campus, how comprehensive are fire safety regulations, and how are they enforced? Are all living quarters protected by smoke alarms? Is the college retrofitting all dormitories with fire sprinklers, if it has not already done so?    Does the college provide guidance to students regarding off-campus housing and its safety? Does it work with local fire safety officials? If you’re renting space off campus, make sure there are working smoke alarms and fire extinguishers, two ways to exit your living space and the building, adequate electrical wiring, and a fire hydrant close to the building, (Bridge)  All these questions arise against the background of the all too frequent behavior of late teens and young adults. Three tendencies of this age group can put you at great risk in both on and off-campus housing. What are they?   

      The behaviors in question are alcohol abuse, risky behavior and poor judgment. Any one of them is dangerous on its own. All too often, two of them, or all three, come together, increasing the potential for tragic results. This program is meant to carry a dual message: be conscious of your own behavior and surroundings as a typical young adult, and protect yourself from the behavior of others who may not be as conscientious, when they are caught up in part of the cycle shown in this slide. (Bridge)  The tragic fire shown on the following slide is the result of only one of these three factors, poor judgment.

      This handsome fraternity house at the University of North Carolina  was destroyed in a fatal fire that took the lives of several students. It doesn’t look like a place you’d think would go up in flames, Nobody expected it.         The fire broke out after a party. This one ended with a tragedy because a student cleaning up after the party didn’t finish the job. He dumped an ashtray containing a smoldering cigarette into a garbage bag and didn’t take the bag outside.

        This picture shows fire doors propped open in a dormitory building.  Although this practice may seem innocent, the fire doors are there for a reason ---to protect everyone who lives there. If a fire broke out in this basement storage and laundry area, smoke would quickly spread up the stairs, and fire could follow, engulfing the building and everyone in it in a matter of minutes.

       If there was a fire or emergency in this building, people would not be able to escape from their rooms or apartments, because the hallway is blocked with furniture. When you live in a building with other residents, what you do makes you responsible not just for yourself but also for everyone else that lives there. Taking responsibility for yourself may mean challenging others who have put you at risk with their careless behavior.

       Here is a similar hallway in the North Carolina fraternity house pictured earlier. The fire spread rapidly throughout the house by traveling through open stairwells and hallways, many of which  lacked fire doors. (Bridge) Now we’ll look at several common aspects of life for those living away from home for the first time which frequently involve fire and burn injury risk.

Alcohol:  We’ve already noted that alcohol is frequently a factor in college fires, whatever the direct cause of the fire. Fire Play/Arson:  Both intentional fire-setting and merely playing around with fire can have tragic consequences. You must assume responsibility for challenging and reporting any such behavior. Candles:  The increase in campus regulations banning candle and incense burning reflects their increasing popularity, especially among young people, and their increased role in starting fires.  Electricity:  Overloaded sockets and cords placed under rugs are frequent sources of fires in student housing.  Many structures housing today’s students are not wired to handle the growing use of electronics. (Bridge)  We’ll look at each of these factors in more detail, starting with alcohol, an all too common factor in student housing fires.

We’ve noted that poor judgment alone, even if resulting simply from inexperience, is a risk factor. Alcohol further impairs judgment and lowers inhibitions against excessive drinking and fire play. The drowsiness that accompanies drinking further increases the risk of fires related to cigarettes and cooking, and it hinders one’s ability to escape or be rescued from a fire. Many students killed in fires are found to have high blood alcohol levels. (Bridge) Many fires in the college setting result from parties where the three factors of alcohol, risky behavior and poor judgment  have come together. What behaviors related to parties can make your life, and those of others, safer from fire? 

Peer pressure is part of the human condition. It can affect all of us, but its impact can be especially strong on young people experiencing life away from home and family for the first time, especially in the presence of alcohol.  Know and observe your own alcohol limits, and form alliances with friends who know and observe theirs. By helping each other recognize and avoid peer pressure to drink beyond those limits, you can reduce your chances of suffering burn injury in a fire resulting from alcohol-fueled poor judgment or risky behavior by someone else When you arrive at a party in a building you’re not familiar with, look at your surroundings right away before you get caught up in socializing. Notice the exits and how to reach them. If a fire breaks out, the smoke may quickly obscure them. If fire breaks out, knowing where  exits are located may make it much easier to find your way out. If you came by car, be sure someone is a designated driver for the ride home.  If you’re the party host, be sure to check upholstery, ashtrays and trash baskets for carelessly discarded cigarettes. (Bridge)   Alcohol abuse may be a crucial contributing factor to collegiate fires, but all fires require an ignition source.  Cooking, fire play and careless cigarette disposal are the most common starting points for fires involving young adults.

          Cooking for oneself may also be a new experience for college students and others living away from home for the first time. Cooking is the number one source of fires in homes and apartments. The most common kitchen fires are those which break out when food is left cooking unattended. This can be a special risk for young people preoccupied with studies, socializing or taking a TV break, or who go to bed forgetting that something is still cooking. Grease fires can erupt suddenly even when someone is present in the kitchen. Students may not know that when cooking with grease, a matching pan lid needs to be kept close at hand to slide front to back over a pan fire to smother it.

Stay in the kitchen when you are going to fry, broil or boil any food. Stay by the grill if you are cooking outside. Stay in the home while baking, simmering or roasting food.  Use a timer to remind yourself to check periodically on the food you are cooking, if you are going to be doing something else in another room of your home or apartment. If a grease fire ignites, put on an oven mitt and extinguish the fire by smothering it with a matching pan lid, moving the lid from the front towards the rear of the stove.  Do not use a fire extinguisher to put out a grease fire, since it will likely spread flaming grease around the kitchen, possibly increasing the damage.  In case of an oven fire, turn off the oven, close the door and wait for the oven to cool down before opening the door to remove the contents. (Bridge)  Cigarettes rank high as the ignition source of campus fires.  What are the usual circumstances? 

      People who smoke often like to do so at parties, where smoking  may be more acceptable than in many other places.  Party goers may discard cigarettes carelessly without looking for a safe ashtray. Smoldering cigarettes may be dropped in trash baskets or cans along with paper and other combustibles. Cigarettes may simply be left burning unattended, and end up between the cushions of an upholstered couch, where they smolder for hours before the couch bursts into flame. Smoking while drinking will increase the likelihood of these  careless smoking behaviors.     (Bridge)   What should you do to reduce the fire risk from smoking, by yourself and others? 

Check furniture, carpets and waste baskets for smoldering cigarettes at the end of small or large social gatherings in your living space. And if you happen to be a smoker yourself, don’t smoke in bed or when you’re drowsy.   (Bridge)  Alcohol also is typically a contributing factor to fires started by fire play. How many of you have seen dangerous fire play in a student housing or party setting?  What was it like?  Did it involve any of the following?

Fire play is a frequent outcome of the “triple threat” combination of poor judgment, risky behavior and alcohol that we’ve noted before. Fire play draws broad public notice as part of the uncontrolled exuberance that frequently follows victories in major sports, but it is far more frequent in prank behavior. (Bridge)  Fire play involving fire alarms is an especially dangerous example of prank behavior.   

Setting off dormitory fire alarms as a prank continues to be a significant problem. It can be tragic when repeat false alarms lead students to ignore them, as happened at Seton Hall University. Many schools have enacted tough policies regarding fire alarm abuse, and some expel students caught triggering false alarms. Never ignore a fire alarm. You never know when responding to its signal may save your life. Removing smoke alarm batteries to power some other appliance can have equally drastic consequences. (Bridge) Playing with fire itself is always reckless and irresponsible.  Whatever the motives, any fires resulting from fire play which result in property damage or human casualties may be officially classified as “arson”, which is subject to severe penalties. Let’s look at some motives for arson.

       This list of possible motives for setting fires runs the gamut from general emotional distress, to those whose emotions are directed at  specific targets, to those coldly calculated for financial gain. The motives of young adults who set uncontrolled fires tend to fall in the middle of this range, typically involving jealousy, a desire for attention, or retaliation.           (Depending on audience)  Have you ever experienced or known anyone involved in arson? (Bridge)  You’ve witnessed a potential or actual instance of fire-setting behavior.  What is the best response?

          Arson is a very serious crime, and, apart from the coldly criminal intent for financial gain or other reasons, its emotional sources need to be treated with professional counseling. You should report any behavior that suggests an arson motive, to avoid becoming the victim of a fire with life-long consequences.  (Bridge)   Electrical cords and appliances also represent a potential fire hazard.  All the appliances in the next slide have been the source of fire and burn injuries.

      When you are checking out college living arrangements, question whether or not the facility has the electric wiring needed to handle all computer equipment and other electronics which today’s students typically possess.       Most colleges  have strict rules about what students may or may not keep in their rooms. Pay attention to these rules. They are there for  your own safety, as well as that of all the other students in the building. Rules against cooking and halogen lamps in dormitory rooms, for example, have been enacted in response to their frequent role in starting campus fires. (Bridge) The next two slides illustrate some specific safety concerns with these items. What are some of those concerns?

Electric hair curlers and dryers should be unplugged as soon as they are finished being used, especially when the bedroom or bathroom is used by more than one person. A serious contact burn can result from the exposed heating element of a hair curler. Electrical appliances should not be used near water. In particular, hand-held appliances such as hair curlers or dryers could cause a powerful electrical shock, even electrocution, if they fall into a sink or tub filled with water while someone is bathing. All electrical appliances should carry the UL symbol® of Underwriters’ Laboratories, which tests electrical appliances. (Bridge)   Electricity once replaced candles as the main source of light.  Candles are now popular again, for fragrance and decoration more than for light, especially among young people. How are they dangerous, and what guidelines can reduce that danger?  

        If candles or incense holders are permitted in your living quarters, make sure their holders are sturdy, won’t tip, are large enough to collect wax drippings and located where they are not likely to be knocked over.        Keep candles away from combustibles, including loose papers, window curtains, or clothing piles that could be ignited.       Keep the wicks trimmed to ¼ inch to prevent their tops from breaking off and spreading flame to a combustible substance.   (Bridge) Failure to follow rules and precautions in any of these areas can lead to fires like the one on the next slide.

(Bridge)  What are two linked features of living away from home for the first time?

       Living away from home for the first time, in a college dormitory or your own living quarters, is an exciting time. It offers the promise of personal freedom from parents and teachers and the rules they impose.  But the gift of freedom brings with it the burden of responsibility.  Although you are now free from constraints set down by the adults in your life, you are now also free from the safety and protection they provided you.       You are now responsible for yourself and your own safety, and the safety of others who might be affected by your behavior. You’re also responsible for protecting yourself and those around you from the risky behavior and poor judgment of others.   (Bridge)   With fire safety in mind, learn and remember the following guidelines, developed to help you prevent,  prepare for, and respond to a fire. 

      Keep these tips in mind as reminders of the need for fire and burn prevention in each of the following areas. Candles and Incense:  Extinguish before leaving a room or retiring for the night.   (Bridge)  To be prepared for the possibility of a fire, observe the following rules.

Never ignore fire alarms, even when there have been false alarms in the recent past. Have an escape plan from your dwelling place  (Young adults aged 18-24 are the least likely to have one). Keep hallways and exits clear, to make it easier to escape and for rescue efforts. Maintain WORKING smoke alarms.  A large majority of fire deaths now occur in occupancies which either lack alarms, or lack the batteries to operate them. (Bridge)   If a fire DOES still break out in your residence or another building where you happen to be at the time, the next two slides provide some basic guidelines. What are some of them?

Feel all doors before opening and don’t open them if they’re hot. Get out immediately, alerting others in the building if possible as you go. If you can open them, close your door and any others behind you as you leave, to deprive the fire of more oxygen. If your door is one that automatically locks behind you, take your keys, in case you are trapped and have to return to your room. On your way to the nearest stairway exit, pull the alarm if it’s not already sounding and alert your hall-mates. Once you’re outside, stay out. Leave all your belongings behind. Never go back into a building where there’s a fire, because it can spread rapidly and unexpectedly. 

Remember to stay low under smoke. Superheated air, toxic gases and smoke fill a room from the top down. If you live above ground level, always use stairwells, not elevators, to escape a building where there’s a fire. Elevators will be likely to stop and remain at the first floor where they encounter a fire. Once you’ve left the building, be sure that someone has called 9-1-1 to alert the fire department. Don’t assume this has already been done. (Bridge)  What if you’re door is already hot and you can’t  leave your room?  What can you do?. 

       If you are trapped inside your room or your floor of the building, return to or stay in your room. Keep the door closed, and place clothing or linens around your door and across any vents to keep out smoke.       Call 9-1-1 and signal your presence to rescuers with a flashlight, or by hanging colored clothing or other material from your window. (Bridge)     Remember Al & Shawn and their ordeal? We hope you will when you leave home and think of the environment you will be living in. You are starting an exciting chapter in your life. We want you to be able to enjoy it and live free from fire and burns for your whole life time.  

      This is Dave nine months after he was burned. He will continue to receive  physical therapy and he will go back to the hospital for several reconstructive surgery operations. But Dave will never be the same person he was before the fire. He will always be scarred, both physically and psychologically, and he will always have limitations due to his injuries.       This happened to Dave because some students played around with fire, others ignored fire alarms because of prank behavior, and many didn’t know where the fire exits were located. 

     Now that you are moving on to the next phase of your life, you need to realize that with newfound freedom comes added responsibility. You are no longer under the watchful eyes of your parents, instead you alone are now responsible for your own safety.