Today we’re going to talk about the fire and burn injury hazards of outdoor recreational activities and travel. These activities and their related fire and burn hazards are prevalent throughout the year in many places. We’ve called the program “summer burn safety” because  they are associated for many of us with summer recreation and vacation travel. But whenever we enjoy these activities, it’s usually a busy time for the fire and emergency services, and for burn treatment professionals.  As people who share a commitment both to treat and prevent fire and burn injuries, they’ve combined their resources to develop these safety messages.

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. (Bridge)  What are the areas of concern for burn care specialists, regarding summertime, or outdoor fire and burn injury?

Based on their experience with warm-weather injuries, they have developed these messages about….. (Bridge)   First, let’s look at the impact of some of these warm weather outdoor fire and burn injuries.  What is their scope?

Propane or charcoal grills are involved in up to 6,000 reported fires each year. Fireworks are involved in up to 10,000 injuries each year, almost half of them children, along with 6,000 fires and at least $8 million in property damage.         These are just the injuries treated at hospitals and fires responded to by fire departments.  Many more such injuries and incidents are not reported. Some of them may be are just as serious and disruptive to people’s lives as most of those known to authorities. (Bridge)  The best example of unreported but potentially disruptive injury is our first prevention topic, sunburn. What should we know about sun’s most important hazard, ultraviolet rays?

      No, it’s not just (redheads, etc.)……. It’s infants and young children. That’s because:            their bodies haven’t developed pigment qualities that provide some protection,             they can’t tell us what’s making them uncomfortable, and        they can’t move out of the sun on their own. (Bridge)  Fortunately, there’s plenty we can do to protect them from the short-term and long-term impact of sun overexposure. What can we do?

First, infants should be kept completely out of the sun. That’s because their skin is so thin and because they are sensitive to sunscreen chemicals. They should not be exposed to either sun or sunscreen for at least six months. Babies older than six months can tolerate sunscreen lotion, but not direct sunlight, until they’re at least a year old. Sunlight reflected off sand and water can be harmful even if the baby is in the shade. After their first year, (PABA-free) sunscreen with a Sun Protection Factor (SPF) of at least 30 can be used on toddlers. No child should stay in the sun for a long time, even with sunscreen.  Make hats their standard outdoor wear. Continued lengthy exposure over time presents risks for premature skin aging and cancer. Since In our culture  most people get the majority of their sun exposure before age 18, children need to be taught to understand and respect this risk. (Bridge)  Now that we’ve protected our children as best we can, how should we protect ourselves as adults?  What is our risk relative to our skin type? 

    People with skin that burns easily and seldom tans run the highest risk of skin damage from UV rays. People of all colors and complexions can be burned by the sun’s UV rays, regardless of the appearance of their skin.. (Bridge)  What are some sunscreen and exposure guidelines that apply to everyone?

Everyone, regardless of their skin pigmentation, should avoid long sun exposure, even with sunscreen, and especially during the middle of the day.       Sunscreen should be reapplied at the intervals recommended on the package, and always after swimming or perspiring heavily during exercise. (Bridge)  What other guidelines apply especially to UV protection? 

Bathe the burned area in cool (not cold) water and use cool compresses (like soaked washcloths) to ease the pain. Non-prescription pain medicine should help. Be sure to observe the recommended dosages. Drinking extra fluids will help cool down the body and ease the pain. Alcohol and caffeine however may increase dehydration. You can apply regular or special after-sun lotions. Be sure they are perfume-free and alcohol-free. This will prevent further drying of the skin,

Some people are allergic to benzocaine. (It’s an ingredient in certain “over the counter” creams or sprays and should be used with caution). (Bridge) Heat exhaustion and heat stroke are two serious conditions related to summer heat that we should all know about.  (Depending on the audience) First, can anyone describe some symptoms and treatment for heat exhaustion?

      Heat exhaustion can result from strenuous work or play in the sun when it’s very hot.         Someone with heat exhaustion has most or all of the following symptoms:  (Bridge)  What first aid steps should be taken for heat exhaustion?     

(Depending on the audience:)  Can anyone describe how to recognize and treat heat stroke?     

As with heat exhaustion, the victim of a heat stroke likely has a headache, but their other symptoms are quite different. Their skin is extremely hot to the touch, rather than cool and clammy as in heat exhaustion. A heat stroke victim will have a high temperature and an elevated heart rate, and may even lose consciousness. (Bridge)   Now let’s move on from the hot beach, playing field or outdoor job site to the scene of outdoor cooking.  What is the single most important precaution when cooking outdoors?

     In comparison to indoor meal preparation, outdoor cooking is more likely to be a lively special occasion. It’s more likely to involve children, other relatives, friends and guests., and young children are especially likely to get excited. Keep children away from any outdoor cooking fire, no matter what the cooking method, whether it’s a charcoal or propane grill, a raised fireplace or a ground-level campfire.  To help keep children away, establish and mark a “kid-free” zone extending 10 feet from the fire on all sides. Make sure children and their main caretakers are well aware of this zone before starting to cook.

       Pay close attention to these simple rules.  It can be easy to overlook them when entertaining guests at a social gathering. Again, the emphasis should be on keeping children at a safe distance. This can be done by marking a safety zone around the grill which they are forbidden to enter. (Bridge)  These rules apply to starting and maintaining the fire in your charcoal grill.  How should you prepare for putting out the fire in an emergency and when you’re finished cooking?      

Always be prepared for a possible fire when cooking outside, by keeping a water supply or fire extinguisher nearby. Use that water supply to extinguish the fire when you’re finished cooking, so  the coals can be disposed of without being dangerously warm.  After thorough dousing, dispose coals in a proper container. Hot coals recently buried in sand have caused serious burns when uncovered by accident during beach recreational activities. (Bridge)  Many of us have replaced our charcoal grills with propane-fueled grills. We no longer have to worry about coals and starter fluid, but there are new precautions to consider.  What are they?  

A leaky valve on a propane gas grill can be extremely dangerous. Check all fuel connections carefully. As with any other appliance discussed in this program, read and observe the manufacturer’s instruction.  Test the fuel valve connection at the beginning of each outdoor season and every time you change your tank. To do this, apply soapy water to the valve connections and tubing and check for soap bubbles. If there are bubbles, indicating a leak, the tubing, connections or tank may need to be changed.       When you finish cooking, or if the fuel runs out, shut off the valve. Leave it shut when the grill is not in use. (Bridge) Let’s move on to the more rustic conditions of campfires, used either for cooking or evening socializing.   What precautions should be taken around campfires?      

When such a pit is not available, clear the ground around your fire site of anything that could be ignited by a flying ember. How far around should you clear it?  A rule of thumb is 10 feet,  but it depends greatly on the size of the fire and wind conditions. Almost any campfire can be dangerous in a stiff breeze.  Poorly managed campfires are a frequent source of forest fires. Be sure to build your fire downwind from your campsite, that is, away from the direction any breeze is blowing, to keep sparks from igniting tents or other combustible items on the site.  To avoid dangerous flare-ups, never use flammable liquids such as gasoline to ignite or strengthen a campfire. When you’re finished, be sure to douse flames and coals completely. Don’t attempt to smother with dirt -- use water. (Bridge) Some people use candles and lanterns after dark at campsites. What  should we know about after-dark fire safety?  

Tragedies have occurred when an open flame has suddenly ignited a tent, trapping its occupants. Never use candles, lanterns or other open flames in tents. This includes citronella (anti-mosquito) and jar candles as well.  Safety from fire far outranks a few bug bites. Before sleeping, check again to make sure any open campfire has been completely extinguished. (Bridge)  Carbon monoxide can also be a threat during the outdoor camping season.  What proportion of all carbon monoxide deaths do you think occur away from home?             

It may surprise you to learn that 25% of all deaths from carbon monoxide poisoning occur away from home.  The sites where this happens include any temporary shelters which can be tightly enclosed, including recreational vehicles (RV’s), cabins or summer cottages, and tents.  Potential sources of carbon monoxide poisoning include space heaters, stoves, lanterns and power generators. Keep such equipment maintained on a regular basis. Bring a carbon monoxide detector with you when using such equipment in temporary or seasonal lodging.  (Bridge) The next slide should really alarm you. It has something to do with fireworks, and I don’t know how anyone could think of staging such pictures.  The American Burn Association has two basic recommendations about fireworks. What do you think they are?    

       If this slide doesn’t shock you, I don’t know what it would take. Sparkler temperatures can reach 1800 degrees. Would you give your children anything that could reach such a temperature? Almost half of all fireworks injuries happen to children. Every year, burn center doctors and nurses are dismayed by the severe pain and scars children sustain from fireworks injuries. NEVER allow children access to fireworks. Public fireworks displays managed by professionals can be an exciting experience. Such displays are accessible to almost everyone, with little risk to those who manage them and virtually none to those who watch. (Bridge)  Nature provides magnificent fireworks itself in the form of lightning.   How dangerous is lightning to humans and what can be done to reduce this danger?   

       The electrical current from lightning still causes severe injury and even death. That’s because the salty water in the human body conducts lightning better than open air. In open areas, this makes the body a target.. Lightning strikes kill up to 100 and injure up to 1,200 each year, according to the National Oceanic and Atmospheric Administration  (NOAA).       Weather forecasts and warning systems have improved greatly. Millions pay close attention to the TV weather maps for their areas. While most golf courses now have sirens that alert golfers to leave the course when lightning approaches, hikers, campers and agricultural workers rarely have such advance warning.        (Bridge)   By following certain personal precautions, the toll from lightning can be  reduced.

When thunderstorms or dry lightning have been forecast or a local warning system has sounded, avoid open areas. Don’t approach or handle metallic objects that might draw lightning to you, such as metal fences and ladders. If you’re outdoors with others, don’t huddle together. Try to remain 15-20 feet apart. Open water is especially dangerous. If you’re in the water, on a beach, or close to shore in a boat when lighting approaches, be sure to seek shelter away from the water.  (Bridge) Along with avoiding these items and areas, If you are caught in the open as lightning approaches what are the best locations to seek?

If you’re caught outside, stay in or get in your vehicle if it’s close by, and keep the windows closed. If you are unable to reach adequate shelter, seek the lowest available ground, while avoiding ditches or trenches in heavy rain. Seek out a group of trees or shrubs of the same height. Wherever you are, don’t lie flat on the ground.  You present a smaller target for lightning if you squat, kneel or sit. Covering your ears will help prevent damage from loud thunder right above you. (Bridge)   While it’s a lot safer to be inside a building when lighting is in the vicinity, it’s not completely risk free.  What precautions should you take even if you’re indoors?  

     Lightning danger is not limited to the outdoors.  If you are indoors while an electrical storm is passing through your area, be sure to: Avoid contact with piping, including sinks, bath/shower area and faucets (Bridge)  We’ve mentioned getting off the water if you’re exposed during a lightning storm, but lightning is not the only fire and burn injury hazard affecting boating.  What other hazards are involved?

       Power boating is an enjoyable pastime for millions, but it’s not risk-free. Most of the fire and burn injury risk involves fuel connections, especially during refueling operations. Enough gasoline vapor could escape from a leaky connection to be ignited by a spark from an engine, an electrical appliance, match or cigarette lighter. Inspect connections frequently.  In the tight confines of a boat, both below and above deck, the sudden explosive ignition of gasoline vapor can cause a human tragedy. Don’t allow smoking while the boat is refueling. Be sure everyone on a boat knows where fire extinguishers are kept and how to use them.  (Bridge)  Moving from water to land vehicles, cars can be dangerous even when standing still. What steps can avert heat-related injury to children in parked cars? 

      Although several hundred Americans die from fire and burns suffered in motor vehicle crashes every year, we’re not here today to discuss safe driving or safer cars in general. These guidelines refer to heat-related risks, including burns, involving parked cars. Keep your car doors locked, regardless of how safe your neighborhood is. This will keep any young children in the area from getting in and locking themselves in during extremely hot weather. Sunshades in front and back windows will keep the steering wheel, seat belt buckles and seats cooler and therefore safer for your and any passengers.        

        Motor vehicle radiator safety has improved greatly in recent years, but car radiators are not completely foolproof, especially those of older vehicles. Protect hands and face when you open the cap. When a car engine is running, radiator fluid is very hot (180° Fahrenheit) and it may still be hot enough to erupt and cause injury after the cap cools down.  (Bridge)  Personal vehicles, such as motorcycles and ATV’s, have their own burn injury risks.  Can you suggest some of these risks and how they can be reduced?

        Motorcycles and ATVs (all-terrain vehicles) pose a far more serious risk of contact burn injury than cars and trucks,. The engines and mufflers of many such personal motor vehicles are located on the outside, where they might burn those who ride or who might approach them soon after they’ve been driven. Children in particular need to learn to avoid contact with the engines and mufflers of such vehicles. A skid along the road after falling off a motorcycle can send its driver and a passenger to a burn center for the treatment of a large area of road rash. Wear clothes that protect against road rash. (Bridge)  Since the warm weather months are the busiest time for travel, they have the highest hotel and motel occupancy. Can you suggest some guidelines to make your stay more fire-safe?  

Pack a flashlight and a portable smoke alarm whenever you’re away at night. Each lodging place has different exit locations and escape routes.  It may save your life to study each establishment’s escape routes and fire safety guidelines.  Look for them as soon as you finish unpacking. Once you’ve learned the routes, count the number of doors between your room and the fire exit.        It’s also a good idea to take these rules seriously when you’re a guest in the home of a friend or a relative. Stop for a moment to figure out how you would escape your room and get out of the house in case of a fire. (Bridge)  The next slide describes what to do if a fire should break out where you’re staying when you’re not at home.  Can you suggest some of these steps?

The general rule in case of fire is to “get low and go!” as quickly as possible. If the door isn’t hot, be sure to take your room key as you leave, if the door is one that locks automatically behind you. If your escape is blocked, you may have to return to your room. Stay as close to the floor as your physical condition will allow, as you move toward the stairs, not the elevators, to escape . By staying low, you will avoid as much as possible whatever smoke has accumulated in the hallway. Smoke rises and is most dense closest to the ceiling.  If you are trapped, block smoke from the door or vents and call or signal for help. Don’t assume that anyone outside knows you are in your room.       (Bridge)   Now that we’ve covered how not to get burned, let’s take a few minutes to review what to do if you or someone around you does experience a burn injury and when to get medical care.  (This is an opportunity to ask an audience about their own personal or first-hand experience with fire, time permitting.)     

         The guidelines on this slide apply to any burn injury that needs immediate attention. First, stop the burning process. Smother any flames, according to the “stop, drop and roll” message you’ve heard many times. Remove all clothing from the burned area that is not sticking to the body. Call 9-1-1  If the burn is small, it can be difficult to tell if it needs medical care. However, seek medical attention promptly to assess any burn injury to the hand, face, foot, or major joints, any burn larger than the palm of the person’s hand, and any burn to a young child. Any such burn could lead to long-term problems if it is not treated promptly. Always err on the side of caution. (Bridge)  In addition to these guidelines, there are special considerations for electrical and chemical burn injuries.  

     Along with the basic guidelines listed on the previous slide, special considerations are involved in treating electrical and chemical burns. The first rule for an electrical burn is to stay away from the injured person until you are sure the power has been turned off. For a chemical burn, assuming the injury source presents no further threat to the person providing assistance, the first step is to flush the affected area with running water for at least 20 minutes. If the area affected by the chemical burn is still painful, continue to flush until the pain stops.    (Bridge)   In summary, what are some basic guidelines for fire and burn-safe summer weather activities, to take with you from this program?

       Here are some reminders covering key rules in the areas we’ve talked about. For sunburn, protect infants and toddlers carefully, and beware of UV rays in all sun conditions. When cooking outdoors, create a “kid-free” zone to keep children at a distance. Leave fireworks displays to the professionals and never give children access to fireworks. If caught in the open as lightning approaches, seek a low area away from tall objects.  For greater fire safety in power boats, assure there is no smoking during fueling operations. Always review fire safety and escape instructions when checking into a new lodging place.    

Summer and warm weather outdoor and travel-related activities often are associated with fire and burn injury hazards. Almost anyone who participates in such activities could be injured if safety precautions are not observed. By observing simple prevention guidelines, these activities can be fire and burn-safe as well as fun.     Are there any questions, comments, personal experiences you’d like to share?