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Straight, No Chaser: The Roof Is On Fire – The Trauma of Residential Fires

By Jeffrey Sterling, MD November 13, 2018

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As Trauma Week winds down on Straight, No Chaser, we work our way back home, which sadly is the site of most traumatic injuries.  In fact, about 85% of all U.S. fire deaths occur in homes.
The good news is the number of residential fire-related deaths and associated injuries is going down, but that won’t help you if you aren’t aware of how to prevent them and get to safety and cared for in the event a fire occurs in your home.  Let’s address this right off the bat.  You’re most likely to die or be injured from a fire if you’re in one of the following groups, according to the Center for Disease Control (but of course, the fire doesn’t check who’s being burnt):

  • Poor
  • Rural
  • African-American
  • Native American
  • Ages less than 4 or over 65

In the U.S. (2010 data), someone dies every 169 minutes and is injured every 30 minutes, amounting to over 2,500 deaths and over 13,000 injuries (and that’s not including firefighters).  Interestingly, victims aren’t burning to death as much as they are dying from inhalation injuries from smoke and gases (estimated to be the cause of death in between 50-80% of cases).  Speaking of smoke, although cooking is the #1 cause of fires, smoking is the leading cause of fire-related deaths.  Alcohol consumption is a contributing factor in 40% of residential fire deaths.  Most fires occur in the winter.
So What To Do?

  • Install a smoke alarm.  They work.  Over one-third of residential fire deaths occur in homes without alarms.
  • Plan your escape in advance.  Have an exit strategy based on where a fire might break out in your home.
  • Don’t fight the fire.  Nearly ½ of fire related injuries occur from efforts to fight the fire.  Get out of the house.  Of course if you have easy access to an extinguisher, use at your discretion.

Tips on How You’ll Be Treated
Fire-related injuries commonly involve burns and bony injuries (bruises, sprains, fractures), which will be addressed as needed.  However, the most important fire-related injuries involve the airway.  These injuries may be due to the heat’s effects on the airway (burns, swelling and inflammation) and/or the effects of carbon monoxide and/or cyanide (inability to oxygenate).  One important fact for families to realize is the presence of any soot/burns anywhere near or in the mouth or nose needs to be evaluated.  Such signs and symptoms are powerful predictors of potential airways damage and imminent failure.

0 thoughts on “Straight, No Chaser: The Roof Is On Fire – The Trauma of Residential Fires

  1. Thanks for this very important message. I hate the smoke detector that is near my kitchen because it goes off even if you burn toast!!! That thing pisses me and my son off. Well guess what, just two days ago it saved my life because I put something on the stove to boil, and forgot about it. If it had not been for the smoke detector going off……God only knows what would have happened. Smoke detectors are very important and they can save your life.

  2. For persons over 65, are they more likely to die from a fire because they tend to have slow reflexes? What are some tips for those in that age group who live alone?
    I’ve enjoyed this week’s posting. Thanks.

    1. With the elderly, it’s always multifactorial. They’re more likely to have preexisting disease, so recovery from burns, infections or respiratory failure will be more difficult. Diminished sense of smell and reaction time may render escape impossible before it’s too late. Early dementia may make it more likely that cooking accidents occur.

    2. Regarding tips, it’s important to monitor your parents safety and preparedness. Help them test those smoke and carbon monoxide detectors. Assess their fitness to continue cooking. Suggest alterations in what they’re cooking. Practice an escape route with them. Program 911 into their phones and ensure they know how to use it. Hope this helps. Thanks for the great question.

  3. What are the rosado a the CDC says that the poor, rural and AA/NA populations are more likely to die or be injured in a fire?

    1. That’s touchy. Frankly, the common thread appears to be ‘substandard housing’ and ‘manufactured homes’ (their words). These populations correlate with the presence of faulty wiring, high cigarette smoke use, lack of smoke detectors and other conditions that promote fires and fire fatalities.

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