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Interviewer: Are you a new parent? Well, here are three burn dangers you need to watch out for. We'll examine that next on The Scope.

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Interviewer: When you bring a brand new baby home, there are a lot of things that you've got to make sure that your house is safe for them. One of the things you have to start thinking about is potential burn dangers, and we're going to talk about three things you should do . . . three burn dangers you should watch out for when you bring that new child home or you have a new child in the house. Annette Matherly is with the University of Utah Burn Center. Let's cover these three things: number one . . .

Annette: Number one would absolutely be that beautiful glass fronted gas fireplace, which is quite a mouthful for me to say, but that fire is really attractive to young children and that glass stays hot for at least an hour after it's turned off. So it's not just when the fire is on that it's hot. It's when it's off and it looks safe that it remains hot enough to burn a child in about a second.

Interviewer: And I think that's really surprising when people find that out because they think that that glass is like the glass in your oven, right? The oven could be at 450 degrees. You could touch that glass. You're fine. The glass fronted fireplace, not that kind of glass.

Annette: Absolutely not, which is strange because it's about 1,300 degrees when it's hot, which is crazy to think about. And so, now, there's legislation moving forward to ensure that everybody puts a guard around that glass fronted fireplace, but that doesn't protect you if you go to a vacation spot or a hotel or a restaurant that doesn't have that guard around or it doesn't protect you if you've had your glass fronted gas fireplace in for a while and you're not aware of the danger surrounding that.

Interviewer: All right. So, remember, that glass front fireplace, it's pretty, it's like a magnet that kids' hands would love to go up there and it stays hot for a long time. So be aware of that. That's number one. If you're a new parent, you've got three burn dangers to watch out for: number two . . .

Annette: Number two would be hot liquids burn like fire, which seems counterintuitive because we think fire burns like fire. We don't think of something in a cup burning like fire, but to know that hot water right from your water heater is set at about 146 if you haven't turned it down. And so a suggestion to new parents, especially because that child has much thinner skin than an adult, would be to turn that water heater down to 120. You can measure that by putting a candy thermometer in the first water that comes out of your tap and then it's usually a low, medium setting.

Interviewer: So the default settings for hot water heaters is 146.

Annette: 146.

Interviewer: And how long does that take to burn a child?

Annette: Two seconds for a significant injury to occur.

Interviewer: And 120 is a little safer or a lot safer?

Annette: Absolutely. So it doesn't mean that you won't get burn injured, but what it means is that there's some more time. There's minutes as opposed to seconds.

Interviewer: And what about hot liquids like in your cup there that was hot, cups of coffee and stuff?

Annette: If you think about your Starbucks, or whatever it is, your beverage of choice, when a barista pours it, it's around 180, which is crazy if you think 146 is water that comes from your tap and burns you in two seconds. So 180 is outrageously high and much faster than that two second incident. So never carry your young child whilst carrying a hot beverage and ensure that your beverage stays away from countertops and tables, that tablecloths aren't used so young children can't pull on that tablecloth and pull that beverage down onto themselves.

Interviewer: And maybe go out and buy some mugs like your fancy one three with that airtight seal on it.

Annette: Absolutely. My beautiful silver one, so, you know, if you've got a young child then we usually say, "got a kid, get a lid."

Interviewer: Okay. Very good. All right. So glass front fireplaces, hot liquids burn like fire, what's the third thing that new parents should watch out for as far as burn dangers are concerned?

Annette: So we talk about a three-foot safety zone around a lot of things. So around a campfire would be another thing, but also around your cooking area. So, if you have a small child, I know it's not always possible to put a physical three-foot marker with duct tape on the floor. Most people don't want that in their beautiful kitchens.

Interviewer: You could.

Annette: You absolutely could, but to think visually where that marker would be, especially when you have little children roaming around or a brand new infant because that also includes cooking with a child in your arms. So to be aware of what you are holding in that precious bundle and is it worth the risk.

Interviewer: And other than the stove, a lot of people don't really realize the microwave, stuff that comes out of there can be dangerous, ramen noodles, boiling water.

Annette: Absolutely. So ramen noodles are the number one for teens because teens come home from school. They go and they put something hot in the microwave, and oftentimes, again, like you said, it's above head level, and so they're reaching to pull something down and they'll pull it right down on their face.

Interviewer: Yeah. And if you have a child in your arm and you reach up with one hand, you fumble that item. It doesn't take long.

Annette: Absolutely.

Interviewer: All right. So those are the three really good things to watch out for if you're a new parent because a lot of burn prevention is just awareness and implementing some of these changes in your household. Do you have any other final advice for that new parent coming home with that new child to keep them more burn safe?

Annette: So the last thing would be burn prevention is a team sport. We work as a team to ensure that each other is kept safe so when you bring home your new child then to talk to others that are maybe not familiar with the dangers that you've just heard about. So maybe grandparents, maybe babysitters would be another really important one as you go out on a date with your partner and leave your child in the care of another. And so, to ensure that they're aware of the things that could really cause lifelong injury to a small child would be really important to mention before you leave.

Interviewer: And having these conversations really can make a difference.

Annette: Absolutely. Most burns are preventable. It is very, very infrequently that we see somebody come through our unit that it could not have been prevented. So, to know and to educate yourself about the dangers of fire and then to educate those around you would be really important.

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Interviewer: Part of being prepared for disaster at work is what to do if there's a fire at work. We'll examine that next on The Scope.

Announcer: Medical News and research from University of Utah physicians and specialists you can use for a happier and healthier life. You're listening to The Scope.

Interviewer: Annette Matherly is the outreach and disaster coordinator for the Utah Burn Center. If you find yourself at work and there's a fire, what should you do? Well hopefully you've had some sort of training on that. But we're going to find out from Annette what you should do.

Annette: So, a lot of these concepts go back to elementary school, you know, get out fast. Don't stop and call a friend, don't stop and pick up your favorite plant. If there is a fire at work, take it seriously. And I know many of us are guilty about, "The fire alarm again, it's just another drill." But when we hear a fire alarm go off, we instantly should take flight. We should think about what our exit routes are, and we should already know them, because one of the things about life is that we should pre-plan for things that are bad, and if we get into that habit we'll never be disappointed, and we'll always be prepared. So we should know our exit routes out, and we should get out as quickly as possible.
Now if your exit routes are obstructed and you're unable to go downstairs, or you're unable to get out of your room, then one of the things that you need to do collectively, or if you're by yourself, find whatever you can to stuff under that door to make sure that no smoke comes into that room and obviously put the back of your hand against that door. See if it was hot before you opened it. If you close your door at work, feel the knob, make sure that there's no heat on that knob. And if there is, then you will not open your door, because that will cause a draft to come into the room and then you'll get all those hot gasses and that fire that will then come in. So you want to make sure that the gap underneath the door is completely filled with something so the smoke doesn't come in.
Then, if you have a window, then you want to go over and you want to signal for help at that window. Obviously, if you're first or perhaps second floor with a window with a ledge that you can jump down on, then you want to get out your window if possible. But you definitely don't want to jump. If you're too high and you could get injured, then one of the things that you want to do is just stay there, and breathe slowly and be really calm. There have been a lot of studies that have shown if your heart rate is up, then you don't have the ability to think clearly. So to be able to keep your heart rate as low as possible, to function adequately, to think clearly, and to know that there are some great fire fighters out there that would love to get you out of that building in a timely manner and keep you safe.

Interviewer: If I'm in some sort of office where they can't see me, what should I do? Should I be yelling in there? I mean, you told me to stay calm and yelling kind of goes counter to that, should I get out my cell phone? I mean, what do I do?

Annette: Absolutely, every time I ask for a 'hands up' in class, whenever I teach, about who does not have a cell phone, I think there's one person in about the last ten years. But obviously call. Now, calling is not going to be the first thing you do, you're going to try and get out, but if you cant get out, then to call 911 to tell people where you are. So knowing where you are in your building and being aware of your surroundings prior to the event is really important. There's no point in saying "Well I'm the fourth floor down on the right, in that weird T." So to know exactly where you're located would be super helpful for the fire fighters, and one day may save your life.

Interviewer: So, 911 will then take that information and they'll help coordinate behind the scenes and get that information to the firefighters. "We know for sure we have somebody in office 210 on the third floor"

Annette: Absolutely. Absolutely.

Interviewer: Very cool. If you're trapped in your office, is there any place in your office that's better than the others?

Annette: No, the only place that's really safe is underneath the smoke that will maybe come through that door, even if you've packed it. So, to be low to the ground, and to keep under that smoke, because that smoke contains toxins and that's what will kill you, and that's what kills many people. So to keep low, to crawl on the ground, and then to not breathe in any of that smoke. If you have something wet, if you put it over your nose, then, and breathe through that moisture, then that can help so some of those particles don't get into your airway. But, other than that, keeping obviously as far away from that smoke as possible, and keeping low to the ground is the only options that you might have.

Interviewer: All right. Have you ever seen the results of a burning office building, in the burn center?

Annette: You know, I have, unfortunately. And hotels are another one, and manufactured homes, and apartment complexes, and senior centers, and all of those things that break your heart, unfortunately.

Interviewer: What's getting them hurt? What's a common kind of thing that they're doing wrong, that people are doing wrong in these situations?

Annette: You know, sometimes I think we just have that 'deer in the headlights look. So that stop, and take in your surroundings and to grab your bag and think about what books you might want to take. That is not helpful; going back in to a burning building to get something that's been forgotten is something else that we see. Never ever go back into a burning building because you will get injured.
The other thing that we see is that people just aren't prepared. They have never done it before, and so the most important thing is to think about exiting any way you're at. If you're at a hotel, ask for a room on the lowest level close to a fire exit. Although, if we all ask for that, there's not going to be many rooms available for the rest of us. But to think about your surroundings, to be aware, to know that fire can start anywhere, and that fire is powerful, fast and dark, unlike the movies that show this bright exotic flame. Fire is dark, and we can't see, and so to know by feel how to get out of somewhere would be really important.

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Interviewer: What should you do if you're trapped in a burning building? We'll examine that next on The Scope.

Announcer: Medical news and research from the University of Utah. Physicians and Specialists you can use for a happier, healthier life. You're listening to The Scope.

Interviewer: So if you remember back when you were a little kid stop, drop and roll. You touch the door to see if it's hot. What should you do if you're trapped in a burning building? Are those still the same steps or is there something else we should know? Annette Matherly is the Outreach and Disaster Coordinator for the Utah Burn Center.

I'm caught in a burning building, whether it's at home or at work. What do I do? Are those basics I learned in school still good or what?

Annette: Absolutely some things never change; you just try and make them right? So let's just say I'm in my bed, I'm snoozing away and the smoke alarm goes off. I wake up but I'm kind of still sleeping. It's dark, right? But is it dark because there's smoke in my room or is it dark because my eyes aren't open yet or is it dark just because it's night?

Well, I don't know the answer to that and so I roll out of bed and I drop to the floor. My door is closed because remember we're supposed to keep our doors closed when we sleep at night and that's because if there's a fire outside our room, if our door is open and we open the windows so we can escape out the window then it will cause this draft which will pull the heat and smoke into our room.

So that's why we leave our door closed. So I'm crawling across the floor, I'm heading to the door. I use the back of my hand to feel the door. Is it hot? No, I can't feel it. I put my hand up and I feel the knob and the knob is hot so that means there's some fire, something hot outside my room. So now, man, I can't get out of my door. I know that I've got to stay in my room.

So what I want to do is I want to make my way to the window. I'm safe to open it if the doors closed but what if I'm on the 5th floor? What if I'm on the 25th floor? I can't jump out of my window now.

Interviewer: I don't like this scenario you're painting at all. What am I going to do? Tell me.

Annette: Well, so now I know I can't jump so I'm kind of stuck in my room for a while. So what I want to do is pull the sheets off my bed and I want to stuff them right underneath that crack in the door and around the door so I stop that smoke from coming in as quickly as I can. Obviously my first thought is for my safety so I want to get somebody's attention so they can get me out of this burning building as quickly as possible.

It is safe to open the window because your door is closed, it's not going to cause that draft and pull the heat into the room. So I want to get somebody's attention by being at that window. Now obviously if I'm smart I'll also have a flashlight by the bed but I can use the lights if the electricity works to get peoples attention. If not, then to have a flashlight and signal for help and yell and scream out the window so those firefighters who know how to do this, who are experts, can get up to me.

The other thing I might want to think about if I'm maybe on the 3rd or the 4th floor is they have some handy-dandy great ladders that can be used as a fire escape in an emergency situation. If I have one of those I can get out of the house but it's not very helpful if I'm on the 25th floor. I'm pretty sure they don't make ladders that long.

Interviewer: So I'm in my room, my door is closed because I've listened to you. I've checked, it's hot. I would imagine a lot of parents at this point would go, "What about the kids? I need to get out and help the kids." What's the answer to that?

Annette: This is a heart-wrencher, because as a parent of course you want to get your kids out. But we have also many people in saving the children and in saving the hamsters and in saving their dogs, they get severely burn injured. So the key thing is, and this is the kicker, is many people don't want to deal with this because it's kind of an iffy topic and people kind of shy away from things the things that scare us.

But if people practiced their fire escape plans, their home escape plans with their family and they practiced it in the day and they practiced it at night, and they practiced it with their kids and their kids could demonstrate competency in getting out of the house. That muscle memory, that second nature that kicks in when you have fight flight, if you have practiced that then your children are likely to get out of the house.

You may only have two minutes. What's really important is to think about it before. We should just talk about freely in our homes and in our families. Kids love to take responsibility. The kids can be the Fire Marshall and they can prepare the drills and they can have unexpected drills at 2:00 A.M. on a weekend so that parents and everyone can practice crawling out in the dark, going to a safe meeting place and rejoicing with everyone because everyone's got out safe.

Interviewer: You know the worse part about it is that I hear you say all these things and I'm like, "It's never going to happen to me. It sounds like a lot of work." I get totally what you're saying that it has to happen before. You're not going to save lives during, you're going to save lives before. How do you get over that "it's not going to happen to me" barrier?

Annette: Well you know as an ICU Nurse we hear that all the time. Unfortunately because nobody ever thinks it's going to happen to them. It's human nature to think... We don't want to think about bad things. But we need to be motivated enough to engage in preparation and prevention so that we can keep not only ourselves but our loved ones safe and secure. We can know if it happens, and tragedy does, that we did our absolute best that we can to change an awful situation.

Interviewer: I like your idea of turning it into a game to prep for the kids. I bet you the kids would absolutely love that. That's a good idea. What about having a plan where all right you've got the baby, part of the plan is everybody feels their door. If somebody doesn't feel the heat, they are the ones. Like before you plan, they are the ones to go examine to see if the baby's safe. Is that something you can do or is that a bad idea?

Annette: Sure, absolutely. Let's just take there are four people and three of them feel the heat and they're going to get out the window or they're going to stay and they're going to signal for safety. One person doesn't feel the heat. Now not feeling the heat doesn't mean not necessarily hot or dangerous behind the door, so you want to open your door very carefully and slowly because if there is something out there you want to close it really fast.

But if you don't see anything in the hallway and you have a baby next door to you, then you can obviously open up that door, run and grab the baby. Check those corridors because remember if you can see smoke then you need to get underneath it. The toxins that the smoke contains will get into your lungs. Many people don't die from the burn injury; they die from the toxins in the smoke itself. Because the unfortunate thing is it clouds your mind so you can't make very good decisions, so maybe you're not clear.

So you need to get underneath that smoke. You need to crawl either out of the house through your escape route with your child or if you can't escape, you've seen it, there is smoke at the bottom of your stairs and fire down through that exit way, you need to go back into your room and then you need to signal for help from your room. Do all those things under your door. Stuff your blankets underneath so that you and your child can stay safe as long as possible.

Interviewer: Keep your child's, keep your baby's door closed as well.

Annette: Absolutely.

Interviewer: Because then there might be a chance that you get out. The Fire Department shows up, they're still able to save the child.

Annette: Absolutely.

Interviewer: Wow, all right. So get out and practice those drills. Any final thoughts when it comes to what to do if you're trapped in a burning building?

Annette: The other thing that I would say is there's some amazing websites out there. The NFPA website, the Burn Prevention Network, the Safe Kids, they have some great tool kits, some great games for your kids. They have things for adults too but they have really basic important concepts that you can adapt into your homes and make a part of your every day life to make prevention just the same as can I have an egg and some toast in the morning. That's how prevention should be.

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