Search for tag: "burns"

Deep fat frying a turkey is dangerous. Chances are good you are making at least one mistake that could lead to a fire — or worse, a severe burn injury. Annette Matherly from University of Utah Health Care Burn Center talks about the six big things to watch out for when deep fat frying your turkey and gives some tips so you and your loved ones stay safe this holiday season. Listen to the story above or read the transcript below.

Interviewer: If turkeys were to come up with the ultimate revenge against humans for us eating a whole bunch of them on Thanksgiving, I think it was they invented deep-fat frying turkeys, because it's really dangerous to humans. Six ways you could get really burned by deep-fat frying your turkey this Thanksgiving. That's next on The Scope.

Announcer: We're your daily dose of science, conversation, medicine. This is The Scope, University of Utah Health Sciences Radio.

Interviewer: Deep-fat frying a turkey can be really dangerous. There's a lot of potential danger and it can cause a life-changing burn injury. Annette Matherly is the Outreach and Disaster Coordinator for the University of Utah Healthcare Burn Center. We're going to find out the six ways that turkey's trying to burn you. It's like turkey's revenge here. They're trying to get back at us. But hopefully with this information, they won't.

But before we get to the six things, how would you rate deep-fat frying a turkey as far as burn danger is concerned, compared to what we come into contact with the rest of the year?

Annette: Ten. It's absolutely a ten.

Interviewer: How long would it take a 350-degree bucket of oil or tub of oil to cause a pretty severe burn, and could it kill somebody?

Annette: Absolutely, it could kill somebody. And it takes seconds if we think about hot water, which, if you haven't turned it down, it's set at 146, that can cause an injury in two seconds. So if you think about 350, that's much faster, that's much deeper and devastating injury.

Interviewer: All right, lots of things can go wrong. We'll cover some of those. I know that the experts say that you probably should avoid even doing this.

Annette: Absolutely. The Burn Center and the National Fire Protection Association discourages the use of home-fried turkeys.

Interviewer: All right. Way number one that turkey's trying to burn you.

Annette: Oil overflow. It's an explosion. It just doesn't catch on fire, it explodes. You have to figure out how much oil you need and this has to be correct. The turkey obviously will displace a certain amount of oil and so you've got to factor that in. You need to have at least five inches of space between the top part of the oil and the top of the pot or it can burn over. And it will go onto the flame, remember there's that flame underneath, so that if the oil hits it, again you've got that explosion. So you should turn the burner off while lowering the turkey into the oil and also when taking it out.

Interviewer: And if you want to see what these explosions look like, just Google "deep-fat fried turkey fires" and you'll get a whole bunch of videos of people that overflowed the oil. And it is an explosion. You would think it would just burn, but it's an explosion. All right. Reason number two or way number two that deep-fat fried turkey's trying to burn you.

Annette: Water and oil do not mix. So if you have not thawed your turkey out all the way, if you haven't checked that cavity for residual ice, then that ice can turn to water, which can make the oil splatter and that, in turn, can get onto the flame and so then you're back to your explosion again.

Also, it's pretty chilly sometimes around Thanksgiving, so rain or snow can get onto that oil, again causing it to splatter, again causing that potential explosion. And then let's take the worst-case scenario. So now, you do have a grease fire and instead of reaching for a class-B extinguisher, which you should use, you reach for the hose or you reach for the bucket and now you've got a bigger chance of that fire spreading. Not a smaller chance. Water and oil do not mix.

Interviewer: Way number three that that deep-fat fried turkey is trying to burn you.

Annette: You get that oil too hot. Remember, you can only keep it to about 350, so you've got to keep an eye on it. If it gets too hot then it can ignite so you have to pay attention.

Interviewer: Number four.

Annette: It can tip over. You've got this five-gallon tub of hot oil and if there are unsupervised kids or dogs or cats around, even if they're not yours, if you're not used to people in your home, then it could tip over. Never, ever leave it unsupervised.

Interviewer: Yeah, especially you don't want somebody tripping over the hose and pulling the whole thing over, that would be pretty bad. All right, number five, the fifth way that that deep-fat fried turkey is trying to burn you.

Annette: Well this sounds like a no-brainer in comparison to everybody else, but don't touch the pot. It is hot.

Interviewer: That's pretty simple, I guess, and you're right, it does sound like a no-brainer. How about number six?

Annette: Well, you've got the burner flame itself, and after all this, this does seem like the most dangerous thing but remember there's fire underneath that hot oil. So beware and stay away from it. It can still be very dangerous.

Interviewer: What are some tips if somebody does choose, things to keep in mind, some of the major things?

Annette: Always turn the burner off while lowering the turkey into the oil and when removing it. Don't wear shorts and flip-flops. Wear protective gloves, wear eye protection, wear shoes, wear long pants, remember to keep a circle of safety around that pot so you don't want anyone anywhere near it. We suggest three feet around a campfire, I would suggest even further around this boiling oil.

Then again, make sure it's on a level, sturdy surface, away from any building and anything flammable, anything that you value. Lastly, don't put alcohol in the mix. We really need to be clear-minded if we're doing something that's this potentially dangerous.

So probably the final thought would be something that the National Fire Prevention Association put out, and that would be, just don't do it. Leave the show to the pros, like they say about fireworks. If you must have a deep-fried turkey, then buy one from a grocery store.

Interviewer: And these are the experts in fire danger and they're saying it's just really a little too hot to handle, there are too many things.

Annette: There are too many risks. So at the end of the day, if it's not something you're 100% comfortable with, you might want to leave that deep fat turkey frying to somebody that has done it many times, so you can keep yourself and your family safe.

Announcer: TheScopeRadio.com is University of Utah Health Sciences Radio. If you like what you heard, be sure to get our latest content by following us on Facebook. Just click on the Facebook icon at TheScopeRadio.com.

Interviewer: Don't get burned this Halloween. That's coming up next on The Scope.

Announcer: We're your daily dose of science, conversation, medicine. This is The Scope, University of Utah Health Sciences Radio.

Interviewer: Halloween is kind of a recipe for disaster, really. Think about it. You've got a bunch of really candy-motivated kids running around in their costumes, some of which limit vision or are a tripping hazard or are hard to see in the dark. They're not thinking straight because they just want to get to that next doorstep, and they're running on pure excitement and giddiness. A lot of potential dangers and one of those potential dangers could be burn.
Annette Matherly from the University of Utah Burn Center, she's our expert. Let's, first of all, talk about kids, Halloween, and burns.

Annette: Burn injury is one of the most painful injuries that a human body can suffer, both emotionally and physically, and they last a lifetime. Prevention of burn injury is always preferable to treatment. If we can make simple changes in behavior in our environment, then we will be less likely or our loved ones will be less likely to sustain a burn injury.
So this is probably something that many don't think about, but kids love to wear those costumes that trail around with the capes. They love to be superheroes with billowing sleeves and big princess dresses. But what parents need to remember is that those capes and those dresses can touch candles unexpectedly, and that clothing can ignite. So that's really an important factor when choosing a costume for your child.

Interviewer: But I thought most costumes nowadays are fireproof. So why would you even have to worry about that?

Annette: Well, they're not exactly fireproof. They're fire resistant, and what that means is that they will still catch on fire. It will just take them a little while longer. They may catch, and then by the time the child realizes that their cape is on fire, it may be too late and the cape may be engulfed, and then they need to stop, drop and roll. The other thing about that is that homemade outfits will catch on fire. They may not have that fire resistance attributed to costumes that can be store bought.

Interviewer: In the Burn Center, you've seen costumes that have caught on fire?

Annette: Absolutely. Unfortunately, one that I particularly remember is a little boy whose cape caught on fire as he was running around the house. It caught on a portable heater that was just stuck there. Nobody ever expects that. It's just something that catches you out of the blue.

Interviewer: Yeah, so it's not necessarily the jack-o-lanterns with the candles inside. It can be anything.

Annette: Absolutely, although the jack-o-lanterns with the candles inside are a problem, too. Hopefully, everyone remembers that if there is a jack-o-lantern with a candle on it, it should be well away from the walkways of children that are walking to and from the homes collecting candy.

Interviewer: A lot of people like to put up old cornstalks and bales of straw. Keep them away from that stuff in case the wind blows them over or something, I think.

Annette: Oh, yeah. There's nothing more spooky than those cornstalks and the dangly things that are over the doorways, but remember those are not only a fire hazard, but they're an escape hazard too. So exits should not be blocked with any of that stuff.

Interviewer: It's always good to remember the basics, because regardless of the season, I mean, we could talk about Christmas and the fire dangers there, you could talk about a lot of holidays, but it's just important to remember the basics. What are the basics you should teach your family?

Annette: It goes back to kindergarten, right? When we're in kindergarten, we learned to stop, drop and roll. But as an adult, when was the last time that you stopped, dropped and rolled? So this is applicable not only to children, but applicable to adults too. Sometimes we'll see adults come through that forget those basics, and they run when they're on fire, and they don't stop, drop and roll and cover their face. So this is a great opportunity to review with everyone stop, drop and roll.
It's a great opportunity to review home exit drills and the importance of getting out of the home and not returning for anything, no matter what. It's also a great opportunity to test the fire alarms and make sure that they're working so that if something occurs, then everybody will be warned and will be able to get out of the house in a timely manner.

Interviewer: I think it's important to remember we don't need to be alarmist about these sorts of things. We should still enjoy having the cornstalks and the jack-o-lanterns, maybe be a little smarter about it and a little bit more aware. Candles in jack-o-lanterns a bad idea?

Annette: Oh, please, please use a flashlight or use those really cool glow sticks that have those awesome colors. It's just one more danger that doesn't need to exist.

Announcer: TheScopeRadio.com is University of Utah Health Sciences Radio. If you like what you heard, be sure to get our latest content by following us on Facebook. Just click on the Facebook icon at TheScopeRadio.com.

Interviewer: Burn injuries are painful and can affect the person for the rest of their life. There's nothing more devastating than seeing your child with that kind of injury. Today we're going to find out what a parent whose child sustained a burn injury, we're going to find out their story and what he learned from the experience. That's coming up next on The Scope.

You know the pot of boiling water is kind of the quintessential burn hazard. That's one that everybody knows. But what about a hot drink or the hot water in the bath tub, or even chicken noodle soup which, believe it or not, can be really bad? And for the most part, burn injuries don't happen due to out and out negligence. It's just a matter of the right set of circumstances all coming together, kind of the perfect storm.

Hopefully the result of this conversation is you will think about things differently and be able to recognize those circumstances when they arise in your house. We're with Taylor Vowles, and Taylor's son sustained a burn injury not too long ago. First of all, I think a lot of people think this will never happen to us.

Taylor: Yeah, of course. Scot, I think you nailed it. I volunteered for the Boy Scouts of America for 20 years and you go over these first aid merit badge and other things and you think, "Wow, I've never had to face that situation." And you really don't think of it as a parent at all. It's not at the top of your mind.

Interviewer: Yeah. So tell me the story of your son. What kind of burn did he get?

Taylor: He got a second degree burn over 8% of his body, mainly on his leg. Initially, we didn't think it looked like a second degree burn but it we found out later how incredible painful it was.

Interviewer: Yeah. I think a lot of people kind of make that mistake. I think they take a look at that burn, this is what I've heard anyway from the burn center here, and they think, "Oh, it's not that bad. I don't need to contact anybody." They always recommend if you have a burn injury give them a call. So what did you do at that point? Well, let's back up. How did it happen?

Taylor: He was on roller blades. It was his birthday a few weeks before it happened and he got roller blades and it being cold outside he didn't have time to roller blade much outside. So he's wearing his roller blades in the house despite, we kind of have a family rule for him not to do it. He was rollerblading around in the house and he just learned, a 7-year old, this is like the first cooking thing they learn but he just learned to make a hot water ramen in the microwave. So he started making ramen in the microwave and he got it out and he was on his roller blades and all the water just came right down in his leg and the back of his rear, essentially.

Interviewer: I've heard that that's a burn danger not a lot of people are aware of, those ramen noodles, because the severity of burn are two things. It's temperature and time, and those noodles stick to your skin and increase the amount of time. Is that what happened with him?

Taylor: Yeah, I think so. And what also contributed to it is he had his roller blades on, so when the water came, the water rolled down his leg and it kind of settled at the top where the roller blade boot met his calf.

Interviewer: Oh, so it stayed there longer.

Taylor: So it even put a more severe line where that happened, but it got all over his leg. I mean, it was horrible.

Interviewer: Yeah. So then that happened, what happened after that point?

Taylor: Yeah. We didn't think it was that big of a deal. In fact, when we initially saw it he wasn't in too much pain. But I thought it best to take him to the instant care just to get it checked out anyway, and right when we got there they didn't even admit us. They just took one look at it and said, "You've got to get up to the burn center up the University of Utah. This is bad."

Interviewer: Yeah. They say that if that happens you can actually call the burn center directly which is something I'm sure you've learned since your experience. So you go to the burn center, what happened at that point?

Taylor: So they cleaned off the wound eventually of dead skin, skin that had seared off. And then they dressed it with clean dressings. And that was probably, of the whole process that's the least painful of the process because I think, at least my son, he was still in shock, he was handling it all very well. But later down the road when you have to go do the re-dressings, that's when it got really sketchy. I mean, the hardest part about the whole experience, really, is that redressing.

I mean, you have a kid who goes up there to get his burns redressed and he's a tough kid, right? He hasn't cried up to this point with the injury but then after, when he goes to get his burns redressed he literally has tears starting to come out of his eyes and then he's starting to shake with pain. The severity of pain is so bad he starts to shake for hours.

And then hours after than all your pain receptors are exposed, the new skin and because your pain receptors are exposed to air that's coming around you, the pain is just excruciating. That whole day, my wife said it was the worst day of her life. She cried for him. He cried and she said it just didn't stop for hours, and he's a tough little kid. The pain is really excruciating.

Interviewer: And this is all from a burn that at first glance didn't look like it was that big of a deal.

Taylor: Yeah, exactly.

Interviewer: Which I think is a good testimony that you should take all burns . . .

Taylor: Very seriously. And it's like the whole sunburn adage. You get a sunburn, it doesn't really hurt after, but the day after, within 24 hours you're singing a different tune.

Interviewer: Is there going to be any sort of long-term?

Taylor: The nice thing is the second degree burn on him, at least we've been told, you can still see it heavily now but there shouldn't be any long-term consequences.

Interviewer: But you just don't know.

Taylor: You don't know.

Interviewer: Some children, they get their hands burned, for example. They don't quite have full functionality for the rest of their life.

Taylor: It's a concern. I wonder, too. He tans up really easy. That's a part of his leg, too, where you go out swimming. I just wonder how it's going to affect him. I mean, he's 7 years old. He's got the next 50 years of his skin which is the largest living organism in your body.

Interviewer: Yeah. What did you learn from this experience? What's your takeaway?

Taylor: For me it's just being vigilant with your kids, common sense type stuff. As parents you don't think it matters. Maybe your kids think you're too strict and I don't know if every parent's experience it but a lot of parents hear their kids say, "I hate you," or "That's a dumb rule," or "You're so dumb."

Interviewer: Yeah, like wearing roller blades in the house.

Taylor: Yeah, like wearing roller blades in the house.

Interviewer: That's stupid.

Taylor: I'm being pro-active. I mean, we probably should have said, "Can we help you with that? Can we help you get that hot dish out of that microwave?" Just being more aware of your surroundings because it happens in a second and you really can't prepare for it that well unless you're being vigilant.

Interviewer: Yeah. So it sounds like you see things a little differently now. When you go around the house do you see potential burn dangers?

Taylor: Yeah, burn dangers, sharp corners, everything. I've thought about burns before and I turned down our water heater a long time ago because I never wanted that to happen. I didn't want the hot water burns but I never thought of it with cooking.

Interviewer: Yeah. And especially microwaves. I don't think people think of that. There again, it come back to the quintessential burn dangers, that pot of boiling water. You're supposed to turn the handle in but there's a lot of other things as well. What one message would you communicate to a parent listening right now based on your experience?

Taylor: Well, watching the excruciating pain that my son had to go through and my wife who took him up when they had to redress the burn, it's not worth it. If you can do all you can to safeguard your kids and just watching them and helping them, it's kind of a tragedy, it happened so fast. It could have been a lot worst.

Interviewer: Yeah. I mean, you hate to kind of say that but the leg is probably one of the better places it could have landed.

Taylor: Yeah, exactly. And it landed on the outside of his leg. If it were to have landed on the inside of his leg it would have even been worse.

Interviewer: Yeah. Well, Taylor, thank you very much for sharing your experience. I'm sure it's difficult for you but hopefully if we could prevent one burn injury because somebody maybe notices now the set of circumstances arising or realizes how fast it happened, hopefully it was all worthwhile.

Taylor: Thanks, Scot.

updated: February 3, 2023
originally published: February 4, 2015

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.

Announcer: The ScopeRadio.com is University of Utah Health Sciences Radio. If you like what you heard, be sure to get our latest content by following us on Facebook. Just click on the Facebook icon at TheScopeRadio.com.

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.

Announcer: We're your daily dose of science, conversation, medicine. This is The Scope. The University of Utah Health Sciences Radio.

Announcer: Health information from expects, supported by research. From University of Utah Health, this is TheScopeRadio.com.

Interviewer: Do you have a body ache or pain? What do you do? A lot of people go and grab the heating pad, even if they're cold they just go grab a heating pad, but there's actually a burn danger, which surprises me. We're talking with Brad Wiggens, nurse manager of community outreach at the University of Utah Health Care Burn Center. I can't believe that a heating pad could actually burn you. Really?

Brad Wiggens: Absolutely, heating pads actually pose a big risk to the elderly population, the geriatric population. They can burn anybody, never should be used with a small infant, but again, our number one population that we see the most that is an elderly, geriatric type of patient.

Interviewer: How hot do they get?

Brad Wiggens: Well actually a heating pad will only get to about 120 degrees, at the most, when it's kind of in a confined space, but I think the danger of that is that people don't realize that leaving it in the same place, falling asleep on it, putting it on a patient who may be, or a loved one that has some neuropathies, maybe as you get older you don't feel as much in certain areas of your body, they leave it in the same place, they get left alone, maybe they don't have as much movement or ability to get away from it when it does get hot, and people don't realize it'll actually cause a second degree burn over just a few hours of time of exposure.

So they really should be used for short durations of time and really pose a lot of risk to breaking the skin and having a significant burn injury, and even nationally, this is a surprising stat that most people don't realize, is that there is a risk of actual death. So there are reported deaths nationally from heating pad burn injuries.

Interviewer: So it's not the intensity of heat, it's the heat plus the time, it sounds like. So what's the difference between like if I put a heating pad on my back and fall asleep versus an elderly person, is their skin like thinner or something or?

Brad Wiggens: Sure, so there skin is a little bit thinner or more frail, but they don't have nearly the best circulation that you and I have at a younger age. So definitely there're at a higher risk because their skin doesn't heal as well. So you're heating up an area, damaging it, you're causing inflammation and then you're trying to heal that injury, so it is a little bit more complicated because of their age, you're just, your skin is more frail and you don't have good circulation.

Interviewer: So is a burn from a heating pad a third degree, is a third degree burn a third degree burn, whether it's from a flame or a heating pad?

Brad Wiggens: Sure, yeah, I mean a third degree burn is a third degree burn. So a first degree burn would be a sunburn, a second degree burn would be when you get significant blistering from touching something hot, not blisters that you get from a sunburn, and a third degree burn would be burning all the way through all the layers of your skin, down past your dermal layers and down into subcutaneous tissues.

So a third degree burn is a third degree burn no matter which way you got it. Whether it was from the glass front fireplace, whether it was from a heating pad, it's pretty difficult to get to that point with a heating pad because of the heat they do put out, however, because it's on an elderly person we see of danger with that, where you actually have such significant amount of damage, you have a deeper injury, they don't have the good circulation that they need to heal that injury, so it actually ends up being a deeper second to a third degree burn and lends itself to needing to have a skin graft, which lends itself to a hospital stay within our intensive care unit, and really longer outcomes.

Interviewer: So it's the kind of complications more than the burn itself, for an elderly person, like breaking their hip for example?

Brad Wiggens: Yes, it's the complications, it's the same type of thing. You're taking someone who has a lot of problems and a lot of comorbidities typically, a lot of elders, as we all get older you have more ailments, I mean things get harder to do. It's harder to recover from the flu, it's harder to recover from falling and breaking your hip, those are the dangers and it's exactly the same type of situation when you're using a heating pad.

Now, a lot of people chose to use those with infants as well. The danger risk of all those types of things, heating pads should never be used with infants, they shouldn't be used with people who are paralyzed, either I think that that's a big focus. So you have someone that's paralyzed and has no feeling and maybe they're going to put it on something to make themselves try to feel better in that area, for some reason, or they'll have a loved one that does it, and they won't even know they got burned because they can't feel it, so those risks really are there.

Another huge risk is that people actually fold them and wrap them, and it's a heating element that sits inside a piece of fabric and when it gets a little bit used, it starts to get a little bit more rigid, so you fold it up, you wrap it, you stuff it in your, you know, in your towel closet and you know, you pull it out when you need it, but there's some electrical safety risks there too. I think at the end of the day really think about what you're doing. You're placing something hot against the biggest organ of your body, your skin. And you're putting your skin at risk. Really focus on that safety, that personal safety piece of what am I doing and why am I doing it and for how long should I do it.

Announcer: Have a question about a medical procedure? Want to learn more about a health condition? With over 2,000 interviews with our physicians and specialists, there’s a pretty good chance you’ll find what you want to know. Check it out at TheScopeRadio.com.

updated: November 23, 2018
originally published: March 3, 2014

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: Probably just about every house has one. Talking about a portable heater, and you would think that they would be fairly safe, I mean, there is so much stuff in between you and those heating elements, how could you possible burn yourself? Well, you can burn yourself.
Annette Matherly is the Outreach Education and Burn Disaster Coordinator at the Burn Center at University of Utah Health Care. I wouldn't think that a portable heater would be a serious burn hazard, but it is.

Annette Matherly: Absolutely. Especially if it's in a kid's room. Kids are naturally curious about hot things. You know, when they're a year old, we give them a candle with a cake and they blow it out and they think they can control fire, and then we reward them with gifts and cake so why are we surprised when they want to prod and play and light fires and touch fires?
So obviously children are very curious about fire, and so they will touch it. They will touch the bars. They will put things in it. Kids, again, love to play and they'll build tents, and they'll put the heater in the tent because the tent is cold, and they'll put things around the fire, and they'll throw clothes in a pile, and those clothes are too close to those fires. There should be a three foot radius around any portable heater, and when those things are closer than that, they will ignite and they will ignite very quickly.

Interviewer: So the real danger of portable heaters more so is of a fire starting, not so much, I'm touching it I'm going to get burned.

Annette Matherly: Absolutely.

Interviewer: Even with the modern-day heaters with all of these safety things? I mean, my heater, sometimes it just shuts off when I get too close to it because I don't know why.

Annette Matherly: Well, you know the heaters that blow hot air are a little bit different. Oftentimes the heaters that cause the fires are propane heaters . . .

Interviewer: Oh, okay.

Annette Matherly: . . . and are the electric heaters with the coils. And so, those get extremely hot and oftentimes they have open bars. And so those are usually what catches, ignites curtains and then the curtains catch on fire.
The other thing with propane heaters, or actually with any heater is that if you are working in a garage, so let's say you have your heater in the garage and maybe you are working with an accelerant and those fumes that come off those accelerants are pretty dense and they travel really fast and when they hit the heater, they can ignite.

Interviewer: Let's talk about some preventative things as kind of our final thought here. What are some things you can do with portable heaters to prevent these things from happening?

Annette Matherly: You know, always, always have a three foot radius around any heater no matter what kind of heater it is. You know, make sure that your bedding isn't close, make sure that the curtains aren't close. Sometimes we have long curtains that drape down against a heater that's on the wall.
Talk to our children and to our families about the importance of staying away, you know, knowing that children are naturally curious and love that warm glow, to talk to our children and to say, you know, this is hot and let's talk about what hot is.
The other thing would be to always have a home escape plan, to make sure that in the worst possible scenario if something were to happen, that our families and ourselves have a plan that we can talk to our kids about stop, dropping, and rolling in case they, you know, they catch on fire from backing too close whether it be at our home or it be a neighbor's home.

Also, to talk to them about the basics going back to kindergarten, and to make sure that we have a place to meet outside of the home, a safe meeting place. A place where everyone can gather so that firefighters, when they're fighting a blaze in that house aren't going back in for a child that's maybe in the backyard or a parent that's in the backyard when people think that they're still in the house.

Interviewer: Medical news and research from the University of Utah physicians and specialists you can use for a happier and healthier life. You're listening to The Scope. There's nothing better in the wintertime than gathering around a warm fireplace with the family, but it can be dangerous, and maybe in ways you haven't considered. We're talking with Brad Wiggins, Nurse Manager of Community Outreach of the University of Utah Healthcare Burn Center. So fireplaces and glass fireplaces is what you said you wanted to talk about. What's the difference between a regular, old school and a glass fireplace, and what's the concern?

Brad Wiggins: Sure. Well, they both have significant dangers for risk of burn injury. But particularly, this time of year here in Utah and throughout the Intermountain West, we really see a very high percentage of children, particularly toddlers, that do not understand the safety risks of how hot the glass gets. Parents leave a small child in a room where the fire's going, and I don't think, really, there's been a lot of emphasis on education to help people to understand the dangers of those risks and how detrimental it can be.

Interviewer: I'd imagine a lot of parents say, 'That's fire. That's bad.' But they never say, 'That's glass. That's hot.'

Brad Wiggins: Absolutely. I think that those are the risks of parenthood; the safety moments where you think everything's fine, and you find yourself trapped in one of those moments where, all of a sudden, it comes back to get you. I think that, really, the emphasis here is about education, teaching people, and getting the word out about those safety risks. Right now, particularly in an environment here where we have this incredibly difficult inversion, people do use a lot more natural gas fireplaces. They have a lot more glass, and the glass is getting bigger. People are choosing larger, more beautiful types of fireplaces. And they are beautiful, but they come with a very inherent risk.

Interviewer: How hot does that glass get?

Brad Wiggins: Greater than 350 degrees, actually.

Interviewer: You're kidding.

Brad Wiggins: No. It will actually give you a third degree burn in less than one second. And one of the biggest complications we see if it's toddlers who are pushing around the room and pushing off the furniture, they get to the glass, and they put both hands on, and they lean in with their weight. It's so hot that they actually end up sticking to the glass and they can't pull themselves off. It gives you a third degree burn to the entire palm or surface of your hand. So not only are you dealing with a burn, but you're dealing with a third degree burn that must be skin grafted, and it will impact the movement and the functionality of that hand for the rest of that child's life.

Interviewer: Is a child's skin more easily burned than an adult's? I mean, at 350 degrees, I don't know if it's really . . .

Brad Wiggins: Absolutely. But if you think about an adult's hand, they have callous all over it. They have a little bit more reaction time where they know they're touching something hot, and they pull off. So a toddler doesn't understand the instinct that once they touch something hot they should pull off. The reaction is different. They feel something hot. They feel the pain. They start screaming. They're looking around for someone to help them, and they don't remove their hands from the glass. They actually stay attached for a longer period of time, and it sounds absolutely horrible, it's incredibly difficult to recover from, and it really leads itself to a lot of long-term complications throughout life.

Interviewer: And I'd imagine also not just the physical pain, but there's some mental thing. I bet you'd never forget that.

Brad Wiggins: I'm sure that you won't. From a parent perspective, I think you deal with a lot of people who are not forgiving themselves for allowing that to happen in their home. Again, it's an accident just, like, if you get in a car accident. Things happen.

Interviewer: What about prevention other than trying to tell the child, 'Be careful,' which might be lost on the child? So what else do you recommend?

Brad Wiggins: The number one thing that you can do if you have a small child is don't use your glass fireplace. If you're going to be sitting in the room with your small child toddling around, don't turn the fireplace on. The second thing would be definitely get a screen in place. There's lots of different types of opportunities and different manufactures out there for you to find that actually have types of coverings that keep your child from actually getting to the glass fireplace.

Interviewer: Any final thoughts?

Brad Wiggins: If you walk into the room, the fireplace is on and you go to turn it off, it doesn't immediately cool the glass. It's actually been recorded that it takes almost 25 minutes for that glass to actually cool in that room to a safe, touchable thing. The other issue is that most of them are actually hot right now. Your pilot light's in there running. Whether you're at work or home or wherever you are, it might not be on, but it still actually has quite a bit of heat. You'll be surprised. So feel it and get an idea of what exactly what you're dealing with. Protect yourself. Put those screens around it. Turn them off. Teach your kids not to teach that area if possible. But still, at a toddler age, they just don't know. Again, don't use it. Put a screen around it if you have to use it for some reason and that's your main heating source for your home in the wintertime. Protect your young ones. Protect your families. Really pay attention to those safety needs of each of those children.

Announcer: We're your daily dose of science, conversation, medicine. This is The Scope, the University of Utah Health Sciences Radio.

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: My name is Vivian Lee. I'm the senior vice president for health sciences at the University of Utah, and today we're going to talk about the cold. This can mean dangerous medical problems for people that are exposed to the cold for long periods of time and even short periods of time. Joining me today is Dr. Amalia Cochran, assistant professor of medicine at the University of Utah's department of surgery. She's also an attending surgeon in the university hospital's burn unit and a leading expert on frostbite. Welcome to the show.

Dr. Amalia Cochran: Thank you very much.

Interviewer: We had an experience that made me have to go online and look up frostbite and I realized there wasn't as much information as I would hope. My daughter came back. She was fine after a whole day of skiing, and then she got into the bathtub and she started screaming because she said her feet were really painful and then the tips of her toes were dark red, almost bluish. At that point in time you can imagine I just panicked and tried to look online. I thought, here you are, the expert, let me ask you, what was happening with her? How could I have prevented that?

Dr. Amalia Cochran: It honestly sounds to me like she probably had a case of frost nip. When you're out skiing you've got a prolonged exposure, as does anyone who's outdoors during this weather. The fact that prior to that exposure to the warm water bath she hadn't really had any significant complaints and you hadn't really noticed anything different . . .

Interviewer: No, and is that because you have numbness so you don't even realize what's happening?

Dr. Amalia Cochran: Precisely. There is numbness with frost nip and you see very few changes in the skin if someone has a case of frost nip.

Interviewer: Frost nip is different from frost bite?

Dr. Amalia Cochran: Frost nip is the extremely mild form of frost bite. The way that we tend to differentiate between them is that frost bite involves tissue changes where the skin will actually blister up versus frost nip where there is some of that damage to the skin and the soft tissue but not to the level where it blisters.

Interviewer: Is it blistering because the tissue is actually freezing? What's actually happening there in the skin?

Dr. Amalia Cochran: There are really two different things that occur in the skin with a frost bite or a frost nip injury. One of those is the direct cold injury from the temperature. That impacts the tissues. They do freeze. Little crystals form in them. The other phenomenon that occurs in association with that is ischemia where there is poor blood flow to the cold effected areas. Initially, when the outdoor temperature drops or when we're exposed to lower temperatures somewhere in the neighborhood of 50 degrees fahrenheit, there's a cold induced phase of dilation that occurs.

Interviewer: Blood vessels expand. All of a sudden this blood rushes back in, and then what happens?

Dr. Amalia Cochran: Right. But then after that they constrict. They narrow back down and so the blood flow diminishes.

Interviewer: One of the things about this that worries me is that because of the numbness the kids don't even seem to know that it's happening, so how do we know that that damage is occurring?

Dr. Amalia Cochran: Cold checks are what are recommended in the Alpine mountaineering literature. I think they apply to those of us that are recreational outdoor in the winter as well. The concept of cold checks is that you get yourself to a relatively sheltered location, and I phrase it that way since this is from the Alpine mountaineering literature because there would be a relative shelter if you're skiing, you can say, hey, let's take a hot chocolate break after an hour and a half, and go in and check fingers, check toes.

Interviewer: We do them every half hour sometimes.

Dr. Amalia Cochran: Some days that's really appropriate. You can check everyone's fingers, check everyone's toes. If you notice that the fingertips or the toes are looking particularly pale, if they start getting a little bit woody in terms of how they feel, if they're not as soft as they normally feel, any of those sort of characteristics, that would make you concerned that you may have the early phases of a cold injury occurring.

Interviewer: How can we prevent it?

Dr. Amalia Cochran: Preventing it is a little bit tough if you have a love for winter sports. One of the things is that if you are someone who knows that you have circulatory challenges finding ways to keep your fingers and toes warm.

Interviewer: So even when it's not that cold our fingers and toes get kind of cold. We're particularly sensitive to developing it.

Dr. Amalia Cochran: Absolutely. Be mindful. I tell people I have something known as Raynaud's phenomenon, which means that when I get cold my blood vessels in my fingers and my toes clamp down. So I not only very easily get cold fingers and toes but I'm at higher risk for cold injury. So when I ski I have heaters in my boots and my mittens.

Interviewer: Those hand warmer, toe warmer type things?

Dr. Amalia Cochran: They're actually battery packs.

Interviewer: Oh, I didn't know they made that.

Dr. Amalia Cochran: Yeah, they're a little spendy but they're worth it. I whine a lot less and I have to take fewer breaks.

Interviewer: But short of that, you recommend the hand warmers and toe warmers?

Dr. Amalia Cochran: They're definitely helpful.

Interviewer: Dr. Cochran, you're not only an expert in frostbite but you're also a leader in burn injuries. I noticed we recently had an avalanche victim who had frostbite and was cared for in our burn unit. Maybe you can explain to us this relationship. Why are the frostbite patients and the burn patients all cared for by the same people?

Dr. Amalia Cochran: That surprises people and I know our avalanche victim was a little confused when I showed up and introduced myself and said I was a burn surgeon. She gave me this puzzled look. I said, "Trust me. This is going to be okay." There are a couple of reasons that frost bite victims end up in the care of the burn unit, and one of those is because the mechanism of injury, the way that the body works to generate the frostbite injury or the cold injury is actually very similar to what ends up happening if people have a burn injury. The underlying pathophysiology, to use the big fancy word for it, of what causes the tissue damage is very similar. The other part of it is that with more major cases of frostbite when people have blisters or if they don't get treatment in a timely fashion they can even have gangrene where the tissues die, we are experts in managing soft tissue loss and getting areas of soft tissue loss closed or covered because of the fact that that's what we do with burns. So it ends up making our frostbite practice a very logical extension of what we're already doing.

Interviewer: One of the things I read online when I was reading about this was that you're not supposed to rub the tissues. Why not?

Dr. Amalia Cochran: That's an old wives tale. Historically, people were advised to remove their gloves and their boots and rub the area with snow even to help with cold injury if they thought they were getting cold injury. The problem with doing that is you extend the damage in the soft tissues with the friction. So it's actually not helpful to do that

Interviewer: So the tissue is already pretty fragile and if you're rubbing it you're just making the damage worse.

Dr. Amalia Cochran: Right. So the recommendation for rewarming now is a 40 degree centigrade, which is around 100 degree fahrenheit, warm water bath.

Interviewer: Is 100 degrees about a normal temperature bath?

Dr. Amalia Cochran: It would be a warm bath.

Interviewer: A warm bath.

Dr. Amalia Cochran: Yes.

Interviewer: I was always told that you need to keep your central body really, really warm and if you kept your trunk warm your extremities would sort of take care of themselves. But you're sort of saying, no, those hand warmers are important too.

Dr. Amalia Cochran: Yes, it's both. You need to keep your core warm because of the risk of hypothermia, but when you're looking at a risk for frostbite you need to look at keeping your extremity areas, your fingers, your toes, even your nose is an area that's at risk for lower blood flow when you get really cold.

Interviewer: So those face warmers too.

Dr. Amalia Cochran: Yes.

Interviewer: Well, Dr. Amalia Cochran, thank you so much for being my guest today.

Dr. Amalia Cochran: Thank you, Dr. Lee.

Announcer: We're your daily dose of science, conversation, medicine. This is The Scope. University of Utah Health Sciences Radio.

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.

Host: Hot oil, barbeque grills, falling into a campfire; you know I don't think that there's much more that is more terrifying than a severe burn. We are here with Dr. Stephen Morris Medical Director of The University of Utah Burn Center to talk about severe burn cases, why they're so bad, and the recently renovated Burn Center at The University of Utah Hospital. Thank you for taking some time to talk to us today.

Dr. Stephen Morris: Thanks for having me.

Host: For me anyway there's nothing much more terrifying than a thought of a severe burn. From a medical stand point is that the case as well? I mean that's kind of the worst of the worst. How bad is it?

Dr. Stephen Morris: Yeah the pain in and of itself is very terrifying. I think all of us we've had small burns and we know how much they hurt.

Host: Yeah.

Dr. Stephen Morris: And we can imagine if a patient has fallen into hot water, or had severe flame burns, over more than half of their body how much it hurts as well as how badly it affects them.

Host: Yeah, so what are some of the things that a burn will do to the human body that you're worried about if somebody comes in?

Dr. Stephen Morris: Well what we worry about initially is just maintaining the circulation because that's one of the first things to go.

Host: Really?

Dr. Stephen Morris: And the patience will lose fluids in there burns. They will also lose fluids throughout their body and so they become very swollen, and they become severely dehydrated and go into what we call Burn Shock, and so we have to worry about that. Likewise, they can often have severe problems with breathing. They can swell enough to block off their airways, or they can have injury that goes down to their level of lungs so their lungs don't work properly and so they can die from breathing problems as well.

Host: Even if they just burn their legs it can affect the lungs?

Dr. Stephen Morris: Correct.

Host: And your circulation throughout your whole body?

Dr. Stephen Morris: Correct.

Host: What are your other concerns that you have? Are infections a concern?

Dr. Stephen Morris: And that's just what I was going to say, and the next thing...The next thing down the road of course is trying to get the areas where the skin is now destroyed get that covered because you can imagine skin is an important barrier to infection.

Host: Yeah.

Dr. Stephen Morris: And so through their lungs, through their intestinal tract, and through their open wounds of their skin we have great concerns of infection, and that ends up being one of the causes of death in burn patients.

Host: Okay, so then a burn patient comes in you take care of a couple of the first issues, you try to take care of infection, what then? I mean the skin's damaged will it ever grow back?

Dr. Stephen Morris: It depends... If the skin is only partially burned through then of course the underlying areas will regenerate. We call that a partial thickness, or second degree burn.

Host: Okay.

Dr. Stephen Morris: But frankly if it's burned all the way through, no that skin will not grow back.

Host: Yeah.

Dr. Stephen Morris: And that's where surgery is required to remove the dead tissue and to put new skin in the areas where the skin was destroyed.

Host: And where do you get the new skin? Do you have like a skin bank here on site, or...?

Dr. Stephen Morris: Well the skin bank that we use actually had its origins in this hospital, now it has gotten much larger, and is off site, but the problem with bank skin is that it is temporary.

Host: Okay.

Dr. Stephen Morris: No matter where you get the skin, unless you have an identical twin that is, you have to use your own or it will reject. We can't use anti-rejection medicines like heart transplants, and lung transplants, and kidney transplants do because of the infection problems.

Host: Okay.

Dr. Stephen Morris: And so the skin has to come from the very patient who is injured.

Host: So you have to find some good skin and then start the process of doing some transplants?

Dr. Stephen Morris: Correct, these transplants are called skin grafts, and that's exactly what we do a lot of here.

Host: And how long of a process is that for somebody that's burnt maybe on 15%, 20% of their body?

Dr. Stephen Morris: Well there's a generally accepted rule of thumb, maybe it's a little antiquated, but the rule of thumb is this, for every percent of your body surface area that's burned, and if you look at your hand, the palm surface, the fingers, and the palm together that is 1%.

Host: Okay.

Dr. Morris: And so in a full grown adult that's a pretty good sized area, in a little child it would be much smaller.

Host: Yeah.

Dr. Stephen Morris: But we figure that every percent that is burned will require about one day in the hospital.

Host: Okay, wow.

Dr. Stephen Morris: So a 15% burn would be at least a couple of weeks.

Host: Yeah, so tell me a little bit about the renovated burn center. What makes this facility so incredible?

Dr. Stephen Morris: Well it's the people that work here I think that make it incredible, but they need to have a facility where they can actually do their job.

Host: Yeah.

Dr. Stephen Morris: And we've had a burn unit here with 12 beds for the past 30 years, and we've outgrown it. Certainly we're busier than we were back then, but more importantly I think we've learned how to take care of patients even better, and we needed to update the facility so that we could do the best possible job.

Host: What's different from this facility than the old facility and how does that help you treat patients better?

Dr. Stephen Morris: I think it's the space. We were so crowded it was actually fairly cramped. We have expanded to more than twice the area to take care of about the same number of patients and so it makes it much more comfortable for the patient; it makes it much more comfortable for the families, and the friends, of the patient.

Host: Is there anything else like this Burn Center in the Intermountain West?

Dr. Stephen Morris: No we are what's called a Verified Burn Center that we are independently assessed, and reviewed, and there's nothing like this Burn Center between Denver and the coast.

Host: All right.

Dr. Stephen Morris: And from the Canadian Border down to Phoenix, and so it really is the largest area for a single Burn Center to cover in the United States.

Host: Now what does this all mean for patients and/or people that live in the five state area of University of Utah Hospital Burn Center?

Dr. Stephen Morris: Well that means that they can go to bed at night knowing that we're, you know God forbid that they're injured, but were they severely injured, or were they to have a severe problem where they would lose their skin or have bad wounds that there's a facility that is quite close to home that provides world class care.

Announcer: We're your daily dose of science, conversation, medicine. This is The Scope, University of Utah Health Science's Radio.

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.

Host: At a family barbeque, everybody's laughing and having a good time. You lose track of the three year old for a couple seconds. They lean into the barbeque grill and they get burnt. How bad is really bad, and what should you do if that happens? Dr. Stephen Morris, medical director for the University of Utah Burn Center is going to help us answer some of those questions. First of all, when it comes to burns, what's bad, what's really bad and how do I know as a normal person?

Dr. Stephen Morris: We look at burns maybe a little differently than you might in the community. We know they all hurt, but in fact, the worse they are sometimes the less they hurt. If it is your fingertip it's going to hurt a lot or your palm or if you step on some hot pavement and have a small area on the bottom of your foot, even though that hurts a lot, it's probably going to heal because it's partial thickness or second degree burn. That is, it doesn't go all of the way through the skin, so there's enough there to heal back. However, if a little kid falls into a fire, into a barbeque pit, and has very deep burns that are basically numb because not only is the skin burned, but the nerves are burned too, those can be some of the worst.

Host: So if you're touching it and it's numb that's a sure sign that you probably should go to an E.R. or call 9-1-1?

Dr. Stephen Morris: That's right.

Host: Okay. First degree is least dangerous and third degree is most dangerous.

Dr. Stephen Morris: Correct.

Host: If it's just a second degree burn what do I do to treat that?

Dr. Stephen Morris: Cleanliness is an important thing because if it gets dirty, if it's not well cared for infection will get started. You can get infection that spreads beginning at the burn out to areas that are not burned.

Host: It's a painful thing. Do you use just soap and water? What do you use to clean it?

Dr. Stephen Morris: Soap and water is a great thing. Just wash it off with a washcloth, soap and water, and put a little burn ointment or a band-aid on it if it's small. If it takes more than that you ought to get in to see a doctor.

Host: Okay. I'm going to draw an analogy here. For your ears an airplane would produce so many decibels of sound which they would say that's very dangerous to your hearing. Are there things around the house you could look at like that boiling pot of water and go, "That's going to generate probably only a second degree burn if it contacts the skin for a second." Is there any way that you can judge the dangers in your house?

Dr. Stephen Morris: Yes, we normally don't check the temperature of the bath or of water on the stove. If it's bubbling at this elevation you know it's going to be close to 190 or 195 degrees. That in a matter of a second or less is going to cause a very serious burn. We recommend that you check your water temperature. You can use a candy thermometer early in the morning, turn the water on long enough for it to heat up and check the temperature. Make sure that it's less than 130 degrees.

Host: A lot of times it's kids that are getting burned, and a lot of times those burns are happening in the house. Let's talk prevention for a second.

Dr. Stephen Morris: Sure, we would much rather see safe and healthy children than have to take care of them here. For that reason it's important that you remember the kitchen and the bathroom are two of the most dangerous and perhaps even deadly places in the home for a number of reasons. Burns are really near the top of that list. When there's a small child they should not be left unaccompanied in the kitchen particularly while cooking is going on or in the bathroom particularly when there is a tub full of hot water and the potential for tap water which could cause serious burns.

Host: Or curling irons.

Dr. Stephen Morris: Curling irons are all over the place. Treadmills are another danger in the home that people don't think about. Friction burns can happen basically instantaneously and you have to make sure that little children won't be sticking their hands under that whirring belt. We think about treadmills making us healthy, but they can also hurt us.

Host: You don't think of burns coming from a friction burn. That's a great point. What are some sources of friction burns that you might want to watch out for?

Dr. Stephen Morris: Well, I think that certainly treadmills are something that we see a lot of, bicycles, motorcycles, any place where there is a very rapidly moving object near a not so rapidly moving kid, that's danger.

Host: What other causes of burns have you seen here that might surprise a regular person?

Dr. Stephen Morris: I think most people think about fireworks, barbeques and fire pits. Despite the fact that everybody knows about it we still see little kids that are injured. I suspect probably a good rule of thumb is when you're around dangerous environments like that a kid under the age of two ought to be attached to an adult.

Host: What's the one take home that you would offer to our listeners at this point?

Dr. Stephen Morris: Many things in our lives we take for granted, such as a boiling pot of water or the radiator of a car, but a second or two tipping that pot of water or popping the radiator cap off can change your life unalterably forever, so always be aware.

Announcer: We're your daily dose of science, conversation and medicine. This is The Scope, University of Utah Health Sciences Radio.