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Contrary to popular belief, the main cause of death -- in case of a fire -- is not burns but smoke inhalation. The toxic, soot-laden smoke from the fire can kill a person even before the fire can get to him. The Kamala Mills building blaze claimed 14 lives on the night of December 28, 2017. And according to media reports, maximum casualties were due to suffocation, since the victims fled to the washroom and locked themselves in a bid to keep themselves safe from the fire. During combustion, oxygen depletes rapidly and large amount of toxic gases such as carbon monoxide, carbon dioxide, hydrogen cyanide and hydrogen chloride are released into the air, which is then inhaled by the victims. These poisonous gases then cause lung injuries, subsequently resulting in respiratory obstruction, cellular injury and organ failure. More than 80 percent of all fire-related mortality is brought on by carbon monoxide poisoning during fires. Here are some of the dos and don ts of fire safety you must know about
How do these poisonous gases affect the human body?
Carbon monoxide: This deadly gas is released during the process of combustion, inhalation of which can cause tissue hypoxia and possible death when combined with haemoglobin.
Carbon dioxide: Another by-product of fire is carbon dioxide, which can increase respiratory drive and make breathing difficult.
Hydrogen cyanide: This poisonous gas is released when household products such as mattresses, silk fabric, carpets, wool or furniture are burnt. Like carbon monoxide, hydrogen cyanide can cause death due to tissue and organ damage.
Hydrogen chloride: A by-product of burning polyvinyl (a common compound used in upholstery and furniture), hydrogen chloride causes acute bronchitis by destroying the airways mucosa.
What are the symptoms of smoke inhalation?
Symptoms of smoke inhalation differ according to the severity of the poisoning. It's important to give medical attention to the person if his carboxyhaemoglobin (compound formed when carbon monoxide and haemoglobin interact in the blood) levels exceed 15 percent. When the levels are between 15 and 20, the victim may suffer from headache and confusion. At 20-40, it can cause disorientation, fatigue, nausea and vision problems. Hallucinations, combativeness and coma can be expected in victims with 40-60 percent carboxyhaemoglobin levels. Anything above 60 percent will cause death.
Who are at a high risk?
What should be done to prevent smoke inhalation?
In case you are trapped, some caution and quick thinking on your part will help you prevent this potentially fatal consequence of fire accidents. To prevent the risk of lung injury and smoke poisoning, take these following steps:
1 React as soon as you sense danger. Look for the exit routes.
2 Look for a way out instead of staying locked inside a safe room.
3 Drop to the floor and crouch on your hands and knees. Since smoke and gases rise upwards, you will breathe less of them if you stay close to the ground.
4 Take a piece of cloth or a large item of your clothing, moisten it and hold it against your nose and mouth. The water will filter the poisonous gases, preventing you from inhaling it.
5 Steer clear and avoid making a dash for rooms from where you can see smoke billowing.
6 In case you are trapped inside a room, close the doors to prevent smoke from coming in and line the gap around the door frame and ventilator with wet cloth or tape.
8 If your clothes catch fire, drop and roll till the fire is doused.
What care should be taken afterwards?
Once you are away from the source of the fire, alert emergency medical personnel who would be present at the scene. The first priority will be to reduce the level of carboxyhaemoglobin in your blood. For that, an oxygen mask will be administered by the emergency technicians with a high flow of 100 percent oxygen. Rush to the nearest hospital to address cases of burns and trauma. Also, go through these tips to keep in mind during a fire explosion.
To prevent such tragic instances, institutions should not cut corners and compromise the safety regulations. Even in homes, install smoke alarms and carbon monoxide detectors. Check for electrical irregularities and get them fixed as soon as possible. Keep flammable liquids, matches and lighters in safe places out of the reach of children. Discourage practices such keeping lit cigarettes unattended. Ensure there's no possibility of cooking gas leak by keeping the outlets locked when not in use.
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Zawacki, B. E., Jung, R. C., Joyce, J., & Rincon, E. (1977). Smoke, burns, and the natural history of inhalation injury in fire victims: a correlation of experimental and clinical data. Annals of Surgery, 185(1), 100 110.
Rehberg, S., Maybauer, M. O., Enkhbaatar, P., Maybauer, D. M., Yamamoto, Y., & Traber, D. L. (2009). Pathophysiology, management and treatment of smoke inhalation injury. Expert Review of Respiratory Medicine, 3(3), 283 297. http://doi.org/10.1586/ERS.09.21
Demling, R. H. (2008). Smoke Inhalation Lung Injury: An Update . Eplasty, 8, e27.
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