Killer Flames | Political economics

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The ballot box is a global public health problem, responsible for around 180,000 deaths per year (WHO 2018). Thermal (heat) burns occur when some or all of the cells of the skin or other tissues are destroyed by hot liquids (scalds), hot solids (contact burns), or flames (flame burns). Fire accidents among women are higher than among men. The higher risk for women is associated with open-fire cooking and unsafe stoves. Loose clothing also poses a fire hazard. Like adult women, children are particularly vulnerable to burns. Risk factors for house fires are poverty, overcrowding and young girls handling utensils in the kitchen. Underlying medical conditions such as epilepsy and peripheral neuropathy also increase the risk of burns. Alcohol abuse and smoking are also fire risk factors.

The most common accidents reported in homes are kitchen fires, gas leaks causing a fire, injuries in hot tubs, and electrical appliances catching fire.

We have witnessed serious injuries, disfigurements and prolonged hospitalizations due to such events. Many times such accidents have resulted in fatalities.

Community education and awareness are very important to prevent these accidents. If we are careful to take precautionary measures, such incidents can be avoided.

It is necessary to educate family and friends. Initiatives in this regard should be taken through print, television and social media. Training and awareness sessions should be organized in schools, offices and commercial organizations. It is important to encourage the use of smoke detectors, sprinklers and fire escape systems in homes and workplaces. Promoting safer stoves and less hazardous fuels and educating women about loose clothing in the kitchen can also help. Long scarves, shawls and dangling sleeves are said to have caught fire. Basic precautions such as cooking on the back burners of the stove when children are around and never holding a child while cooking can prevent the worst from happening. The entrance to the kitchen can be protected by barriers for toddlers and young children. Family members should know the location of the gas hose and button; they must always be accessible. Gas knobs should be turned off before going to bed and leaving the house as a precaution. All family members should know where the main supply shut-off valve is located outside the house so that they can access it quickly in an emergency. It is essential to keep an escape ladder on the upper floors of your home in case of fire. The ladder should be kept in or near the bedroom of an adult or older child who knows how to use it. Having a fire extinguisher in the kitchen and learning how to use it can prevent fire-related accidents. Smoking should be avoided in the home, especially if they are drowsy, on medication or in bed. Matches, lighters, chemicals and lighted candles must be kept out of the reach of children at all costs. Replacing smoke alarms over ten years old is an integral part of home safety.

In an emergency, don’t panic. Be alert and act smart. Be aware of the warning signs and take appropriate action. Evacuate the house immediately when gas is suspected. A gas leak can be identified by its rotten smell and hissing sound. When leaving, open doors and windows. Shut off the gas supply. Do not strike a match or lighter. Do not turn on a light or any electrical device if it is dark. It can start a huge fire.

Community education and awareness are very important to prevent such accidents. If we are careful to take precautionary measures, such incidents can be avoided. It is necessary to educate family and friends. Initiatives in this regard should be taken through print, television and social media.

Hazardous chemicals like acids should not be placed in kitchen cabinets, as improper handling has often resulted in serious acid burns. Also, combustible liquids such as bug spray, spray cans, paint thinner, nail polish remover, rubbing alcohol, gasoline, and linseed oil should not be kept near stoves or homes. Many uncontrollable fires have been reported due to careless storage of these products.

Injuries from hot water baths are common in children and the elderly. Check the temperature of tap water with an elbow before putting a child in the bath or toilet. Set geysers/water heaters to temperatures below 120 F. Check the temperature of foods, soups, and other hot drinks before serving them to children.

As soon as an electrical device catches fire, first switch off the power supply. Lay down a blanket to suppress the flames. Baking soda (sodium bicarbonate) can also be used. Do not bring water nearby.

To prevent electrical fires, check all cords for frays or cracks, and replace if damaged. Always pull by the plug, not the cord, when unplugging electronic devices. Avoid using extension cords for too long. Unplug all appliances when not in use. Keep all electrical appliances away from water sources. Never store combustible materials (clothes, papers, cleaning products etc) near your main power board. Still buy household appliances from reputable brands and follow the instructions provided to install and use them.

You need to know the initial management steps. In case of emergency, call 16 for the fire department. You can also dial the emergency number 911. These contacts have been issued by the Government of Pakistan. Flames can be extinguished by cutting off the oxygen supply to the burning object by spreading a blanket or mud, or by using water or liquid extinguisher. If a utensil containing oil/ghee catches fire on the stove, do not shower with water. The best way would be to turn off the stove knob and cover this utensil with a lid. If your clothes catch on fire, practice the stop, drop and roll routine. Stop where you are; drop to the floor and lie flat with your legs straight, and cover your eyes and mouth with your hands; roll over and over and back and forth until the flames are extinguished. Remove or dilute chemical agent in chemical burns by irrigating with large volumes of water. Stay away from water in case of electrical fire.

In the event of a burn, hold the wound under running tap/cold water for 20 minutes. Do not apply toothpaste, oil, Haldi (turmeric) or raw cotton to burn (recommended by WHO). Do not apply ice as it aggravates the injury. Do not apply any material directly to the wound as it may become infected. Rubbing the wound with povidone/iodine solution, chlorhexidine or other cleansing agents is not recommended. Cleaning the wound with sterile water/normal saline is usually sufficient to remove debris. Burns heal best in damp, not wet, environments. Topical agents control pain, promote healing and prevent infection of wounds. Cover the wound with topical antibiotics like bacitracin and mupirocin. Silver sulfadiazine also promotes wound healing. Do not attempt to pop the blisters yourself as this can complicate the wound. The patient should be taken to a burn care facility as soon as possible for prompt assessment and management. The risk of complications depends on the area of ​​the body affected, the depth of the burn, and the site of the burn on the body. In addition, if a person is diabetic or immunocompromised, expert advice is essential. If the burns involve areas of the body such as the face, major joints or genitals, you should see your doctor immediately. If the burn appears deep, you have blisters, the burn site is very sore, or the burn does not heal within two weeks, you should see your doctor for proper management.


The author is Senior Family Medicine Registrar at Baqai Medical University


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