It can feel great to get outside after many months of being stuck inside, whether that means lighting a bonfire, BBQing dinner or lighting off some fireworks to celebrate Victoria Day.

The May long weekend also marks the beginning of ‘trauma season’, and our Ross Tilley Burn Centre (RTBC) has already started to see a spike in admissions of patients who have been burned in bonfires or scalded while cooking. However, there are a few simple things you can do to stay safe and injury-free.

Dr. Marc Jeschke, medical director of the RTBC at Sunnybrook, says that common sense can prevent many of the injuries they see each summer.

“In the summer, you’re more relaxed, maybe some alcohol is involved. This is when burn injuries can happen,” says Dr. Jeschke. Here are some of the most common causes of burn injuries RTBC staff see, and how to prevent them:

BBQs and fire pits

When barbecuing, Dr. Jeschke says, stick to the rules: use fireproof gear, don’t put gasoline or igniter fluid on the grill and don’t wear loose, flowing clothing while cooking.

“With loose clothing, you turn around quickly or get too close, and the fire ignites the clothes. You then have a major injury for no reason whatsoever,” says Dr. Jeschke.

He recommends waiting until after you’ve finished cooking to consume alcohol. The same principle applies to tabletop fireplaces, which have been growing in popularity as a backyard patio feature.

“These can be dangerous because they’re at the exact same height as small children and pets. Keep loose clothing away from these too, and don’t throw any accelerants on them,” he says.

Ethanol-fueled fire pots

Ethanol-fueled fire pots are often more decorative in nature, set on tabletops or in small bowls or pots, but don’t let that fool you: they are dangerous because they use highly flammable fuels, like butane and ethanol. In fact, Health Canada issued a consumer warning in 2019 and asked manufacturers to stop selling these products.

“Explosions can happen when you try to re-light the fire, because there can still be fumes or low flames that can ignite during the refuelling process,” says Anne Hayward, a social worker at the RTBC.

If you have an ethanol-fueled fire pot at home, Dr. Jeschke recommends getting rid of it.

“We’ve seen way too many people injured while refueling ethanol fire pots. It can happen to anyone. They are dangerous, and they can be deadly,” he says.

The post Tips for preventing burn injuries this summer appeared first on Your Health Matters.

“Even though people are staying close to home, physical distancing can lead to an increase in high-risk behaviours, which in turn cause the types of injuries we often end up treating here,” says Dr. Marc Jeschke, medical director of the Ross Tilley Burn Centre at Sunnybrook.

The good news is that often, a little common sense can go a long way. Below are some tips from our Ross Tilley Burn Centre (RTBC) team:

Be careful when burning brush and debris

It’s understandable that many people want to make use of their time at home to get a head start with spring maintenance around their properties. Those who live on larger properties outside of the city, however, should think twice before burning large piles of brush and debris.

“Do not pour gasoline or another igniter fluid onto a fire that’s already burning, like a bonfire. The fire can come right back up into the container you’re holding, which will then explode,” he says. The person holding the container may also react by throwing it, inadvertently spraying other people nearby with burning fuel.

There is also the risk of a sudden shift in the direction of the wind, or the potential for unknown substances to be added to barrel fires. Have a safety plan in place, which includes having a container of water nearby or a garden hose on standby before starting the fire, and make sure someone else who knows what you’re doing (and where).

“With fires, you should always remember safety, and know where the closest water supply is,” says Dr. Jeschke.

Try not to use alcohol as a coping mechanism

Tolerating isolation is difficult for many people, particularly as the pandemic drags on, but Dr. Jeschke warns against drinking more alcohol as a coping mechanism.

“People are staying at home and drinking and smoking more, putting themselves at risk,” says Dr. Jeschke.

He says many of the injuries they see in the RTBC are the result of poor judgment. Simple activities like smoking and cooking can become deadly if a person falls asleep. Dropping a lit cigarette onto the carpet or leaving a stove unattended can ignite a fire very quickly.

If you do decide to consume alcohol, enjoy responsibly.

Take care of your mental health

The past year has brought huge changes to our daily routines, significantly impacting the mental health of many people. Anne Hayward, RTBC’s social worker, says it’s important to remember that physical distancing does not equal emotional or psychological distancing.

“For many people, physical distancing increases feelings of isolation, anxiety and depression, especially in at-risk populations. This, in turn, can lead to an increase in substance misuse and self-harm,” says Hayward.

“It’s more important now than ever to keep engaged, which can include staying in contact with people by phone, text, e-mail and using virtual technology.”

Hayward also recommends limiting the amount of time spent reading, watching and listening to the news, and only using reliable sources when you do.

“There’s a balance between being informed, but not overwhelmed,” she says.

If you are feeling anxious or overwhelmed, one strategy Hayward recommends is Expressions of Gratitude.

“By asking yourself what you are grateful for, it shifts the focus away from some of the negativity and worry and helps you to focus on something positive. This could include something simple like an act of kindness, spending time with people you love, or realizing what’s important,” she says.

Take care when cooking

With stay-at-home orders in place once again, more people are preparing and cooking meals at home. Keep some simple safety tips in mind, such as not wearing loose, flowing clothing while cooking.

“With loose clothing, you turn around quickly or get too close, and the fire ignites the clothes. You then have a major injury for no reason whatsoever,” says Dr. Jeschke.

Make sure your smoke alarms are working, stay in the kitchen at all times when you’re cooking, move anything that can catch fire away from your stovetop, and keep kids away from areas where hot foods or liquids are being prepared, like stoves and microwaves.

If you do suffer a burn:

If it’s a significant burn, call 911. While waiting for help to arrive, don’t put butter, vinegar, oil or lemons on the burn.

“The best initial treatment for all burns is cool running water. Don’t soak the injured area, just let the water run over it,” says Dr. Jeschke.

Help is available

Hayward says there are many reasons for people to feel anxious or overwhelmed right now.

“People may be struggling with financial, housing, food and job insecurity concerns, new or pre-existing mental health issues. They may also have immune-compromised or senior loved ones who are at risk, or loved ones who are living in other cities, provinces or countries that they can’t get to right now,” she says.

Others may be self-isolating in abusive or volatile living situations, which can lead to scalding, contact or chemical injuries, she adds.

Help is available through a variety of organizations, including 211 Ontario, Kids Help Phone and Connex Ontario, among others. A complete listing of crisis support hotlines is available at ontario.ca/coronavirus. If you are experiencing an emergency crisis situation, please contact 911 immediately or present to your nearest emergency department. 

If you’re a former RTBC patient and feel as though you need support during this challenging time, Dr. Jeschke encourages you to get in touch with the burn centre.

“Please reach out. You are not alone, and we will assess how we can best help you,” he says.

Note: this article was originally published in April 2020 and has since been updated.

The post Staying safe during COVID-19 lockdown: tips from our burn centre appeared first on Your Health Matters.

There was a time when Alan MacDonald was too traumatized to discuss some of the details surrounding the October 2018 accident that left him with severe electrical burns over 13 per cent of his body.

As part of his recovery program at Sunnybrook’s Ross Tilley Burn Centre, Alan has spent the past year in treatment with Dr. Sam Iskandar, a clinical psychologist at St. John’s Rehab.

Dr. Iskandar diagnosed him with post-traumatic stress disorder (PTSD) resulting from the event. PTSD is a condition that can cause symptoms such as recurrent flashbacks, nightmares, intrusive thoughts, extreme anxiety and depression, all manifested differently through the filter of each survivor’s individual psychology and life experiences.

Alan can now speak about his accident with an astonishing degree of openness. It’s a tribute, he says, to the work he’s done with the Sunnybrook team that took his emotional health as seriously as the repair of his body.

“You have to get to the point where the more you talk about it, the better you feel,” says the Bradford, Ont., resident.

The life-changing incident happened one morning at a strip mall in midtown Toronto. Alan, an electrician and business owner, had been called in with his team to help solve a problem resulting from a proposed electricity shutdown. A new bank branch was scheduled to go into the mall, and in order to safely install a new electrical disconnect, the power had to be shut down for four to six hours, which was not sitting well with the other mall tenants, who complained the outage would impact their businesses.

Alan agreed to inspect the site to see if they could manage the installation without shutting off the lights. Against his better judgment, he removed the electrical panel to install the new disconnect. He was alone in the room with the door closed due to the potential danger of the task.

“You have to get to the point where the more you talk about it, the better you feel.”
– Alan MacDonald on the 2018 accident that resulted in severe burns

“The next thing I knew, there was an explosion,” Alan says. “[It] knocked me into a pipe, where I hit my head pretty hard.” The culprit was a faulty disconnect, but that would only be discovered much later. At the moment, Alan had no clue what had happened and that he’d been hurt.

“I came out the door, and my guys are just staring at me; these big, broad guys were like, ‘Oh my God,’” Alan recalls. “I looked down, and my entire shirt was gone – just disintegrated. The only thing that was left was the zipper that went down halfway. The flesh was gone. My face was black. Then I had what looked like a piece of plastic stuck to my hand from the thumb down to the wrist, so I pulled it off. And that’s when I realized that wasn’t a piece of plastic. It was my skin.”

Alan’s team insisted on calling an ambulance. But Alan was in shock – he didn’t register any physical pain and, in fact, felt it was his responsibility to go right back in and fix the power outage.

He was rushed to the Ross Tilley Burn Centre. “I got in the ambulance and closed my eyes,” he says. “When I woke up, I was in a hospital room, and the doctor told me I was going to be okay.”

The surgical team treating Alan at the burn centre was led by Dr. Marc Jeschke, director of the Ross Tilley Burn Centre and a highly regarded surgeon and research scientist. Dr. Jeschke assessed Alan’s injuries, which included “significant” electrical burns, corneal abrasion due to the flash, and a torn rotator cuff.

Dr. Jeschke and his team performed multiple surgeries and skin grafts to repair the damage to Alan’s body. Dr. Jeschke also understood the mental toll the injuries would take on Alan and his family, and so he built a recovery program that went beyond the physical.

“Mental health is still completely under-appreciated,” says Dr. Jeschke. “I think that that’s something to emphasize – we are lucky we have access to psychiatry at Sunnybrook, and that we have access to psychology and psychiatry at St. John’s Rehab.”

Alan was referred to the in-patient burn rehabilitation program at St. John’s Rehab, the only such program in Canada. Its holistic approach to healing the mind, body and spirit has brought the centre international acclaim.

At St. John’s Rehab, survivors of burns, amputations and other grievous injuries have access to resources, including occupational therapy, clinical psychology and massage, that are critical to recovery. Alan worked with Dr. Iskandar, in addition to his own psychiatrist, to help him through the stages of emotional recovery and to adjust to his new life.

One of Dr. Iskandar’s main therapeutic tasks was to prevent Alan from slipping into long-term depression. He says that in many cases, even well-meaning people tend to focus on the fact that someone has physically survived a major physical trauma and are surprised to see that the person has become more taciturn and withdrawn.

“People with PTSD will continue to try and avoid people and situations that remind them of their trauma. In the case of burn injuries, that can be a barbecue, a cigarette, people associated with the event,” Dr. Iskandar says. “And then the more they avoid, the less fulfilling their life becomes, and the more depressed they may feel.”

Dr. Iskandar points out that a major injury can also have a significant impact on the survivor’s family. Someone with PTSD may not have the same capacity to deal with the daily stressors of parenting and relationships that they did before their injury, and the requirements for their care can be emotionally and physically draining for family members.

Alan says his wife, Tara, has been his “rock,” and that his three daughters have been immensely strong and supportive. But the year has brought its share of challenges at home. Once the “life of the party,” Alan became more withdrawn and occasionally angry. In March 2019, Alan spiralled into a depression while coming off his pain medications. He also experienced some mental health challenges months later, following surgery on his shoulder.

These types of setbacks are not uncommon on the road to recovery from traumatic injuries. But Dr. Iskandar notes that to the people directly affected, they can be overwhelming and trigger fear that it will be like this for the rest of their lives.

At Dr. Iskandar’s suggestion, Alan and Tara have sought out family counselling, and both are doing well. At some point in the future, Alan is planning to return to work. He says the care he has received at the Ross Tilley Burn Centre and St. John’s Rehab has given him a good shot at resuming a full life again.

“The team at Sunnybrook was just incredibly helpful,” Alan says. “The support you get there really, really makes you feel like you’re on the right track, like you’re on the road to recovery.”

The post Recovery for the body and mind: Sunnybrook’s holistic approach to PTSD treatment after traumatic injury appeared first on Your Health Matters.

Whether you’re staying in the city, heading to a cottage or taking your chances with the weather and going camping, there are a few simple things you can do to stay safe and injury-free.

Dr. Marc Jeschke, medical director of Sunnybrook’s Ross Tilley Burn Centre (RTBC), says that common sense can prevent many of the injuries his centre sees each summer.

“In the summer, you’re more relaxed, maybe some alcohol is involved. This is when burn injuries can happen,” says Dr. Jeschke. Here are some of the most common causes of burn injuries RTBC staff see, and how to prevent them:

BBQs

When barbecuing, Dr. Jeschke says, stick to the rules: use fireproof gear, don’t put gasoline or igniter fluid on the grill and don’t wear loose, flowing clothing while cooking.

“With loose clothing, you turn around quickly or get too close, and the fire ignites the clothes. You then have a major injury for no reason whatsoever,” says Dr. Jeschke.

He recommends waiting until after you’ve finished cooking to consume alcohol. The same principle applies to tabletop fireplaces, which have been growing in popularity as a backyard patio feature.

“These can be dangerous because they’re at the exact same height as small children and pets. Keep loose clothing away from these too, and don’t throw any accelerants on them,” he says.

Camping

When camping, there can be a lack of familiarity with the tools you’re using. For example, while you use your stove at home every day, you don’t use your camp stove every day. The same goes for cooking over an open fire or refilling lamps with kerosene or gasoline.

“Do not pour gasoline or another igniter fluid onto a fire that’s already burning, whether it’s a bonfire or a camping lamp. The fire can come right back up into the container you’re holding, which will then explode,” he says.

Always have a container of water nearby or a garden hose on standby before starting the fire.

Fireworks

“Fireworks can be dangerous because if a large number of fireworks blow up, you get explosive burns,” says Dr. Jeschke.

Read safety instructions for fireworks before using them, and don’t let children be around them unattended. Don’t use fireworks inappropriately, like letting them explode in your hands or holding them while igniting them.

If you do suffer a burn:

If it’s a significant burn, call 911. While waiting for help to arrive, don’t put butter, vinegar, oil or lemons on the burn.

“The best initial treatment for all burns is cool running water. Don’t soak the injured area, just let the water run over it,” says Dr. Jeschke.

The post How to fireproof your summertime plans appeared first on Your Health Matters.

1. 3D skin printing

It sounds like science fiction, but Sunnybrook researchers have developed a machine that produces human-like skin to treat burns. A handheld version of the skin printer was unveiled this year; one day, physicians may be able to print skin directly onto a patient’s wound at the bedside.

2. Stem cell and tissue engineering

This newly published study (in November 2018) found that skin discarded during burn surgery has useable stem cells. With human trials beginning in early 2019, this discovery could be ground-breaking for burn patients at Sunnybrook and across the country.

3. Hypermetabolism

A Sunnybrook study found the behaviour of fat in the body fundamentally changes after a severe burn. This state of hypermetabolism causes an increase in energy expenditure and insulin resistance in the patient, and the resulting complications can be fatal.

4. Sunnybrook Protocol for treatment of SJS/TENS

A team of Sunnybrook specialists developed the Sunnybrook Protocol for SJS/TENS. It’s the first Canadian protocol for dealing with the disease, which happens when the immune system attacks the outer layers of skin, the eyes, genitals, throat and lips, similar to flesh-eating disease. Of the 300 patients treated every year at the Ross Tilley Burn Centre – the largest burn centre in Canada – up to 10 are admitted with SJS/TENS.

5.  Reducing blood loss

This study found that a modified surgical technique significantly reduced the number of blood transfusions needed by burn patients.

6. Formation of the Canadian Burn Association

After hosting several successful burn symposiums, Sunnybrook played an integral role in the development of the recently created Canadian Burn Association.

7. Glucose control

This Sunnybrook-led study found that patients with good glucose control had a lower incidence of infection, sepsis and death compared with patients with poor glucose control. It also found that patients with good glucose control had milder inflammatory and hypermetabolic responses.

8. Ventilation modes

High-frequency oscillatory ventilation (HFOV) is an unconventional ventilation strategy in burn patients. However, this Sunnybrook study found that it played a useful role in the supportive management of burn patients with severe oxygenation failure, unresponsive to conventional ventilation. Importantly, HFOV allowed surgery to proceed in patients who may have otherwise been too unstable to go to the operating room.

9. Use of albumin in burns

This review article examines the use of human albumin (HA), the most abundant protein in human blood plasma, in burn treatment.

The post Highlights from 20 years of burn research appeared first on Your Health Matters.

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Skin discarded during burn surgery has useable stem cells: Sunnybrook study

November 5, 2018: The Future of Burn Care.

For a long time, burned skin tissue has been considered to be nothing more than medical waste.

Now, Sunnybrook researchers have found in a pre-clinical study that debrided burned skin, which is routinely removed from patients during surgery and discarded,  contains viable, undamaged cells that show characteristics of mesenchymal skin stem cells (MSCs).

These cells can be extracted, characterized, expanded, and incorporated into skin substitutes to promote wound healing.

Why is finding new ways to heal wounds so important?

Worldwide, 11 million people are burned and 265,000 people die from burn injuries every year.

The larger the burn, the less healthy skin remains for skin grafting . More alternative wound coverage materials are needed, because current materials are either ineffective, cause immunologic rejections, take too long to produce sufficient cell numbers or are too expensive.

The study

1. Burned skin tissue debrided during surgery.
2. Tissue added to sterile containers, carefully wrapped and transferred to research lab.
3. Cells extracted and cultured. Later stored in liquid nitrogen.
4. When cells began to grow out from the tissue, the tissue was removed, and adherent cells continued to grow.

5. Applied the cellular coverage material onto excisional wounds. Found that BD-MSCs facilitates healing and decreases healing time

Burn-derived stem cells are a promising new source of skin stem cells for regenerative medicine and burn-wound management.

Without being limited by the common obstacles of stem cell therapies and its availability, this method could revolutionize the way we treat burn patients, and potentially patients with complex wounds.

Authors: Saeid Amini-Nik, M.D., Ph.D.; Reinhard Dolp; Gertraud Eylert,; Andrea K Datu; Alexandra Parousis; Camille Blakeley; Marc G Jeschke

Published in EBioMedicine Journal on November 5, 2018.

Funding: Canadian Institutes of Health Research # 123336; CFI Leader’s Opportunity Fund: Project # 25407; National Institutes of Health 2R01GM087285-05A1; EMHSeed: Fund: 500463; A generous donation from Toronto Hydro; Integra©Life Science Company provided the meshed bilayer Integra© for porcine experiments

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More on this topic

Engineering a handheld 3-D skin printer to heal burn wounds

The post Skin discarded during burn surgery has useable stem cells: study appeared first on Your Health Matters.

We spoke with former burn patients Fangshu Yu and Shintaro Tsukamoto. They have never met, but their stories are eerily similar. Both were in second-year university, living in off-campus housing, when they were seriously injured in house fires. They each only narrowly escaped, leaving both with extensive burns that required skin grafts.

Fangshu and Shintaro were both treated at Sunnybrook’s Ross Tilley Burn Centre, and now want to share their stories to help others avoid ending up in similar situations.

1) Look

Look for potential fire hazards around your home. According to the Ontario Office of the Fire Marshal, there are a few things you can do, including:

• Always stay in the kitchen while cooking. If you must leave, turn off the stove.
• Encourage smokers to smoke outside. Always extinguish cigarettes in large, deep ashtrays that cannot be knocked over.
• Check electrical cords for damage such as fraying or nicks. A damaged cord can expose wires and result in a potential shock or fire hazard.

Simple activities like smoking and cooking can become deadly if you fall asleep. Dropping a lit cigarette onto the carpet or leaving a stove unattended can ignite a fire very quickly. Use good judgement, particularly if alcohol or other substances are involved.

2) Listen

Listen for the smoke alarms in an emergency. Make sure there are working smoke detectors in your home and test them regularly. Confirm that everyone knows the sound of the smoke alarms and can hear them in an emergency. There is no time to spare in a fire – early detection gives you the extra seconds you need to get out safely.

Not being able to hear the smoke detectors when the fire started was a factor in both Fangshu’s and Shintaro’s experiences – and in Shintaro’s case, there were no working smoke detectors at all.

“Working smoke detectors are so important. If they had been working in my house, maybe I would’ve had more time to get out,” Shintaro says.

Fangshu’s home did have smoke detectors, “but by the time I heard them going off, the smoke was so black and thick that I couldn’t see anything. When I opened my bedroom door, smoke just came pouring in,” she says.

Fangshu Yu, left, and Shintaro Tsukamoto were both injured in fires in their off-campus rental homes.

3) Learn

Learn two ways out of every room. Practice a home fire escape plan with everyone in your home before a fire starts so you and your family can get out quickly.

Fangshu and Shintaro each had only one way out of their homes because they were unable to escape through the windows; Fangshu’s didn’t open far enough, while Shintaro’s basement window was too small to fit through. Both were forced to leave their rooms and navigate dangerous, smoke-filled hallways and staircases in order to escape.

“If the window opened further, maybe things would have turned out differently,” says Fangshu. She received extensive burns to her arms and hands as she crawled along the floor to escape through the front door.

“Basements are not an ideal place to live, because many of them don’t have direct exits. Make sure there’s a way for you to safely escape in the event of a fire,” says Shintaro, who passed out from smoke inhalation while trying to unlock the back door after escaping from his basement bedroom.

He eventually regained consciousness and got out of the house, but the extreme heat generated by the fire caused thermal burns to Shintaro’s hands, arms, neck and face while he was unconscious. The smoke Shintaro inhaled during the fire also damaged his lungs, meaning he was intubated and unable to speak for weeks.

4) Get out and stay out

When smoke alarms sound in an emergency, get out immediately and call 9-1-1 from outside. Never re-enter a burning building.

“It was probably a minute from the time I heard the smoke detector until I got out of the house,” Fangshu says. “Another minute after that, I could see the whole main floor in flames.”

If you do get a burn, the best initial treatment is cold water. If it’s a significant burn, call 9-1-1 and get to the nearest hospital. Do not attempt to use homemade remedies on the burn, such as butter, vinegar, oil or lemon.

The post How to prevent yourself from being injured in a fire appeared first on Your Health Matters.

Fangshu Yu, left, and Shintaro Tsukamoto were both seriously injured in fires in their off-campus rental homes.

Each year, the health care team at Sunnybrook’s Ross Tilley Burn Centre sees far too many students injured by fires in unsafe off-campus housing.

“Windows that are too small or don’t open, not enough exits, smoke detectors that don’t work – these things may not seem like a big deal, but they can mean the difference between life and death if there’s a fire,” says Dr. Marc Jeschke, the medical director of Sunnybrook’s Burn Centre.

Here, two university students share their stories of how they survived and thrived after devastating fires in their off-campus rental homes.

Shintaro Tsukamoto says that even though his injuries “caused huge setbacks in my life, I’m motivated to keep moving forward. I’ve kept a positive outlook throughout my recovery, and that’s helped me a lot.”

Shintaro’s story

Shintaro Tsukamoto, 21, was excited about moving into his new place last July. He had just completed his first year of university in Ottawa, and with only a few weeks until classes started up again, he’d found a basement bedroom in an off-campus rental house.

He had only been living there for three weeks when, one night, he heard a loud noise and glass shattering upstairs. Concerned that someone was breaking into the house, he called 911.

“That’s when the operator told me they had already gotten a call about my house, and that it was actually on fire,” Shintaro says. “I had no idea, because there were no working smoke detectors.”

The 911 operator told him to get out of the basement immediately, but he quickly realized there was no way to escape through the tiny windows.

“I left my room, walked upstairs to the main floor, and saw the entire front half of the house was on fire. I made it to the back door, but it was so smoky that I couldn’t find the lock,” Shintaro says. Overcome by the intensity of the smoke, he passed out.

He eventually regained consciousness and managed to get the door open, escaping into the backyard.

“I have no idea how I got out of there,” he says. “I think it was just pure adrenaline.”

—

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“For a long time, it was difficult and painful to speak, to make my voice heard.”

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The extreme heat generated by the fire caused thermal burns to Shintaro’s hands, arms, neck and face.

He was stabilized at a hospital in Ottawa before being airlifted to Sunnybrook Health Sciences Centre’s Ross Tilley Burn Centre in Toronto, the provincial centre of excellence for burn treatment and Shintaro’s hometown. He received treatment there for three weeks, led by Dr. Alan Rogers, a plastic and reconstructive surgeon in the Burn Centre. A month of inpatient rehabilitation at Sunnybrook’s St. John’s Rehab followed.

There were concerns he wouldn’t regain full use of his arms and hands, a distressing possibility for a talented athlete who had won several national championships with his ultimate frisbee team.

The smoke Shintaro inhaled during the fire also damaged his lungs, meaning he was intubated and unable to speak for weeks.

“For a long time, it was difficult and painful to speak, to make my voice heard,” he says.

Now, Shintaro wants to use his experience to tell other students how they can avoid ending up in a similar situation.

“Basements are not an ideal place to live, because many of them don’t have direct exits. Make sure there’s a way for you to safely escape in the event of a fire. Working smoke detectors are so important – if they had been working in my house, maybe I would’ve had more time to get out,” he says.

Shintaro was living in the house with people he didn’t know, which meant it was unclear to first responders how many people were actually home when the fire started. Having your housemates’ cellphone numbers, or even having a group chat set up, would be helpful in the event of an emergency.

He also advises taking your time when choosing somewhere to live.

“I was rushing, so I overlooked things about the house,” he says. “Survey all of your housing options, and make sure you feel comfortable. Your safety is the most important thing.”

—

Shintaro describes his recovery as a long, slow road. Still, he counts himself as one of the lucky ones.

“Even though these injuries caused huge setbacks in my life, I’m motivated to keep moving forward. I’ve kept a positive outlook throughout my recovery, and that’s helped me a lot,” he says.

Shintaro has spent the last year recovering, working and even traveling to Japan to visit family.

This month, he is finally set to return to Carleton University for his second year of studies in the human rights program. With help from his friends, he’s found a new rental house that he feels comfortable living in. He’s also looking forward to returning to the field with his ultimate frisbee teammates.

“My hands and arms have healed really well and I pretty much have full function, thankfully,” he says. “My voice is better too. It’s definitely gotten deeper, although maybe that’s not such a bad thing!”

Dr. Marc Jeschke examines Fangshu Yu’s arms and hands during a follow-up appointment at Sunnybrook’s Ross Tilley Burn Centre.

Fangshu’s story

Fangshu Yu, 20, gently takes off the pressure garments she wears for 23 hours a day, covering the skin from her shoulders all the way to her fingertips. Dr. Marc Jeschke nods approvingly as he examines her arms and hands. “Your skin is healing really nicely,” he says.

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“If the window opened further, maybe things would have turned out differently.”

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Fangshu, a second-year statistics student at the University of Toronto’s Scarborough campus, was injured three months ago when a fire started in the basement of the off-campus rental house she shared with three other students.

“The house had smoke detectors, but by the time I heard them going off, the smoke was so black and thick that I couldn’t see anything. When I opened my bedroom door, smoke just came pouring in,” she says.

While Fangshu’s bedroom was on the main floor of the house, the window didn’t open up far enough in order for to her jump out.

“If the window opened further, maybe things would have turned out differently,” she says.

Instead, she dropped to the ground and started crawling toward the front door. Covering her mouth with one hand, she held her cellphone in the other, using its flashlight function to navigate the pitch black, smoke-filled hallway.

Though it was only a short distance to the front door, she could feel herself losing consciousness.

“I got so tired, I had to stop and take a break,” she says.

The floor, heated by the intensity of the fire directly below, caused extensive burns to her arms and hands as she crawled. She managed to make it out to the front yard, where neighbours helped her until first responders arrived.

—

Fangshu was immediately taken to the Ross Tilley Burn Centre at Sunnybrook. There, Dr. Jeschke performed surgery to graft skin from one of her thighs onto her arms and hands. After two weeks in the hospital, she began a five-month course of outpatient rehabilitation at Sunnybrook’s St. John’s Rehab.

“I’m at St. John’s four days a week, working on getting the range of motion back in my elbows, wrists and fingers,” she says. “If I’m lucky, I may be able to stop wearing the compression garments after nine months, but I’ll probably need to wear them for two years.”

Fangshu credits the fact that she wasn’t asleep as the main reason she was able to get out of the house quickly.

“The fire happened at 2 o’clock in the morning, and I was up late, sending out resumes to try and find a co-op job for the next semester,” she says.

Sadly, while four people were in the house at the time, only three of them were able to escape the fast-moving fire.

“It was probably a minute from the time I heard the smoke detector until I got out of the house,” she says. “Another minute after that, I could see the whole main floor in flames.”

—

Fangshu hasn’t yet been able to return to school, but she’s hoping to recover enough to start classes again in January. Her mom came from China to stay with her, and has been helping her with daily tasks, from getting to medical appointments to putting her hair in a ponytail.

There are some things she still insists on doing herself, though.

“I usually eat using my chopsticks, but for now, I’m stuck using a fork,” she says with a laugh.

Despite her busy rehabilitation schedule, Fangshu is slowly getting back to a routine. She’s determined to find a co-op placement for next year, and to finish her degree. She recently moved into a new condo with her friends, and smiles when recalling the biggest selling point of the unit: the fire-safety features.

“There are smoke detectors everywhere,” she says. “There’s one in every room, out in the hallway, even in the elevator. I feel safe there.”

Fangshu Yu currently goes to appointments at Sunnybrook’s St. John’s Rehab four days a week, where she’s “working on getting the range of motion back in my elbows, wrists and fingers.”

Are you a student looking for off-campus housing? Ontario’s Office of the Fire Marshal has tips on finding fire-safe student accommodation.

Important things renters should know about the provincial Fire Code can be downloaded here.

If you have concerns about fire safety in your current rental accommodations, in Toronto you can contact the Fire Prevention Office by dialing 3-1-1.

The post Is your off-campus rental fire-safe? Two students survive, thrive after devastating fires appeared first on Your Health Matters.

“Frostbite is no joke. The effect it has on the skin is similar to a burn, so people with severe frostbite are treated here in our burn centre,” he says.

Here are five tips to avoid frostbite, and what to do if you think you may have it:

1) Layer up

If you know you’ll be outside for an extended period of time, dress for the weather.

“The easiest thing you can do to prevent frostbite is to dress properly, with a warm coat, boots, hat and gloves,” says Dr. Jeschke.

2) Wear gloves at the gas station

Take extra care when fueling up your car in the winter, and wear gloves when doing so.

“Getting gasoline on your hands when it’s very cold out will cause your skin to freeze within seconds, because it conducts the cold extremely well,” he says.

3) Don’t use hot water to thaw out

If you think you have frostbite, get indoors as soon as possible and use lukewarm water to warm the affected area. You can also take ibuprofen to help ease pain and swelling.

“Hot water can actually cause more damage. So can a direct heat source, like a fireplace, because your skin has lost sensation and you won’t realize you’re actually burning yourself,” says Dr. Jeschke.

4) Know the signs of severe frostbite

There are different degrees of frostbite, ranging from superficial (called frostnip) to deep freezing that can destroy bone. The feeling of pins and needles, lack of feeling in a certain area, or skin that is hard and pale may mean you’ve developed frostbite.

“If your skin turns black or some other strange colour, and then blisters, you’re in trouble. Get medical attention immediately,” says Dr. Jeschke.

5) Alcohol and cold temperatures don’t mix

“Drinking alcohol can give you a false sense of warming. It, in fact, widens your blood vessels, increasing heat loss and the risk of frostbite,” says Dr. Jeschke.

Alcohol can also affect your judgment, causing you to make poor decisions like going outside without proper clothes on or passing out in a snow bank.

“You may not feel the cold when you’re intoxicated. Or maybe you feel pain at first, but suddenly don’t feel cold anymore. When the pain goes away, that’s not a good sign,” says Dr. Jeschke. “Using common sense will help you avoid a frostbite injury.”

The post How to protect yourself from frostbite appeared first on Your Health Matters.

You can add another one to the list: the salt and ice challenge, which involves putting salt and water on your skin (usually the arm or hand), then seeing how long you can hold a piece of ice against it. Many people, particularly teens, have been recording themselves taking the challenge and then posting it on social media. Often, the people in the videos look to be in a fair amount of pain, showing off painful-looking red welts on their skin afterward.

So, what’s the problem with this challenge? Is it harmless, or is it actually dangerous?

“All the winner gets is a serious burn and a trip to the hospital,” says Dr. Marc Jeschke, director of the Ross Tilley Burn Centre at Sunnybrook.

You read that right – a burn. The mixture of salt, water, ice and body heat creates a unique chemical reaction that actually drops the temperature of the ice down to -28°C (-18°F). Holding something that cold directly against your skin will result in a full-thickness burn after only two to three minutes.

“A full-thickness burn means that the skin is totally destroyed. The skin becomes leathery and hard, and if the burn covers a large enough area, surgery and a skin graft may need to be performed,” says Dr. Jeschke.

So, why are people getting burn-type injuries from the salt and ice challenge, rather than typical frostbite? A key difference is the salt, which acts as an accelerant.

“In general, frostbite takes some time to develop, as the blood slowly crystalizes and causes damage,” says Dr. Jeschke. The salt and ice challenge causes injuries much more quickly, damaging the skin and nerve endings in the process.

You may be wondering how salt can cause ice to get colder, when we often use salt to quickly melt ice on our driveways and sidewalks. The answer lies in the unique chemical mix that ice, water, salt and body heat create. If you remove one of the ingredients from the equation, the chemical reaction will not happen. There is no source of heat present when you put salt on your icy driveway, meaning a different type of chemical reaction occurs, causing the temperature of the ice to rise rather than dramatically plunge (like it does in the salt and ice challenge).

Much like other challenges that have come before it, taking part in the salt and ice challenge is not a good idea.

“When you hold something cold against your skin and you feel pain, it’s your body’s way of trying to protect itself,” Dr. Jeschke says. “If you overcome the original feeling of pain, that’s not because you’re tougher or stronger, it’s because the nerve endings have been destroyed. Sometimes, that nerve destruction can be permanent, along with scarring on the skin.”

The post Why you shouldn’t take the salt and ice challenge appeared first on Your Health Matters.