“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.

“Thanksgiving isn’t ‘cancelled’ this year; it’s always important to be thankful. The most important thing is to have close contact only with people in your household,” says Dr. Jerome Leis, Medical Director of Infection Prevention and Control at Sunnybrook.

He says that the next one to two weeks are going to be crucial in terms of reducing the spread of COVID-19 in the community.

“Gathering with fewer people is something we can all do right now to help get the number of positive cases down again.”

Some creative ways to stay connected with loved ones include virtual get-togethers, enjoying a physically distanced walk outside, and sending gifts or cards.

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““Occupancy at our Burn Centre is already very high, and we’re concerned about needing to admit even more people this weekend because of burns from cooking.”

– Dr. Marc Jeschke, Medical Director of Sunnybrook’s Ross Tilley Burn Centre

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While gatherings need to be smaller this year, it’s still important to stay safe while preparing a holiday meal of any size. Sunnybrook’s Ross Tilley Burn Centre (RTBC) often sees more cooking-related injuries during upcoming holidays like Thanksgiving and Diwali.

On the Thanksgiving holiday weekend last year, the RTBC admitted four patients who had been burned while preparing food.

“Occupancy at our Burn Centre is already very high, and we’re concerned about needing to admit even more people this weekend because of burns from cooking,” says Dr. Marc Jeschke, Medical Director of the RTBC.

Below, he offers some tips on staying safe while preparing a holiday meal.

“If we can prevent one cooking-related burn this weekend, it’s worth it,” says Dr. Jeschke.

Cut down on distractions to avoid burns

Cooking multiple dishes at the same time can be a challenge. Be careful not to overwhelm yourself in the kitchen – a brief moment of distraction can end in a burn from pulling hot items from the oven or a fire starting on the stovetop.

Avoid wearing loose, flowing clothes while cooking

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

Do not try to deep fry a frozen turkey

Deep frying a turkey comes with several risks: you could spill scalding hot on yourself, or burn your hands touching the very hot pot.

That risk escalates even further if your turkey is not completely thawed before it goes into the pot of heated oil. The water inside the frozen parts of the turkey will turn to steam, causing the oil to boil over and resulting in huge flames that can set you (or your home) on fire.

Don’t cook or BBQ after consuming alcohol

“This is something we see all year round, not just during holidays,” says Dr. Jeschke.

Alcohol impairs judgement and can cause dangerous behaviour such as falling asleep while food is still cooking in the oven.

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 Tips for giving thanks, safely appeared first on Your Health Matters.

Trevor Levine, centre, with his children Josh, Sara, Avery and Jack

On the Friday of the Victoria Day long weekend two years ago, Trevor Levine developed a fever. Excruciating pain in his right thigh followed soon after.

By the time he went to the emergency room at his local hospital three days later, things had gone from bad to worse.

“I needed a wheelchair to get to the ER, my lips were blue as the nurse was triaging me and my oxygen level was in the low 80’s. I even lost consciousness as I was moved from the wheelchair to the examination table,” he says.

After blood tests, antibiotics, a lumbar puncture and a CT scan on his leg, he was diagnosed with necrotizing fasciitis, a rare condition commonly referred to as flesh-eating disease.

Trevor woke up in the intensive care unit (ICU) two days later to learn that a large amount of dead tissue had been surgically removed from his leg, leaving him with an opening “almost the size of a keyboard” on his inner thigh.

Nevertheless, within a few weeks Trevor seemed to be on the road to recovery, even walking around the unit and starting to go up some stairs.

But then the fever returned. Trevor went into septic shock again and was sent back to the ICU. His wife Carrie, a registered nurse at Sunnybrook, knew that the best place for Trevor was the Ross Tilley Burn Centre at Sunnybrook, and he was transferred there soon after.

“What had been missing from my care was a long-term wound management plan and being in a place with incredibly rigorous infection control practices. Sunnybrook’s Burn Centre has a lot of experience with both,” Trevor says.

Once he arrived at Sunnybrook, he knew he was in good hands. After five more surgeries and several weeks as an in-patient, Trevor’s leg was finally healing well, and he was discharged home.

He became an outpatient at Sunnybrook’s St. John’s Rehab, working on strengthening his body in twice-weekly occupational therapy and physiotherapy sessions. After spending a good chunk of the summer in the hospital, “I could hardly walk four houses down the street,” Trevor says.

Five months after his initial emergency room visit, Trevor returned to work as a risk management and process improvement consultant. He feels very fortunate to have regained full use of his leg.

“I’m lucky that the infection was caught early, and I’m grateful everything turned out the way it did, because it easily could have gone the other way,” he says.

“I think it was a lot harder on my family than it was on me, but I never felt scared because I trusted the process.”

He also can’t say enough about the “fantastic” culture in the Ross Tilley Burn Centre.

“The staff really have an ‘all hands on deck’ mentality. They take their jobs seriously, but they don’t take themselves too seriously, and that made a huge difference in my recovery,” he says.

“It really felt like I was being taken care of by family.”

The post How the Ross Tilley Burn Centre helped this patient recover from necrotizing fasciitis 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.