Individuals who are involved in impaired driving crashes often incur bruises, broken
bones, and head injuries. But unlike many victims/survivors, those with burn injuries wear the scars of their trauma for the world to
see. Burns can be physically and psychologically devastating. Fortunately, survival and mortality rates have improved substantially as
a direct result of medical advancements. These advancements include painful and sometimes life long medical procedures. With survival
comes a need for support and information to cope with the emotional, mental, and spiritual issues that remain with the physical scars.
The Experience: There is a physical, mental,
and emotional experience associated with being burned. When a person is exposed to fire, the heat is
so intense that it literally takes one's breath away. Fire grabs and
feeds from oxygen, so it is nearly impossible to breathe. As a
consequence, there is little or no time to react.
The human body responds remarkably to any potential threat
of danger with a "fight or flight" response. When this reaction is
triggered, our brain sends messages to the adrenal glands, which
release chemicals into the bloodstream that cause our bodies to
change. These changes include increased respirations, increased
blood flow to muscles and limbs, intensified awareness, enhanced
impulses, and diminished pain.
Many crash victims/survivors report recognizing the need to get
out or away from the fire and after doing so, remember little else
about the event. Some only remember vague details such as smells
Despite removal from or extinction of the fire, the burn victim/survivor
remains in immediate danger. Depending upon the size and degree of
the burn injury there is now the risk of respiratory failure and shock.
Shock is a physiological response to trauma and a life-threatening
condition that should not be confused with the "fight or flight"
response. Shock reduces blood flow to vital organs and affects a
person's blood pressure, heart rate, respirations, as well as state
of consciousness. Shock may also account for a victim/survivor's
inability to recall details of a crash.
If you were burned as a result of a drunk driving crash you may not
recall feelings of panic, fear, and anxiety often associated with
burns. On the other hand, you may describe the experience as terrifying.
Either way, immediately following a crash and for some time thereafter,
a burn victim/survivor is faced with a potentially life threatening condition.
Types of Burns: A burn is an
injury to the skin that damages or destroys skin cells and tissue.
Burns are generally caused when skin makes contact with flames,
chemicals, electricity, or radiation. Thermal burns are burns
caused by intense external sources of heat, such as flames,
scalding liquids, or steam. Burns resulting from an impaired
driving crash are most likely thermal burns.
Degrees of Burns: Your skin is
the largest organ of your body. It prevents infection from entering
your body and it limits the loss of important fluids. Your skin
"holds everything together." Once a victim/survivor with burn
injuries is identified and stabilized, the burn team begins to
assess and classify the burn injuries. Burns are assessed by their
size in relation to the entire body and by their depth. They are
rated according to how many layers of skin are damaged.
A first degree burn involves the top
layer of skin called the epidermis. The epidermis is the outer most
layer of skin made of flat, scale-like cells called squamous cells.
Under these cells are basal cells, and at the deepest part of the
epidermis lie melanocytes. Melanocytes produce melanin, which gives
skin its color.
First degree burns are
labeled superficial and the body can heal itself quickly by creating
new, healthy cells in a process called epithelialization . First degree
burns are often caused by sunburn or scalds, appear pink to
red, can be painful with swelling, and typically leave no scarring.
Second degree burns
involve the epidermis and the second layer of skin called the
dermis . The dermis contains blood vessels, lymph vessels, hair
follicles, oil glands, and sweat glands. Second degree burns can
range from superficial to partial thickness depending upon the
extent of the damage.
While the body can heal from second degree burns
by epithelialization and a process called contraction , scarring
and thickening frequently occur and
healing can take up to six months. Contraction happens when the
burn is deeper and the skin cannot heal with epithelialization.
The body closes the wound by drawing on the surrounding skin, or
contracting. Because of these factors, doctors often recommend skin
grafts for second degree burns.
Third degree burns
involve all layers of the skin and are referred to as full thickness burns. Full
thickness burns destroy all of the epidermis and dermis, as well
as nerves, hair, glands and vessels. Because of the damage caused
by third degree burn, the body cannot repair itself and skin grafts
must be performed to prevent infection to the body. Fourth degree burns
involve the damage of bone and muscle and are rare.
The severity of a burn injury
is not only determined by burn classifications, but also by the
victim/survivor's age, the victim/survivor's previous health status,
the size of the injuries, how much of the injuries can be attributed
to third degree burns, and other medical complications related to
the fire. It is often difficult to accurately assess a burn at first
glance as the injury may change over the first several days following