It's another hot summer night in the emergency room at the University of Michigan Hospital. And the doctors and nurses know what that means: any minute now, another burned patient will come through the door needing immediate treatment.
Maybe it'll be a woman who burned her bare feet walking over the buried coals of a beach bonfire, or a child who got too much sun and developed skin blisters.
Maybe it'll be a teenager who came too close to the hot exhaust of a lawnmower, or a father who didn't heed the warning on a package of fireworks.
Or maybe it'll be a toddler who strayed too close to a fire pit, or a backyard chef who got impatient with a charcoal fire and tried to jump-start it with a squirt of lighter fluid.
Whatever kind of burn comes through that emergency room door, says U-M emergency physician Edward Walton, M.D., it almost surely didn't need to happen.
Every summer day, hundreds of people get burned in situations that could have been prevented by simple common sense or some basic precautions. Some of them come to the ER, but many others nurse minor burns at home - or suffer silent, but dangerous, damage to their skin and eyes that will add up to problems years later.
"Summer brings a lot of special burn risks, including some that might surprise you," says Walton, an assistant professor of emergency medicine and pediatrics at the U-M Medical School. "I see a lot of patients who suffer intense pain from burns that could have been prevented, and it's important for all of us to take a moment to think when we're around fire or out in the sun, so we can keep more people from getting burned."
Walton offers these tips to help everyone understand and prevent summer burns:
Sunburns hurt, they peel, and when they're really bad, they blister or make you feel nauseous or weak all over. Not only that, but they also age your skin faster and raise your risk of developing skin cancer later in life. In fact, just one blistering sunburn will double a child's normal risk of getting melanoma, the deadliest form of skin cancer, in adulthood. Michigan ranks eighth in the country for cases of melanoma. Fortunately, burns are preventable with sunscreen, clothes and other tools.
"There really isn't any safe level of sun exposure," says Walton. "Anytime you're going to be outside, you really should be thinking about protecting your skin. You can even get sunburned when it's cloudy, because the ultraviolet rays go right through the clouds."
Slather on the sunscreen, with a factor 30 or 45, a half-hour before you go outside. Once you're out, re-apply it every hour or so - or more often if you've been sweating or swimming. Stay in the shade between 10 a.m. and 4 p.m. if you can, and keep babies completely out of the sun at all times.
Wear loose-fitting, long-sleeved shirts, pants and wide-brimmed hats while walking, gardening, working or playing outside. If you have very fair skin, or you know you burn easily, be especially careful. The same is true if you're taking any medicines that make you more likely to get burned - ask your doctor or pharmacist. And forget about the idea that having a tan protects you from sunburn - you can still get burned.
"Sunburn is what burn experts call a partial-thickness burn, and it can be superficial or actually go deeper into the skin, which is when you start to blister," Walton explains. Aches, chills, and nausea are signs of a serious sunburn, or what some people refer to as "sun poisoning."
You can tell when your skin gets burned, because it turns red within a couple of hours. But your eyes can also get ‘sunburned' and they don't turn red. They just absorb the damaging UV rays and build up damage that can lead to problems later on, including cataracts and loss of vision.
So, Walton says, sunglasses are important for everyone to use during any outdoor activity - even children. "Most parents wouldn't let their children go outside without sunscreen, but they often forget to protect their eyes," he notes. "As early as a child will tolerate wearing sunglasses, they should start wearing them because just like the skin, eye damage early in life becomes more severe as you grow older."
Cooking outside is one of the best things about summer. But it's also one of the most dangerous - at least, if you don't follow safety precautions. The fact that people tend to do their grilling while also consuming alcohol, which can get in the way of making smart decisions or paying attention, doesn't help matters.
Walton says many injuries result from simply lighting the grill. "Never light a propane gas grill with the top closed - the gas can accumulate inside the grill and you can have an explosion," he says. "If you're using charcoal briquettes, saturate them with lighter fluid before you start the first, then step away - and never add more lighter fluid or other accelerant to a fire that's already burning. The first can actually ‘walk' up the stream of fluid and cause the container to explode."
Kids might be naturally attracted to the grill, but just like a hot stove inside the house, they need to stay away. "It's always a good idea to create what's called a ‘No Zone' around a stove or grill," Walton advises. "Mark the area with a chalk line or lay down a piece of rope a few feet away from the fire in every direction, and make sure children understand that they can't go inside the line."
Campfires, fire pits and fire bowls
The "No Zone" idea also applies to non-cooking fires, including bonfires on the beach, campfires, fire pits in the backyard, and the freestanding metal fire pits and ceramic chimeneas that have become popular patio accessories in recent years. Set one up and enforce it rigorously. Just like you wouldn't give a toddler or kindergartener a box of matches to play with, don't let them play around a summer fire.
Even the innocent summer activity of toasting marshmallows can lead to burns. "Kids are naturally intrigued by fire, and people really don't think about this when they hand a child a stick with a marshmallow on the end - it can soon become a flaming torch with a very sticky projectile on the end," Walton says. "I've seen some pretty serious burns from marshmallows sticking to skin while they're still on fire."
If you're cooking over a fire and bringing pans to the picnic table, carry the pans close to the ground while you walk, so that if you trip the hot grease or food won't splash your face, arms and chest.
One type of summer fire danger poses the biggest threat to people long after the fire is out: beach bonfire pits in the sand.
"Just by covering a fire pit with sand you haven't put that fire out - you've actually created an oven," Walton says. The coals can stay hot enough to burn for up to a day - a big, painful surprise to a person walking over the spot later on, or to a child who thinks the low area is a sandbox. "To douse a fire pit, you need to soak the coals with water, at least two gallons. Most beaches and camp areas have a receptacle where you can dispose of the coals safely - use these if they're available."
Every emergency room doctor and nurse dreads Fourth of July week because of all the fireworks injuries to people who aren't trained in fireworks safety.
"We see people who have picked up fireworks, thinking that they're duds, and then they explode in their hands. We see burns from sparklers, which burn at over 1,000 degrees. We see lots of eye injuries," Walton says. "Most parents wouldn't hand their child a lit match, but on the 4th of July they hand their three-year-old a lit sparkler - and it's the same thing."
The bottom line: Leave the fireworks to the professionals. If you absolutely must light a few small, legal ones of your own, consider them "live" unless you've doused them completely with water.
One surprising source of summer burns, Walton says, comes from engines - on cars, lawnmowers, recreational vehicles, and more. Kids and teens who are mowing lawns may not realize that the hot exhaust from the mower can burn. And the summer sun and heat means that it takes longer for all types of engines to cool down - so they may be hot for hours after you switch them off.
"The hood of a dark-colored car in the summertime can get hot enough to fry an egg, which is definitely hot enough to burn skin," Walton says. "Be careful around any engine especially for several hours after it's been running."
Written by Kara Gavin