Checking and understanding the limitations to your policy can be the difference between being covered for a major loss or losing potentially tens of thousands of dollars. This point is again being brought up by us because we recently handled a claim where a family had a major water loss on a secondary property. A water line burst on the second floor of the home and caused extensive first floor and basement damage. Floors, walls, ceilings and contents were completely destroyed by the loss. Their policy had a $10,000 total cap for a water loss. If the home had caught fire, they would have been covered for the loss and also $40,000 would have went toward contents that were destroyed. But overlooking an option in their policy capped the loss at $10,000 including the contents. The total cost of the claim was between $40,000 and $50,000 and this does not include the loss to their personal items. Many people never read their policy and trust the underwriter to explain it to them. This is a major mistake because the underwriter will give most people the cheapest coverage to insure they write your policy and not have you go somewhere else. In these cases, families who can not afford the difference for the loss tend to take loans, leave the house in its current condition or sell the property because they can not afford the reconstruction fees. By taking the time to read through your policy and ask as many questions as possible you will not only understand in full detail what is and what isn’t covered, but you will potentially save yourself a major amount of heartache and an enormous amount of money.
The number one cause of death related to fires is smoke inhalation. An estimated 50-80% of fire deaths are the result of smoke inhalation injuries rather than burns. Smoke inhalation occurs when you breathe in the products of combustion during a fire. Combustion results from the rapid breakdown of a substance by heat (more commonly called burning). Smoke is a mixture of heated particles and gases. It is impossible to predict the exact composition of smoke produced by a fire. The products being burned, the temperature of the fire, and the amount of oxygen available to the fire all make a difference in the type of smoke produced.
Smoke inhalation damages the body by simple asphyxiation (lack of oxygen), chemical irritation, chemical asphyxiation, or a combination of these.
- Simple asphyxiants
- Combustion can simply use up the oxygen near the fire and lead to death when there is no oxygen for a person to breathe.
- Smoke itself can contain products that do not cause direct harm to a person, but they take up the space that is needed for oxygen. Carbon dioxide acts in this way.
- Irritant compounds
- Combustion can result in the formation of chemicals that cause direct injury when they contact the skin and mucous membranes.
- These substances disrupt the normal lining of the respiratory tract. This disruption can potentially cause swelling, airway collapse, and respiratory distress.
- Examples of chemical irritants found in smoke include sulfur dioxide, ammonia, hydrogen chloride, and chlorine.
- Chemical asphyxiants
- A fire can produce compounds that do damage by interfering with the body’s oxygen use at a cellular level.
- Carbon monoxide, hydrogen cyanide, and hydrogen sulfide are all examples of chemicals produced in fires that interfere with the use of oxygen by the cell during the production of energy.
- If either the delivery of oxygen or the use of oxygen is inhibited, cells will die.
- Carbon monoxide poisoning has been found to be the leading cause of death in smoke inhalation.
Smoke Inhalation Symptoms
Numerous signs and symptoms of smoke inhalation may develop. Symptoms may include cough, shortness of breath, hoarseness, headache, and acute mental status changes.
Signs such as soot in the airway passages or changes in skin color may be useful in determining the degree of injury.
- When the mucous membranes of the respiratory tract get irritated, they secrete more mucus.
- Bronchospasm and increased mucus production lead to reflex coughing.
- The mucus may be either clear or black depending on the degree of burned particles deposited in the lungs and trachea.
- Shortness of breath
- This may be caused by direct injury to the respiratory tract, leading to decreased oxygen delivery to the blood, the decreased ability of blood to carry oxygen because of chemicals in smoke, or the inability of the body’s cells to use oxygen.
- The patient may have rapid breathing as they attempt to compensate for these injuries.
- Hoarseness or noisy breathing
- This may be a sign that fluids are collecting in the upper airway and may cause a blockage.
- Irritant chemicals may cause vocal cord spasm, swelling, and constriction of the upper airways.
- Eyes: Eyes may be red and irritated by the smoke, and there may be burns on the corneas in the eyes.
- Skin color: Skin color may range from pale to bluish to cherry red.
- Soot in the nostrils or throat may give a clue as to the degree of smoke inhalation.
- The nostrils and nasal passages may be swollen.
- In all fires, people are exposed to various quantities of carbon monoxide.
- The patient may have no respiratory problems, but may still have inhaled carbon monoxide.
- Headache, nausea, confusion and vomiting are symptoms of carbon monoxide poisoning.
- Changes in mental status
- Chemical asphyxiants and low levels of oxygen can lead to mental status changes.
- Confusion, fainting, seizures, and coma are all potential complications following smoke inhalation.
When To Seek Immediate Care.
If the smoke inhalation victim has no signs or symptoms, home observation may be appropriate. If in doubt, call the doctor or go to the local emergency department for advice.
Seek medical attention if the patient experiences the following symptoms with smoke inhalation:
- Hoarse voice
- Difficulty breathing
- Prolonged coughing spells
- Mental confusion
Decide whether to call an ambulance for assistance.
- Someone with smoke inhalation can get worse quickly.
- If such a person were transported by private vehicle, significant injury or death could occur on the way that could have been avoided if that person were transported by emergency medical services.
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Exams & X-Rays
A number of tests and procedures may be performed. Which tests are performed depends on the severity of the signs and symptoms and is at the discretion of the doctor.
- Chest X-ray
- If the patient has respiratory complaints such as persistent cough and shortness of breath, a chest X-ray should be done.
- The initial chest X-ray may be normal despite significant signs and symptoms.
- A repeat chest X-ray may be necessary during the observation period to determine if delayed lung injury is occurring.
- Pulse oximetry
- A light probe is typically attached to the finger, toe, or earlobe, to determine the amount of oxygen in the blood.
- Pulse oximetry may be inaccurate if the patient has low blood pressure, and enough blood is not getting to parts of the body where the probe is attached.
- Blood tests
- Complete blood count: This test is done to determine if there are enough red blood cells to carry oxygen, enough white blood cells to fight infection, and enough platelets to ensure clotting can occur.
- Chemistries (also called basic metabolic profile): This test reveals any changes of pH in the blood that may happen because of interference with oxygen diffusion, transport, or use. Serum electrolytes (sodium, potassium, and chloride) can also be monitored. Renal (kidney) function tests (creatinine and blood urea nitrogen) are also monitored.
- Arterial blood gas: For people with significant respiratory distress, acute mental status changes, or shock, an arterial blood gas may be obtained. This test may help the doctor to determine the degree of oxygen shortage.
- Carboxyhemoglobin and methemoglobin levels: These levels should be measured in all smoke inhalation victims with respiratory distress, altered mental status, low blood pressure, seizures, fainting, and blood pH changes. It is now routinely done in many hospitals whenever arterial blood gas is assessed.
Self Care At Home
Remove the person with smoke inhalation from the scene to a location with clean air.
Make sure that you are not putting yourself in danger before you attempt to pull someone from a smoke-filled environment. If you would be taking a serious risk to help the person, wait for trained professionals to arrive at the scene.
If necessary, CPR should be initiated by trained bystanders until emergency medical help arrives.
A number of treatments may be given for smoke inhalation.
- Oxygen is the mainstay of treatment.
- Oxygen may be applied with a nose tube, mask, or through a tube down the throat.
- If the patient has signs and symptoms of upper airway problems (hoarseness), they will most likely be intubated. The doctor places a tube down the throat to keep the airway from closing due to swelling.
- If the patient has respiratory distress or mental status changes, they may also be intubated to enable the staff help with breathing, to suction mucus, and keep the patient from choking on secretions.
- Bronchoscopy is procedure performed through a small scope to directly look at the degree of damage done to the airways and to allow for suctioning of secretions and debris.
- Usually bronchoscopy is done through an endotracheal tube after the patient receives adequate sedation and pain relievers.
- Bronchoscopy may be necessary if the patient has increasing respiratory failure, fails to demonstrate clinical improvement, or a segment of the lung remains collapsed.
- Hyperbaric oxygenation (HBO)
- If the patient has carbon monoxide poisoning, hyperbaric oxygenation may be considered.
- Hyperbaric oxygenation is a treatment in which the patient is given oxygen in a compression chamber.
- Some studies have demonstrated that hyperbaric oxygenation causes a reduction in symptoms of the nervous system, and if the patient has carbon monoxide poisoning, it may make recovery quicker.
- The indications for and availability of this treatment vary depending on the institution and the region in which the patient is hospitalized.
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Once the patient leaves the hospital, follow-up care is typically arranged. The patient should return immediately to the emergency department if they feel that their condition is worsening after discharge from the hospital.
- Medications may be prescribed, such as various inhalers and pain medications.
- The patient may notice shortness of breath with minimal exertion.
- It may take time for the lungs to fully heal, and some people may have scarring and shortness of breath for the rest of their lives. Avoid triggering factors, such as cigarette smoke.
- Persistent hoarseness of the voice may occur in people who have sustained burn or smoke inhalation injuries or both. Early attention to these problems, many of which are treatable surgically or behaviorally or both, could lead to an improved voice.
Prevention is key when discussing smoke inhalation. Numerous prevention strategies can be employed to avoid exposure to smoke.
- Smoke detectors should be placed in every room of occupied buildings. This should ensure early detection of smoke to allow plenty of time for evacuation.
- Carbon monoxide detectors should be placed in locations at risk for carbon monoxide exposure (such as from malfunctioning furnaces, gas water heaters, kerosene space heaters, propane heaters and stoves, gasoline or diesel generators, and boats with a gasoline engine).
- Escape routes and plans for how to escape should be worked out prior to the onset of a fire and reviewed often.
- Numbers for the police, fire department, and your local poison control center should be kept in a visible place in the event of an emergency. Find your poison control center now by checking the Web site of the American Association ofPoison Control Centers.
This concludes our four part blog on Smoke Inhalation. For more, visit our website at Biowashing.com
For all of those following and asking us for updates on Xena, I am so happy to tell everyone that she has been adopted. After several long months of earning her trust and getting her reintroduced to living with people after the tragedy she witnessed, Xena has found a Forever Home. We would like to thank, Red Paw Emergency Relief, Jen Leary, Emily Miller and Jen Baris for their tireless work in helping us place this beautiful dog.
To donate to Red Paw, click this link: RedPawDonations
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Insurance companies employ their own adjusters. They’ll evaluate your property damage and help walk you through the claims process, free of charge. In many states, you can also hire public adjusters to help you file claims and negotiate your insurance payment. Public adjusters represent the claimant, and usually charge you 10-15 percent of any insurance settlement.
Schemes: Most public adjusters are honest and competent, but some are crooked. They may come from out of town, and go door to door, trying to bilk disaster victims with insurance schemes. They might:
• Charge you a large fee, and then disappear without handling your claim.
• Refer your repair to a dishonest contractor for a kickback, and you may receive shoddy repairs in return.
• File false and inflated claims against your policy. Sometimes they’ll also try to convince you to join the scheme.
• Use their position of trust to access your Social Security number and other personal data for scams involving identity theft.
Licenses: Public adjusters need licenses in most states. Ask your state insurance department if an adjuster is properly licensed in your state, or has any complaints or disciplinary actions. If the adjuster comes from another state, contact that state’s insurance department to make sure the adjuster is licensed.
References: Ask people you trust if they can recommend a reputable adjuster.
Remember: You are fully within your right to hire whichever contractor you desire. Your home owners insurance adjuster or your public adjuster may recommend contractors, but the decision of whom you hire is completely up to you.
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Pictured here is Xena. She was rescued by Red Paw after her house was intentionally set on fire. Her parents were murdered in the house prior to it being set ablaze, and Xena was rescued in an abandoned building two days later. The owner of MSI, Joe Fiorilli, is fostering her after several months of being in a kennel. She shortly became well adjusted to living in a home and is up for adoption. Even if you can not adopt or foster a dog, donating to such organizations like Red Paw Emergency Relief allows such people like Jen Leary to save lives.