Knapp, Jerry. Fire As a Mechanism Of Injury. Journal of Emergency Medical Services. May 1987.

Abstract: This article provides information on treating victims who have suffered injuries from a fire. It explains how a residential fire will behave and how a fire injures its victims. It describes the most common injuries found at a fire scene and how to treat them.

As a fire starts out, it produces a large amount of heat and smoke. The heat and smoke rise to the ceiling, while the cooler air remains near the ground. The rooms of the house will reach a thermal balance, making the atmosphere above the thermal balance line intolerable. The fire will then progress to either the flashover stage or a backdraft stage. A fire will usually flashover because heat production is high and there is enough oxygen to supply the expanding fire. Backdraft occurs when there is not enough oxygen to supply the flames. The fire smothers itself and waits for oxygen. When oxygen is provided the flames will violently explode.

Most victims of a fire suffer from inhalation of products of combustion. Gases produced from the flames cause upper and lower airway injuries. The face, neck, nose, and mouth will swell. An inflammation of the larynx and trachea may also occur. This swelling causes airway obstruction and requires immediate intubation and in some cases, a tracheotomy. The longer a victim inhales the gases, the more carboxyhemoglobin will form. This substance results in hypoxia, which prevents the body from absorbing oxygen.

Flames can also cause injury, although usually not directly. Heat from flames will cause panic in victims who are trying to escape. Panic will cause irrational thoughts and may provoke those trapped by flames to escape any way possible. Victims who stand and attempt to run will be overwhelmed by the intolerable atmosphere of smoke and other gases and will suffer inhalation injuries, possibly causing unconsciousness. Any flame or burn injuries will usually occur after death.

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