Burn Injuries

I was emptying the potatoes out ready for roasting into the sink. And she was bringing the fat, boiling hot fat out the oven, and she turned rather quickly towards the sink. And the fat spilled over onto my arm, and it was immediately apparent that it was quite a serious burn. And so it was just pure accident really, and I mean, she was so upset about it. But, you know, you try to make light of it. You know yourself when the skin's peeling off. It's not going to fix itself anytime soon. So yeah, that's how it happened. Pure accident really. I was in the wrong place at the wrong time. You know. Shame.

From what I’ve been told, I was only 13 months or so. From what I’ve been told, I was sat in my highchair in the kitchen and my mum was boiling the kettle and making some just food and she turned round to take something off the hob, and it was like seconds or so that she was turned round, I managed to pull the kettle cord over me. So, the water just sort of splashed everywhere and down me. So, she got me out of the highchair, put me in the bath, like water running over me and I got assisted to the ambulance. That’s what I really remember from what I’ve been told anyway.

So, I was on duty as a parent, if you like, and I was in the kitchen and I was cooking – I can’t remember what, this was a little while ago now, that was less relevant – something on, we’ve got one of the glass-top stove things. So, it’s like a flat thing with the circles that glow, and electric top thing. There’s a technical name. And I was cooking and one of the things which I did at that point, which I no longer do, is sit my daughter up on the worktop, so my eldest daughter is in school at this point and my youngest, who sustained the burn injury is not in school yet, she’s too young so she goes to play group occasionally and stuff like that, but she’s often at home in the day. So, I sat her on the side where she would sit there eating, usually prunes out of a packet – that was her favourites thing to do – and I turned my back to look to the sink and she put her whole palm flat on the top of the stove glass top thing that was at full, full temperature, and immediately started screaming.

So, I was wearing a party dress and, I was upstairs, and my dress caught fire, and then, luckily my parents came in and found me and called an ambulance and, yeah, that’s basically how the accident happened.

What did it catch fire from?

It was an open fire, just like a gas fire. My parents didn’t know that I was upstairs, obviously, otherwise they wouldn’t have had it on.

So, I know that my dress caught fire, my parents ran in almost straightaway, and my dad jumped on me and rolled me on the floor to squash the flames, so he acted really well, and then they called the ambulance, which came. 

I was trying to play like cooking in the kitchen. So, my mum was around and cooking at the same time, and I reached up to get this, it was a metal jug. So, the handle must have been kind of towards me, but she'd cooked chips, I think it was.

So, I reached up and grabbed it and it and it went all over me. So, it somehow missed my face. I think I might have a tiny little, some sort of bit here under my chin, but the worst bit is kind of my shoulder. There's a really bad scar there and under my arm, but basically all down the right side. It was, it's down my arm. It's gone to like my wrist and my side, and mainly the top of my right thigh. So, it's kind of all down that right side, and yeah, so I don't think my mum knew what to do.

So, I was on holiday with my family with my parents, and we're staying in a little self-catering flat, and it was over winter. So, it was quite a cold flat. So, the, we had a heat... we had heaters to keep us warm, but the electrics were really faulty. So, in the middle of the night, one of the sockets caught alight in the lounge, which was our exit out of the building.  And so there was... we spent quite a while in the flat close to the fire. Not, didn't go through it at any point but close to it, and the heat caused a lot of burn injuries to me and my family before we managed to get out of the flat.

So, I was in a house fire when I was 18 months old and from that I received 70% burns to my face and body. I lost a few fingers, a few toes and I lost an ear and I’ve had, like, multiple skin grafts. I actually lost all my hair, so this is a really good disguise. [laughs] And, yeah, from that, I had round-the-clock care in hospital, numerous surgeries, I can’t tell you how many, there’s been that much. Yeah, so I’ve had to go back quite often for reconstructive surgeries, skin grafts. You name it, I’ve probably had it. Fat transfusions to help stop the skin deteriorating, yeah, that’s that. You know what? I feel like I can never answer that question fully because I was so young. I was 18 months, compared to there’s other people who remember everything fully and their family have been so open about it, so they know every little detail, yeah. I only really know my story from what other people tell me.

This was seven years ago, and my partner was out on a night out. I was putting the kids to bed, I was making them hot water bottles, it was February, I think, 2014. I was making hot water bottles, had the boiled kettle in my hand and was just filling up one of the hot water bottles when I had one of my epilepsy auras, which is a kind of warning that a seizure is about to happen. What I should have done is put the kettle on the side and moved it away, but I didn’t, I put the kettle on the side and must have left my hand there because, well, the next thing I remember was being in the bath with about four paramedics in there and totally and my partner and the two children and being showered with cold water and immersed in cold water. So, what apparently had happened is that I had fallen over with my seizure, poured boiling water all over my body. The children had heard a thump, I don’t think I’d screamed or anything, but they’d heard a big crash, so they came down to find me on the floor with boiling water all over me.

So, the next thing you remember, after having the aura to say it was coming on, that you were just in the bathroom. So, some time would have passed, I assume then?

I suppose so. So, that must have been a pretty long one. Yeah, generally, they’re only about five minutes, maybe 10 minutes maximum but that must have been like half an hour, yeah.

So, what do you remember happening from waking up or from regaining awareness?

Yeah, complete shock. ‘What on earth am I don’t naked with all these people around me?’ was my very first thought. …Then it suddenly started dawning on me ‘Oh yes, I had that aura, didn’t I?’ And so those pieces of the jigsaw started to come together.

I was involved in a road traffic collision when I was 15 years old. I was a passenger in a car that was being driven by an older friend of mine. When my friend crashed the car, my friend died instantly due to his aorta bursting and then he fell on top of me. We both flew forward, hit the windscreen and then fell back into our seats, but my friend fell on top of me and because the fuel pipe had come loose and because of the sparks that had come from the car scraping on the ground, the car just, like, exploded basically and, again, my friend was on top of me whilst the car was on fire and then, when the fire services arrived at the scene, they actually thought there was only one person in the car at the time. So, when they pulled my friend out, it was a paramedic that was there with them, and she spotted that I was in the car still and she’d seen my finger just twitch. She said that he’s still alive and then they took me out of there and took me to my local hospital near to me.

I’ve asked the fire service since the accident as well, what they remember about the night of the accident and a couple of firemen who were actually at the scene of my accident, told me that I was actually conscious when they took me from the car but, obviously, I can’t remember anything like that. It’s like the next thing I can remember after the crash was waking up in the hospital on the burns’ unit.

Ok, so I was unblocking a sink with a very nasty chemical which was sort of 90-something percent sulphuric acid, and it just comes in a sort of a regular bottle once you’ve opened the lid, which I think is child-proof, it’s just a sort of a big opening at the top of it. So, I was pouring this chemical down the sink and after I’d finished pouring I was sort of holding it in my hand upright like that and nothing happened immediately, and then after five or six seconds, I wasn’t expecting it, all of a sudden there was this big gurgling noise from the sink. And, because I wasn’t expecting this loud noise from the sink I kind of jumped back a bit, like that, and as I jumped back, and I was holding the bottle still, this chemical splashed onto me. And, it splashed onto my face, it splashed onto my clothes, my t-shirt, my shorts.

And, also it’s a warning to other people as well. If you’re ever going to be doing this, bear in mind that, if you’re unblocking a sink nothing might happen for the first few seconds, so don’t be … don’t be sort of shocked when all of a sudden there’s a bit gurgling noise. Ideally, pour it down the sink, put the bottle straight down afterwards.

So,William was preparing dinner for the three children, which he’d done many, many times before. Pasta was one of his things he made quite regularly. So, it wasn’t... it wasn’t a new activity, it wasn’t something he was unsure about, he had done it many times before. And I was just sat working, he was making dinner and then just this... you could only describe as a... just a house-shattering scream and he had... I jumped up to see what he had done, and he was stood in the middle of the kitchen with all the pasta all over the floor, just... And really unable to actually even interact and tell us what he had done.

And interestingly, the... On that kind of front, people were more questioning of the fact that we’d let him cook. Not that he was cooking but, “Oh you let, you let the kids cook?” It’s like, yeah, it’s … what’s he going to do when he goes to university? Just eat beans out of a tin? You know – no, of course he cooks. He’s been cooking for years.

TBSA actually means Total Body Surface Area, or Total Burn Surface Area, people use it interchangeably. But it basically refers to the total in terms of the body’s surface that’s affected by the burn or affecting the body.

So, TBSA is a phrase that I think a lot of people use in burns to define how large a burn is because there are two important things in burns that clinicians need to know. They need to know how large a burn is and how deep a burn is and the way that we work out how large a burn is, is worked out by a percentage, rather than measuring it out in centimetres or inches because everyone’s a different size so something that’s 10cms x 10cms would be quite small on me, but on a very young child, it would be very large. So, we work it out by percentage and the best way to work out percentage is by using the whole palm of a person’s hand. So, if it’s a baby then we use the palm size area of the baby. If it’s an adult, then we use the palm size of the adult. We also have charts that can help us. So, for instance, a whole arm which may have been burnt would be about 9% and a whole leg, including the lower leg and the thigh, would be about 18% all the way around. So, we’ve got lots of ways of trying to work out how large a burn is by using the size of the hand or by using charts and now we’ve even got apps.

But it’s always a percentage. So, a percentage of the body surface area. And a small percentage, such as 1% or 2%, might be something that we can treat as an outpatient. But as we get larger, so 5% of the body’s surface area, might be something that we have to think about managing in the hospital. And certainly over 10%, we would definitely be treating in hospital for a little while at least. Beyond 25%, so a quarter of the body often has quite a significant impact on the body’s heart and lungs and guts, and so that would require much more careful high-dependency care as well as all the other things that we would need to do to treat the burn itself.

The difference between first, second, and third-degree burns really relates to how deep a burn is. In the United kingdom, we tend not to use first, second, and third degree. What I’ll do is explain what they are and then talk about the terms that we use more commonly because they often help us decide how we’re gonna treat a burn as well. First-degree burns really relate to quite a superficial injury, it’s not very deep, and it often doesn’t require any specialist treatment, it’s just redness of the skin. It’s a bit like sunburn without the blisters. It’s something that we don’t have to do too much for. Secondary-degree burns are often deeper and they often either cause blistering or they can make the skin go very pale and reflect a slightly deeper burn. Certainly, we tend to divide second-degree burns into superficial partial-thickness burns, which tend to be pink and blistered, and often require dressings to get healed and heal within a couple of weeks. Whereas deep dermal burns are also considered second-degree burns, but they often require more extensive treatment and may require surgery or may take much longer to heal and may be related to the risk of scarring. Third-degree burns are deeper and they tend to be called full-thickness burns because the whole depth of the skin has been damaged often these do require surgery or prolonged dressings and they are often associated with scarring. You can imagine one burn might have a first-degree, second-degree, third degree, all in the same burn and so we may treat each of the areas differently. As I said, we tend to call them superficial partial-thickness, deep dermal, and full-thickness because they help us decide what kind of treatment, we’re going to use to best manage that burn.