Outdoor Recreational Fires: A Review of 329 Adult and Pediatric Patients

Abstract

Outdoor recreational fires are a frequent occurrence during the summer months and can be associated with burns resulting in significant morbidity. Both pediatric and adult populations can be affected, and their mechanism of injury is often different. Understanding these mechanisms is important when designing prevention programs. It is the goal of this study to review our experience with outdoor recreational fires. All patients who presented to Spectrum Health Blodgett Regional Burn Unit for burns secondary to an outdoor recreational fire over an 8-year period were reviewed. Demographic data, mechanism of injury, body area involved, TBSA burned, treatments undertaken, and subsequent complications were recorded. Pediatric patients (aged 16 years and younger) were analyzed independently, and risk factors were determined. A total of 329 patients suffered burns secondary to outdoor recreational fires over the length of the study. More than 35% required inpatient treatment, with an average length of stay of 4.8 days. Hands were the most frequently affected body part, with the mean TBSA involved being 3.5%. Ninety-four patients (28.6%) required split-thickness skin grafting. The most common mechanism of injury in both adult and pediatric populations was falling into an ongoing fire. Wound infection was the most common complication. Alcohol intoxication was associated with a higher burn severity and complication rate. Pediatric patients represented 39.8% of the sample. Burns secondary to outdoor recreational fires are associated with significant morbidity. Adult prevention programs should target awareness with respect to alcohol consumption and campfires secondary to the morbidity associated with these injuries. Pediatric patients are particularly susceptible, and parents should remain diligent about campfire safety and be educated about the inherent dangers of both active and extinguished fires.

Risk Factors for Inpatient Hospital Admission in Pediatric Burn Patients

“…Pediatric burn patients who presented with a history of drug abuse (amphetamines, barbiturates, opioids, and/or cannabinoids) were more likely to be admitted by 61% (p=.027). Harmful behaviors associated with substance abuse increases the risk of adverse burn outcomes [ 19 , 29 ]. Up to 60.6% of incidents reported in these studies involved alcohol consumption; these patients had increased surface area of burn coverage, greater number of medical procedures, and lengthened hospitalizations.…”

Alcohol, Health, and Injuries

“…Furthermore, the study reported a higher rate of medical complications among intoxicated individuals, including increased inpatient management, length of stay, wound infections, number of procedures, total body surface area burned, and total area requiring grafting. 57 Evidence suggests that among individuals who consume up to 1 drink per day, there is an increased likelihood that they have had more than 5 heavy drinking episodes in the preceding year. This association suggests that the overall risk of injury may increase with increasing volumes of alcohol consumption.…”

“…Furthermore, the study reported a higher rate of medical complications among intoxicated individuals, including increased inpatient management, length of stay, wound infections, number of procedures, total body surface area burned, and total area requiring grafting. 57…”

Human and climatic influences on wildfires ignited by recreational activities in national forests in Washington, Oregon, and California *

“…Fire is inextricably linked to the outdoor recreational experience in the United States. Fires are typically associated with camping given relatively cool overnight temperatures, fires' use in cooking, and the atmosphere that fires create for storytelling, rituals, and other social gatherings (Mechling 1980, Neaman et al (2010, Young 2017). Campsite selection by visitors is strongly related to the ability to build a campfire (Lillywhite et al 2013).…”