Flash fire injuries: A preventable catastrophe

Yashoda K^1*, Keerthika²

¹Deputy Nursing Superintendent, Kauvery Hospital, Salem, Tamil Nadu

²ICU Staff Nurse, Kauvery Hospital, Salem, Tamil Nadu

*Correspondence

Abstract

Chemical burns are a significant form of tissue injury caused by exposure to corrosive substances such as acids, alkalis, or organic compounds. The severity of chemical burns depends on factors such as the type, concentration, duration of contact, and mechanism of action of the chemical agent. Petrol vapours can ignite rapidly, leading to flash burns, a highly flammable hydrocarbon. These burns commonly occur due to accidental ignition, improper storage& unsafe handling.

This case study aims to enhance awareness regarding prevention of such catastrophic incidents and the critical role of nursing interventions for optimal patient outcome.

Key words: Chemical burns; Catastrophic incidents

Introduction

A man sustained burns while riding in his bike carrying petrol which suddenly flamed. Prompt recognition and immediate management are crucial in minimizing tissue damage and preventing complications. Immediate management is crucial and includes, early airway assessment is essential due to the risk of inhalation injury. Further treatment involves fluid resuscitation, pain management, wound care, infection prevention, and surgical intervention when necessary.

Case Presentation

A 31yr old male sustained chemical burns while carrying petrol on his motorcycle fuel tank pouch, which ignited suddenly while he was riding at around 1.30 pm.

He had burn injury over his face & neck, B/L upper limb, trunk and abdomen with 3^rd degree 45% burns. Initially patient was taken to outside hospital, treated conservatively and referred here for further management. When he was brought to Emergency, he was conscious.

Vitals

BP	120/70mmHg
PR	107/ min
RR	22/min
Spo2	98% in RA

Investigations

Date	23/01/2026	24/01/2026	25/01/2026	26/01/2026	27/01/2026	28/01/2026
Haemoglobin	18.1	18.4	14.5	13.6	11.7	--
Haematocrit	55.6	55.9	44.8	42.7	36.3	--
WBC Count	10210	9330	5060	2510	11290	--
Neutrophil	75.2	80.6	52.4	89.6	92.4	--
Lymphocyte	19.9	13.3	37.5	9.2	6.6	--
Monocyte	4	5.8	8.9	0.8	0.5	--
Eosinophil	0.7	0.1	0.4	0	0.1	--
Platelet	3.54	3.74	2.95	1.71	1.24	--
MCV	84.1	83.8	84.8	--	87.3	--
RFT
Urea	30	35	36	28	31	51
Creatinine	0.91	0.74	0.85	0.84	0.8	1.09
Sodium	129	127	131	135	140	145
Potassium	4.1	4.7	3.6	2.9	2.9	3.1/3.2
Chloride	99	99	103	103	109	107
Bicarbonate	26	23	28	28	26	30
Uric Acid	4.3	4.2	2.9	3.1	3.3	5.9
Calcium	8.1	7.8	7.5	7.5	7.3	7.8
Phosphorous	4.1	3.8	2.5	2.5	1.9	1.5
Magnesium	--	--	--	1.5	--	2
LFT
Bilirubin Total	--	0.5	--	1.7	--	--
Bilirubin Direct	--	0.2	--	1.1	--	--
Bilirubin Indirect	--	0.3	--	0.6	--	--
SGOT	--	20	--	48	--	--
SGPT	--	37	--	26	--	--
Alkaline Phosphatase	--	63	--	--	--	--
GGT	--	12	--	--

Culture Report

Date	Type Culture & Site	Current Antibiotc with Day	24 Hrs Growth	48 Hrs Growth	Final Report
26/01/2026	Blood Culture	Inj. Piptaz	No growth	Klebsiella pneumoniae	Klebsiella pneumoniae
26/01/2026	Urine Culture	Inj. Piptaz	No growth	No growth	No growth
26/01/2026	ET Culture	Inj. Piptaz	No growth	No growth	No growth
28/01/2026	ET Culture	Inj. Meropenem	No growth	Acinetobacter	Acinetobacter
29/01/2026	Wound C/S	Inj. Piptaz	Acinetobacter growth	Acinetobacter growth	Acinetobacter
31/01/2026	Blood C/S Peripheral	—	No growth	Klebsiella pneumoniae	Klebsiella pneumoniae (R)
31/01/2026	Blood C/S CVP	—	No growth	Klebsiella pneumoniae	Klebsiella pneumoniae (R)
08/02/2026	Blood C/S CVP	—	No growth	No growth	No growth

Diagnosis: 3^rd degree burns

Hospital Management

Baseline investigations were carried out. Patient shifted to OT where he underwent wound debridement dressing done on under GA. He was later shifted to ICU in isolation cabin. He was received in intubated status for further management; He was started on IV fluids as he had hypovolemic shock. He was also on antibiotics, analgesic, steroids and PPI. Patients were on continued ventilator care and was sedated. Patient developed hypotension on 2^nd day, and he was started on Noradrenaline and support. Later he had persistent fever spikes & tachypnea hence blood & urine & ET cultures were sent initially but showed no growth. He was started on antibiotics. Cardiologist opinion was obtained 2D ECHO showed normal LV & advice were followed. Nephrologist opinion was obtained for high colored and decreased urine output. Dermatologist opinion obtained advice were followed.

On 4^th day blood culture showed klebsiella pneumonia growth, Wound & ET culture Acinetobacter growth Inj. Meropenem was started and Inj. Piptaz stopped. Repeat blood culture (CVC) showed candida species, still fever persisted so culture was taken from CVP line which showed growth and it was removed. Antifungal was escalated (Inj; Caspofungin. Patients were weaned off from ventilator support.

On 6^th day Patients developed hematuria, Bladder wash was given and catheter changed to silicon later nephrologist review obtained advised antibiotics escalation. When patient was on Ryles tube clear liquids were started and observed for aspiration. Later, semi solid diet started, he had difficulty munching so food was mashed and given taking into consideration high protein pulses were included in his diet.

On the 22^nd day repeat peripheral culture showed no growth. Opthal opinion was obtained advised were followed.

Eleven sessions of wound debridement done. He was managed with PPI, analgesic, oral feeding, chest & limb physio, mobilization and other supportive measures. Patient symptomatically better, Ryles tube was removed 2 days before his discharge.

Nursing Management

Airway management
Preventing shock by inotropes and continues monitoring
Fluid Resuscitation – 2 hourly 200 ml fluid was given through Ryles tube.
Monitoring urine output is reliable indicator of adequate resuscitation.
Maintained a warm environment to prevent hypothermia.
Nutritional support – It was challenge as initially he was on enteral feeding as he refused feeds and difficulty in chewing so mashed food was given.
Infection Control. Though he had culture positive and fever spikes on 3rd day of admission proper Hand hygiene, isolation precautions and assigning only single nurse in each shift during the admission which prevented sepsis. Better outcome and vigilant monitoring. Attenders were explained about visiting time and restricted frequent visits.
2 days once dressing was done under strict aseptic precaution in Operation Theater. Skin grafting was done in chest area by plastic surgeon.
Physio – Regular physio was given to prevent contractures and spiro was also done to improve his breathing.
Diversional therapy like music and TV was initiated.

Outcomes: Patient condition improved.

Discharge

Discharged with stable vitals. He was able to walk with support and came back for review and is now leading a normal life. But scars are present, counselling being given regarding the deformity)

Discharge Advice: Regular follow-up as he is susceptible to skin infection.

Medication

Name of Drug	Dosage	Route	Frequency
Tab. Pan	40 mg	P/O	BD
Cap. Dalacin c	300 mg	P/O	BD
Tap. Dolo	650 mg	P/O	BD
Tap. Zincovit	-	P/O	BD

Conclusion

Petrol burns are preventable injuries. Public awareness regarding safe storage, avoidance of carrying petrol in bottles for later use in front pouch of bikes on tank, and adherence to safety measures can significantly reduce their incidence. Education and strict safety protocols are essential in both domestic and occupational settings to minimize risks. Nursing care is very crucial in infection prevention and better outcomes.

Reference

Flash fire injuries: A preventable catastrophe

Flash fire injuries: A preventable catastrophe

Yashoda K1*, Keerthika2

Nightingale Journals

Yashoda K^1*, Keerthika²