Inhalation injury after exposure to indoor fire and smoke: The Brazilian disaster experience

Rech, Tatiana Helena; Boniatti, Márcio Manozzo; Franke, Cristiano Augusto; Lisboa, Thiago; Wawrzeniak, Iuri Christmann; Teixeira, Cassiano; Maccari, Juçara Gasparetto; Schaich, F; Sauthier, Angelica; Schifelbain, Luciele Medianeira Oliveira; Riveiro, Diego Fontoura Mendes; Fonseca, Daniele Amaral; Berto, Paula Pinheiro; Marques, Leonardo da Silva; Santos, Moreno Calcagnotto dos; Oliveira, Vanessa Martins de; Dornelles, Carlos Fernando Drumond; Vieira, Sílvia Regina Rios

doi:10.1016/j.burns.2016.02.017

Cited by 11 publications

(8 citation statements)

References 19 publications

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“…In relation to the male predominance in the present systematic review, it is known that this group is more prone to be involved in accidents that result in death [27,28]. Earlier studies also demonstrated a greater male involvement among victims of smoke inhalation during enclosed-space fires [29][30][31][32]. On the other hand, regarding the fire location, most studies described a household fire accident [14,15,17,18,20].…”

Section: (Conclusion)mentioning

confidence: 74%

Acute clinical manifestations in toxic smoke inhalation victims: systematic review of observational studies

et al. 2018

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Introduction: Lung injuries from toxic smoke inhalation are the main causes of death in fire victims; however, information regarding the acute effects on the respiratory system after smoke inhalation and its constituents in closed environments are still scarce in literature. Objective: To investigate the acute clinical manifestations observed in victims of smoke inhalation during enclosed-space fires by means of systematic review. Methods: A systematic search was conducted in the following databases: MEDLINE (via PubMed), Lilacs, Scopus and Web of Science. There were no appliedrestrictions in terms of thepublication date. In addition, a manual search was performed on the references of published studies. Observational studies assessing the prevalence of acute clinical manifestations in victims of toxic smoke inhalation in closed environments were included. Results: Of the 4,603 articles identified, eight were included, comprising a total of 233 patients. The signs and symptoms were identified and ranked according to frequency. Dyspnea (58.80%, six studies), carbonaceous sputum (54.51%, four studies), hoarseness (39.91%, three studies), wheezing (34.33%, five studies) and sore throat (33.90%, two studies) were the most frequent acute clinical manifestations of smoke inhalation. Besides these, chest pain and pulmonary edema were observed, respectively in 13.30%, 5.15% of the studies. Conclusion: The results suggest that dyspnea, carbonaceous sputum, hoarseness, wheezing and sore throat were the most frequent acute clinical manifestations in victims of smoke inhalation. Further studies of a higher level of evidence and greater methodological rigor are required.

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Section: (Conclusion)mentioning

confidence: 74%

Acute clinical manifestations in toxic smoke inhalation victims: systematic review of observational studies

et al. 2018

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“…76 Although the sample numbers were small, the study findings did not suggest a significant difference in adduct levels between the two groups, a finding that has relevance to controversies concerning the status of acrolein as a human lung carcinogen in tobacco smokers. 77,78 81 Across a range of patient ages, SII victims exhibit much higher mortalities relative to those with burns of comparable severity in the absence of smoke inhalation. 82 SII is a variable clinical syndrome due to the unpredictability of various determinants of disease severity.…”

Section: Acrolein and Disease: Four Exposure Scenariosmentioning

confidence: 99%

Acrolein and Human Disease: Untangling the Knotty Exposure Scenarios Accompanying Several Diverse Disorders

Burcham

2016

Chem. Res. Toxicol.

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Acrolein is a highly toxic electrophile that participates in many diseases, yet efforts to delineate its precise mechanistic contributions to specific conditions are complicated by its wide distribution within human environments. This Perspective develops the proposal that due to its mixed status as environmental pollutant, metabolic byproduct, and endotoxicant which forms via ubiquitous pathophysiological processes, many diseases likely involve acrolein released from multiple sources. Although the category boundaries are indistinct, at least four identifiable exposure scenarios are identifiable. First, in some syndromes, such as those accompanying chronic or acute intoxication with smoke, whatever role acrolein plays in disease pathogenesis mainly traces to exogenous sources such as the combustion of tobacco or other organic matter. A second exposure category involves xenobiotics that undergo metabolism within the body to release acrolein. Still other health conditions, however, involve acrolein that forms via several endogenous pathways, some of which are activated upon intoxication with xenobiotics (i.e., Exposure Category 3), while still others accompany direct physical trauma to body tissues (Exposure Category 4). Further complicating efforts to clarify the role of endogenous acrolein in human disease is the likelihood that many such syndromes are complex phenomena that resemble "chemical mixture exposures" by involving multiple toxic substances simultaneously. This Perspective contends that while recent decades have witnessed much progress in describing the deleterious effects of acrolein at the cellular and molecular levels, more work is needed to define the contributions of different acrolein sources to "real-world" health conditions in human subjects.

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“…5,6 O Brasil registra cerca de 200 mil incêndios catalogados por ano. 7 Em janeiro de 2013, o incêndio da Boate Kiss, localizada no município de Santa Maria, no estado do Rio Grande do Sul, teve 242 vítimas fatais e 116 pessoas feridas, e foi classificado como o maior do estado e a quinta maior tragédia da história do Brasil, sendo a de maior número de mortos nos últimos 50 anos e o terceiro maior desastre em casas noturnas no mundo. Foi o terceiro maior incêndio em número de vítimas fatais e feridos do mundo ocorrido em uma boate.…”

Section: Introductionunclassified

Impacts and Legacies of a Disaster in a University Hospital: A Reference to The Preparation

Trevisan¹,

Witt²

2019

Reme Revista Mineira De Enfermagem

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Objetivo: o atendimento de vítimas de desastres estabelece o desafio, para as instituições hospitalares, do preparo para atender ao aumento da demanda, ao mesmo tempo em que os serviços essenciais precisam continuar em funcionamento. Foi realizada pesquisa qualitativa do tipo estudo de caso com o objetivo de identificar e descrever os impactos e legados do atendimento às vítimas do incêndio na Boate Kiss para a gestão de recursos do Hospital de Clínicas de Porto Alegre. Método: a coleta de dados foi desenvolvida em entrevistas e consulta a documentos. Participaram 17 profissionais envolvidos no gerenciamento do atendimento. Resultados e discussão: os dados foram analisados por meio de análise de conteúdo do tipo temático. Foram identificados impactos na gestão dos recursos humanos, com recrutamento, capacitações e treinamentos; na gestão de recursos materiais com o aumento de insumos e materiais não padronizados; na gestão de recursos físicos com o provimento de leitos e espaço para acolhimento dos familiares. Entre os legados, um Plano Institucional de Apoio a Catástrofes Externas foi desenvolvido: Conclusão: os resultados confirmam as evidências de que a aprendizagem sobre a gestão de risco acontece a partir de eventos vivenciados pelas instituições de saúde, cujo legado reflete-se na qualificação do planejamento e do atendimento em situação de desastres. Os impactos e legados identificados constituem subsídios para a qualificação do atendimento hospitalar em desastres. Palavras-chave: Desastres; Administração de Desastres; Impactos na Saúde; Avaliação em Saúde; Administração Hospitalar. ABSTR ACT Objective: Disaster victims care establishes the challenge of preparing for hospital institutions to meet increasing demand, while essential services must continue to work. This is a qualitative study carried out in the case study, with the objective of identifying and describing the impacts and legacies of attending fire victims at the Kiss nightclub for the management of resources of the Hospital de Clínicas de Porto Alegre. Method: the data collection was developed in interviews and consultation of documents. Seventeen professionals involved in the management of care participated in the study. Results and discussion: the data were analyzed through content analysis of the thematic type. Impacts on human resources management were identified, with recruitment, training; in the management of material resources with the increase of non-standard inputs and materials; in the management of physical resources with the provision of beds and space for the reception of family members. Among the legacies, an Plano Institucional de Apoio a Catástrofes Externas was developed. Conclusion: the results confirm the evidence that the learning about risk management happens from events experienced by health institutions, whose legacy is reflected in the qualification of the planning and disaster response. The impacts and legacies identified constitute subsidies for the qualification of hospital care in disasters

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Inhalation injury after exposure to indoor fire and smoke: The Brazilian disaster experience

Cited by 11 publications

References 19 publications

Acute clinical manifestations in toxic smoke inhalation victims: systematic review of observational studies

Acute clinical manifestations in toxic smoke inhalation victims: systematic review of observational studies

Acrolein and Human Disease: Untangling the Knotty Exposure Scenarios Accompanying Several Diverse Disorders

Impacts and Legacies of a Disaster in a University Hospital: A Reference to The Preparation

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