Gasoline Explosion to the Face: Surviving the First Hour
In my search for resources to share here for burn victims, I discovered something significant: not many people have experienced a gasoline explosion that engulfed their face in flames, and even fewer have written about it, offering practical advice on how to survive and thrive after a gasoline (or any type of) burn to the face. For those of you who know my story, I was the one who caused a spark in a gasoline vapor cloud, igniting a one-gallon gas container that covered my entire face and left hand in burning gasoline. Fate would have it that I eventually became a Burn ICU RN in the same burn unit where I was a patient three years prior. Some of the survival and scar-minimizing advice I can offer might seem like common sense, while other insights were learned through my own experience.
I plan to create a series on how to not just survive, but thrive after any burn you may suffer. This series will be divided into phases, as the focus shifts significantly as we navigate through the different stages of the burn survival process. With that said, let's examine what's most important in the first moments to the first hour after your burn.
Pre-Burn: Preparing for Immense Stress
Teach yourself to handle immensely stressful scenarios so that when your life depends on controlling your autonomic stress response, you'll be prepared. Before my burn, I joined an expedition to climb the tallest mountain in the Czech Republic, Mt. Sniezka, wearing nothing but swimming trunks in -20-degree temperatures and 50 mph winds. That's quite extreme, but I was able to identify key aspects of that experience that later helped me deal with my gasoline burn. It's important to find something safe yet terrifying for you and to do it! This could be tandem skydiving if you're afraid of heights or a cave tour if you're claustrophobic. However, it's crucial to have experienced individuals around you for guidance. To develop control over your stress response, specific breathing techniques have been shown to release as much adrenaline as bungee jumping. Cold showers and ice baths have also helped me find ways to limit my stress response, as being exposed to ice water is one of the most stress-inducing stimuli for the human body. Practicing these on a daily basis teaches your body to function in simulated high-stress scenarios, allowing you to develop strategies that work best for you. This skill is invaluable, not only for burn situations but for any scenario where you need to be at your best when conditions are at their worst.
The First Hour
First Seconds: Gaining Control
DO NOT BREATHE and CLOSE YOUR EYES. Put out the flames ASAP, then breathe. When the gasoline ignited, I heard a whoosh, and before I could process it, my entire face and hand were covered in flaming gasoline. Time seemed to slow down, allowing me to think through the situation. My instinct was to keep my eyes closed, realizing how critical this was for my future vision. I thought, "If you breathe right now, you'll be dead from flash pulmonary edema tonight." The reason? Breathing in would have pulled the gasoline vapors and flames right into my lungs, causing life-threatening damage. I've always preferred cotton shirts, and fortunately, I was wearing one, which I quickly used to extinguish the flames on my face and hand (polyester can melt into your skin). Once the fire was out, I took a breath and opened my eyes. Had I been wearing a polyester or non-cotton shirt, I would have used cotton underwear or anything else available to smother the flame.
1-5 Minutes: Immediate Action
Your body's primary barrier is now compromised, allowing toxins to absorb much faster than through intact skin. Aware that my actions in the next few minutes could impact my future cancer risk, I focused on mitigating further damage. Shampoos are designed to dissolve oils, so I called 911 from my shower, putting my phone on speaker. I washed my face with shampoo 2-3 times, then continued pouring cold water over my burn to minimize swelling and alleviate as much pain as possible.
5-10 Minutes: Medication and Communication
The moment my face was covered in gasoline was surprisingly not the most painful part of my ordeal; I had no idea of the level of pain that would follow. My medical background informed me that swelling and pain would be my main challenges immediately post-burn. Also, stress slows digestion, meaning any oral medication would take longer to take effect. I took 500mg of Tylenol along with 600mg of ibuprofen for its NSAID effects. I would never recommend any medication or doses to anyone, as only you know your body best.
After medicating, I called my family to explain the situation calmly, ensuring they knew where I was being taken. Experiencing signs of shock, it was immensely helpful to have someone to remember details and advocate on my behalf. After notifying my family, I was overwhelmed by pain and remained under a cold shower until the paramedics arrived.
10 Minutes-EMS Arrival: Warn and Notify
Upon the arrival of EMS, it was crucial to warn them of any remaining fire threats or hazards. Their safety is paramount as they work to save lives. I also made sure to inform them of the medications I had taken and their doses to prevent any miscommunication or double dosing.
EMS Ride to ER: Maintaining Composure
The ride to the hospital was the most painful experience of my life, but there was nothing more to be done at that moment. Filled with thoughts of how this burn could change my life forever, I cried but decided, "Bob, this burn will make you, it will not break you." Losing control over many aspects of my recovery, I clung to the most important thing I still had: my mindset. I resolved to use my story to help others in similar situations, taking selfies as my "Before" images on the way to the hospital. This shifted my perspective from being a victim to a survivor with a purpose.
30-60 Minutes: Advocate and Collaborate
Initially, you'll likely be in shock, making it difficult to communicate. However, it's crucial to work with the medical team to the best of your ability. If you're in pain, speak up so they can address it appropriately. I regret not advocating more for my pain management, as it led to additional trauma. Be clear with your burn team about how you're feeling. If you're frightened, let them know so they can offer support.
As a Burn ICU RN, I often treated patients in the same tub room where I had been debrided. If a patient expressed fear about pain or any aspect of their care, I could address it from a place of empathy, having been in their shoes. Sharing my story with patients showed them they had an advocate who understood their experience, providing immense reassurance.
Every patient I had the privilege of assisting as a Burn ICU RN also helped me. They allowed me to use my experience to support them through their most challenging moments. Over time, I healed from my trauma by fulfilling the promise I made to myself in the ambulance: using my burn to make me, not break me.
This series will continue with the most important insights I've gained from my experience, focusing on what helped in the first 24 hours and what I would do differently if given the chance.
