Two firefighters attempted to "set the bead" on a flat tire by using ether. They arrived in the ED with facial burns.

How did this happen?

If you have not seen this please view the attached utube video

https://www.youtube.com/watch?v=63RAFk1Ae84

Our patients had flash burns of the face.  A flash burn is caused by an explosion of natural gas propane, gasoline or other flammable liquid.  The severity of the burn depends on how long the skin was exposed to heat from the explosion. The burns can be first or second degree.   In the case of our firemen, they presented with first degree burns involving only the epidermis.   There is rarely any inhalation injury since the exposure to heat is so brief.  

Full thickness burns are usually painless because nerves in the skin are destroyed

Flash burns can be caused not only by intense heat but by high  voltage electric injury  or ultraviolet light. One of the more interesting kinds of high voltage burns caused by electricity are Lichtenberg figures caused by lightning strikes. These figures last only 24 hours.

Ultraviolet light can also cause burns and produce painful keratitis in welders not wearing protective goggles. This is because the hotter the material , the more thermal radiation emitted shifts to shorter wavelengths and since acetylenene torches approach 3,000 degrees C, large amounts of UV light are produced.  This typically causes a keratitis which occurs some time after exposure(up to 24 hrs later) and results in severe pain.   This same keratitis occurs in climbers exposed to UV light because thin air at altitude causes less scatter of UV rays and snow increases the reflection of UV light. “Snowblindness” results.

fluorescein uptake in welder’s keratitis

FULL DISCLOSURE: the picture shown was not one of our patients but an individual who suffered a flash burn when he threw gasoline on a fire.   Our patients had the equivalent of sunburns and were discharged from the ED with NSAIDS.  

Rice Phillip, Orgill D  Emergency care of moderate and severe thermal burns in adults. UpToDate May 2022.

Muehlberger T et al. Domiciliary oxygen and smoking: an explosive combination. Burns 1998

Zatrigi V, Arifii H, Zatrigi S, et al. Facial burns-Our experience Mater Sociomed 2013;25(1):26-27

Finn L, Photokeratitis linked to metal halide bulbs in two gymnasiums—Philadelphia PA.,2011 and 2013. MMWR. 2016 . Morbidity and mortality weekly report, 65.

https://www.youtube.com/watch?v=QWwr2mPOTbA if you want to see a jet propelled truck burst into flames when the tire flies off and hits the gas tank.