167 - Structure Fires

Abstract

This chapter examines the problems that structure fires present and how the contents and design of buildings have led to numerous disasters with large loss of lives. Historic structure fires have been analyzed repeatedly as science develops and deeper understanding of the problems come to light. The National Fire Protection Association (NFPA) has become one of the leading agencies that continually looks at the challenges of structure fires and has developed standards to increase building safety. The NFPA is relentless in its commitment to life safety, and it has developed standards to ensure those visiting buildings and those residing in them have the best possible opportunity to survive a fire within the structure. The mass indoor gatherings of people in an assembly fashion have led to large-scale mass casualty events when those structures catch fire or have been attacked by terrorists, gangs, or criminals. This chapter will explore the successes and failures of mass casualty response to structure fires and the increased understanding of the pathophysiology of burns and burn management. It will discuss how care has improved in the past 50 years. As the NFPA has noted, most people die of smoke inhalation at structure fires. The use of CYANOKIT (hydroxocobalamin) for smoke inhalation and cyanide poisoning has emerged as a treatment for smoke inhalation caused by the burning of hydrocarbon in today’s fires. Mitigating risk through building materials, fire protection systems, life safety codes, and occupancy types will have long-term effects in reducing loss of life in structure fires.