AARC member Melanie Ferguson was a student on a critical care air transport clinical rotation when her team received the call that they were going to get a patient who had been severely injured due to an e-cigarette explosion. Although many on the team were bewildered, Melanie had heard of similar cases like this during her mechanical ventilation classes at the University of Alabama.
By Melanie Ferguson, BS, RRT
In July of 2015, I was a student on a critical care air transport clinical rotation when we received an urgent call late in the afternoon. Some of the details were unclear because we had not received the official report from the transferring hospital, but the supervisor in charge said some sort of explosion involving an e-cigarette had injured a young man.
My first thought was that this was one of those, “Well, here we go,” incidences like we discussed in my mechanical ventilation classes at the University of Alabama at Birmingham. Our professor made it a priority to keep us updated on new studies coming out on treatments, therapies, and trends that could potentially affect the way we care for our patients. The emphasis on keeping us in the know, and encouraging class discussion (or brain storming activities) on these topics, proved, in this instance, to be invaluable to me.
Exploding e-Cigarette – It’s A Thing!
I will never forget the look on everyone’s face (everyone being the nurse practitioner, nurse, and several RTs) when they heard it was an e-cigarette explosion. They were bewildered. This team had experienced countless critical care flights but none of them involved transport of a person whose e-cigarette had exploded. The consensus among the crew was this was not an e-cigarette explosion — they were not sure what it was but there was no way it was that.
That’s when I, a senior RT student on clinical rotation with the transport team, spoke up and said, “You’re kidding me, right? You never heard of this? I assure you it’s a thing!” I began to explain that we discussed this in class in great detail on more than one occasion. I assured them that this was not the first time this had happened. It was exciting to be the one introducing this idea of e-cig explosions to this very seasoned and highly-trained group of professionals. They decided that the e-cig had to have been tampered with or modified in some way. I had nothing else to say at that point.
We boarded a jet and went to get the patient. It was a long ride from the airport to the hospital in the back of an ambulance driven by the EMTs who were the first responders to the scene. As they shared what they witnessed at the scene they seemed to have no problem believing the e-cig could have done this. They were the ones who were the first to interview family members who were with the man at the time of the explosion, and they saw no reason to believe any modifications had been made to the device either. But I think this was their first experience with this as well.
Safe and sound
When we arrived at the hospital and received report again there were more mentions of eyewitness accounts. The witnesses said the patient was standing outside against a wall smoking on his e-cig when there was a loud explosion. Flames began at the patient’s head and went up the wall behind him, reaching to the roof. There were only very small pieces of the e-cig recovered at the scene by the EMT team.
We found our patient sedated and intubated. His eyebrows were singed, as was some of the hair on his head, but not too badly. It must have been a quick explosion, otherwise I would have expected more severe burns. The patient was very swollen and missing his front teeth. Actually, they were not missing as much as they were hiding. The explosion blew them into his hard palate.
I am happy to report we successfully and safely transported our patient to the trauma center emergency department, where he made a full recovery and has since been interviewed by news stations, speaking out on the dangers of e-cigs.
Melanie Ferguson graduated from the RT program at the University of Alabama at Birmingham (UAB) in August of 2015 and is now completing a respiratory traineeship in the Pediatric Pulmonary Center at UAB that’s being funded by the Maternal and Child Health Bureau of the Department of Health and Human Services. She will graduate in April with a Master’s in Health Education.
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