VAPE ‘RUSSIAN ROULETTE’ – the 21st Century game of ‘Chicken’

Equipment required: A cheap e-Cigarette or Vape.
How to play: Put e-Cig or Vape in mouth, press button and breathe in.

Here are some pictures of the results of losing at Vape ‘Russian Roulette’

Swansea-DailyPak
BMJ British Medical Journal, “2,035 vape explosion injuries were sustained across the US between 2015 and 2017″.

If you want to live longer by not smoking Cigarettes I’d say that blowing a hole in your face is a high price to pay – there might be less drastic ways available!

The photographs shown here are un-retouched – you can find them on the web. In these two cases, these two ‘Roulette Losers’ survived, but that is not always the case.
The odds of survival nowadays are a lot better than in the days of the six-shooter with one bullet, but the result of losing the gamble can be equally deadly.

Vapers have died because their Vape or e-Cigarette has exploded in their mouth

and fragments have penetrated the skull. In one reported case, the barrel of an e-Cigarette broke through the roof of the mouth and severed the Carotid Artery – the main artery taking blood from the heart to the brain. It was impossible to operate and the 24 year old boy died. It was his first puff of his first Vape.
vape-pen-3D x-ray-bl
In an earlier Post, I stated that Underwriters Laboratory of the US estimated that the odds of any Li-ion Battery exploding may be 1 million to 1, but let’s not forget that it DOES happen. A conservative estimate suggests that there are much more than 100 million Vapes and e-Cigarettes being used in the world. You work out the odds.

If it happens to you, you won’t be thinking about your bad luck. You are likely to be in hospital, fighting to keep your face, or your ‘wedding furniture’, or perhaps your life. Let’s hope your luck holds.

This 3D X-ray is of the face of a 17 year old boy. “Hole ripped in gums, lost several teeth, shattered jaw, and sustained burns..” The Paediatric Surgeon said…. “the tissue got kinda vaporised”
Read some of the actual (factual not graphic) Reports of Hospitals and Medical Journals, so you get the idea – the Doctor’s stories about Vape injuries and what happened.

Here are one or two, selected by me but all available for you to research yourselves. They are surveys of a few of many cases to illustrate the issues.

“Surgeons at Morriston Hospital’s Welsh Centre for Burns and Plastic Surgery said they had been treating numerous patients for burns after the batteries in their e-cigs exploded, The Sun reported. Victims of the most serious Vape pen explosions have required skin grafts and surgery in the most serious instances.

“Far from a “safer alternative” to Cigarettes, these devices are not regulated, and do not have to undergo safety testing before we put them in our mouths. We need to improve the safety of these devices through education and regulation—because although these explosions are rare, they can lead to lifelong consequences, disfigurement and even death.”

From Medical X-press

Western Pediatric Surgery Research Consortium

“…… finds cause for concern:  the potential for the vaping devices to explode during use.  Their study found that between Jan 2016 and Dec 2019, 15 patients at nine children’s hospitals sustained traumatic injuries from e-Cigarette explosions. Ten of those required hospital admission, three required intensive care units.

“An assistant professor of Pediatric surgery at the University of Colorado School of Medicine and a Pediatric surgeon at Children’s Hospital Colorado stated that, if the Li-ion Battery explodes, the pressure comes directly out.  So if it’s in your hand or near your face, it will cause injury. There was at least one child in the study whose jaw was broken. It can also cause injuries to the eye and burn wounds to the hand—there was one child where it exploded in his hand and caused not only a burn to the skin, but also radial (forearm) nerve injury.

“Six out of the 15 children in the series required an operation. Three of those were skin grafts, one of them had a broken mandible (jaw) that required repair, and one child had a hand injury that had to be repaired. In another case, the device was much closer to the mouth when it exploded, so the patient broke several teeth and required both dental examination and airway examination in the operating room.

“Q: What was the goal of this study and putting this information out there?

“A: Our goal in publishing this was to bring it to people’s attention that not only are these e-Cigarettes harmful because they’re addictive and because they can cause an associated lung injury (EVALI) which can be fatal, but they also can explode and cause a traumatic injury. We want to educate people and say, “These are the risks (Actually they are Hazards: Ed) that you face when you use e-Cigarettes.” We laid out in the paper what the next steps should be, including efforts to decrease e-Cigarette use, improving safety of the devices, and educating clinicians about the risk of device explosion.”

* EVALI – E-cigarette & Vape use-Associated Lung Injury. For more info explore – vaping-illness-symptoms
https://www.joms.org/article/S0278-2391(23)00094-0/abstract#back-bib20 Oral and Maxillofacial Injuries Associated With E-Cigarette Explosions: A Systematic Review and Management Guidelines Proposal

…… A total of 32 explosions of e-Cigarettes to 32 patients that caused 105 recorded injuries to the facial region.
Projectile injuries7775%  of all facial injuries
Burn injuries28 
Projectile & burn14 
Burn injuries mostly involved  
the face18 
oral cavity7 
eye7 
Bone or tooth fracture2060%
Surgery required in2060% of patients, which included internal fixing of fractures, tooth extraction, bone and skin grafts, and eye surgery.
  40% Had complications after treatment
These numbers represent the numbers of injuries in the Studies – not a total number of events overall.

https://doi.org/10.1016
https://www.sciencedirect.com
Thermal and chemical burns caused by e-Cigarette battery explosions
2020, Annales de Chirurgie Plastique Esthetique
Citation Excerpt :

…… Several localizations of burns have been described: thighs and legs, external genitalia, hands, face, corneosclera (eyes), cervical spine (neck), teeth, palate (roof of the mouth), and brain. The following have also been described: extensive dilacerations (tearing apart), smoke inhalation injuries, acid/(alkali) battery fluid burns, post-traumatic stress conditions (insomnia, flashbacks, depression, post-traumatic stress).

So that tells you a little bit of the story of what MIGHT go wrong when you put an e-Cigarette or Vape in your MOUTH and press the button.

What happens if you put Vapes or e-Cigarettes in your POCKET…?

They are not safer there than if you are vaping. It seems that there are SLIGHTLY MORE injuries from Vapes exploding in pockets than the number of injuries from when they are being used for Vaping. The injuries are not so likely to be deadly, unless the surroundings like a car or a room catch fire, and the injuries although very serious in some cases are unlikely to be so destructive as the disfiguring cases of explosions in the face. There seems to be no noticeable pattern of the circumstances that cause the explosion. Vapes that are switched on or off, charged or discharged – even batteries on their own – all have exploded in previous events.

In the Next Blog Post, we will examine some of the circumstances and try to find ways to minimise the occasions that vapes explode in a pocket – maybe we can suggest ways to minimise the damage that a vape can cause.

Vape-Exploding-3pix 2
3 images (enhanced by me) from a video of a Vape exploding in a pocket of a Salesperson

Let’s have a quick look at the Medical consequences of a Vape going off in your pocket…

Once again, the comments here are taken from just one of many Reviews of many Medical cases to give you an idea of what can go wrong.
Four different ‘burn mechanisms’ were described:
Thermal burns with flames
Thermal burns without flames due to overheating
Blast lesions from the explosion
Chemical alkali burns caused by the electrolyte solution
These all need different surgical and non-surgical interventions.
Vape-Leg-burns
This is exactly what happened in this injury here There is a Thermal burn combined with a Chemical burn.

It makes for a difficult, or at least uncommon, First Response Management problem. A Lithium-ion Battery explosion is likely to spray Electrolyte on the victim…. The Electrolyte is Alkali – like Household Bleach is an alkali – (not like Vinegar which is an Acid). The alkali will be caustic and may make the wound worse. The essential immediate First Aid for a deep burn is to drench with cool water to cool the wound and prevent further deep burning, but water may tend to spread the Alkali Electrolyte and may increase the size of the Chemical burn …. increasing the damage and the pain.

Going back to the ‘Review of Vape Injuries’ …
The burns were located at the thigh (80%) and the hand (50%) with a mean surface of 3% of TBSA (Total Body Skin Area).

Thirty-one reports were included in the review and described 164 cases. Most patients (90%) were male and between 20 to 29 years old. In the majority of cases (65%), e-Cigarettes exploded in pockets, compared to exploding in the face or hand. Common burned areas included the thigh, hand, genitals, and face. Burn severity was typically second-degree burns (35%).
I hope you will find, in my next Blog post, some advice about how to minimise the risk of being burnt by your e-Cigarette or Vape. Meanwhile, keep safe, as best you can!

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About the Author:

Hi! I’m Jeremy! My goal with this Blog is to explain, simply, what is going on in Li-ion Batteries so everyone understands the Hazards
– how and why they go wrong,
and the Risks
– the chance that they will go wrong.
When we know these, we can clearly see what to do to reduce the risks – making everyone safer.

We offer certified courses for those people who want to learn more and be armed with a Certificate. These may be school teachers, or parents of children with Electric Scooters, E-Bike and e-Scooter stockists, Mariners, Engineers and Maritime Officers. The courses are critically important for anyone involved, through their profession, in the handling or working with Li-ion batteries and the products that are powered by them.

I am a sailor, Maritime teacher, Industrial Designer, manufacturer, and have lived and worked in many countries other than England, which is where I am from.

Note: Most of the illustrations you will see in this Blog are hand drawn or painted, perhaps because they help to get attention, and perhaps because what is important can be emphasised. However they ALL are based on photographs of REAL incidents. If there are any ‘Fake’ images in the Blog, they will be labelled ‘Fake’ and will be presented as we found them off the web, to show you what is realistic and what is not. You will understand when you see some!

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