Burns

[Tony]

What do you do if you receive a burn? The reason I ask is because we tend to have a lot more fires in the winter months and the likely hood is that now is the most likely time to burn yourself.

We have a few medical people on the forum and some wise laymen. Some advice of what to do when miles from anywhere and you burn yourself?

:f:

 

[C_Claycomb]

Alovera is meant to be top stuff to put on burns, think that you can get something in tubes with it as the main ingredient, saves you carting a pot plant around with you! Not sure how this ties up with current thinking.

Don't quote me, but I believe that you are meant to keep burns dry and clean. The few burns that i have had did feel better after being immediately cooled in clean water, but after that kept dry. Don't use cotton pads, the fibres can stick to the burn surface. I think that there are special burn dressings that are meant to prevent this adhession.

 

[ESpy]

Crash cool it as fast as possible. Cold running water is best.

For small burns, I'm fond of a product called Burn-Eze (Boots sell it still, I think) that is a small can of propellant and benzocaine. Chills the burn area and the benzocaine helpe numb the pain. Obviously, there would be liability issues with using this in any official capacity.

Checking the St John's manual, the order of events listed is cool burn (pour cold water on for at least 10 mins), remove constrictions, cover with clean sterile dressing, non-fluffy material, cling film or a plastic bag. Treat for shock & casevac. There's no mention of assessing severity of the burn.

 

[Gary]

ESPY IS RIGHT - you need to cool it quickly and stop the flesh cooking (damaging cells etc)

Immerse in water for 10 mins and then apply a dry sterile dressing - if its bad enough seek medical assistance.

Alternatively dont burn yourself - exercise more caution/common sense around the burny stuff.

 

[Tony]

I do have to point out here that I don't burn myself :f: but it is useful to know other peoples views. Mors book has some good stuff on it although I'm not sire how it translates to the UK

 

[Gary]

thats your excuse mate!!

 

[Rob]

Tony - congratulations on your carefulness - you are a credit to the Bushcraft world :notworthy

Cool it down quick is the right way to do it. If you are with someone who is burned - you may struggle to get them to keep it in running/cold water for 10 mins. Seems like hours. Shock will probably be an issue too.

As for covering it - definitely not fluffy stuff. I came across some "vaseline gauze" recently, which looked very good for a lot of different wounds. Didn't stick and made a good "bottom" layer to a dressing.

As for an assessment on the need for medical help, % burnt (using the palm method) and the severity of the burn would be the way to go. We have at least one GP on here, so I will let him chip in with some specifics.

 

[sargey]

usually when i burn myself i run around hooting, dancing and swearing profanely :roll:

cheers, and.

 

[Rob]

A whole lot of shouting and swearing normally fixes most things, or gets the job done :-D

Only time I can remember holding it in was soaking a dressing off of my thumb the day after some spoon carving unpleasantness - involving my thumb and a crook knife. :yikes:

 

[Andrew Middleton]

Cooling for ten minutes in cool/tepid rather than cold water will reduce the instant hit of shock.

All the advice about covering with non-fluffy material is sound. I would stay well away for creams and ointments though, unless you are likely to be away from medical help for a long time. Putting such substances on severe burns serves the purpose of acting as a barrier to infection and keeping the wound from drying and cracking. This is best left to the experts, if possible.

It is important to remember that the burn compromises the body's physical immune barrier. Therefore, it must be kept clean, hence the sterile dressings. If the burn is large, a surprising amount of fluid can be lost, which needs to be replaced.

That all said, swearing and running around also works for me, and many A&E medics will use the same tactic once you get to hospital.

 

[mbrodw]

I am a big advocate of cling film! I carry it folded. I fold the cling film into a 10-20cm section and then onto it's self, almost into a flat role. I then fold this in half. I have used this for cuts, and burns. It works a treat as for burns it keeps it clean and nothing gets into the wound like fluff. For wounds it stems the blood as it acts a bit like a torunique and also keeps the wound clean! I wouldn't bother with oinments as they are heavy to carry, messy to apply and for the short term they aren't worth it!

Mark

 

[donkeyporge]

I used to work with a Chef who swore by using the white of an egg to create a second skin over the burns.

 

[Tony]

It would usually be a hand that gets burnt, if this is the case are condoms good to use as a glove?

 

[jatherton]

I've heard a lot about lavender being extremely good for burns. Though, you'd probably wan't to be careful about infections from the flower head itself.

Joel

 

[Doc]

Pre-hospital burns management in a nutshell.

1) Extinguish flames, ensure safe to approach.
2) Cool down with water. Be aware of hypothermia risk if outdoors of course.
3) Check airway and breathing ok (if patient talking and not breathless, airway is ok. Smoke inhalation can cause later swelling of airway, so keep under review.)
4) Estimate area. Rule of Nines – in an adult 1 arm is 9%, head is 9%, front of chest and abdomen 18%, back of chest and abdomen 18%, 1 leg is 18%. This leaves a mere 1% for the wedding tackle. Sorry guys.
5) Estimate thickness. The old ‘third degree burns’ terminology is no longer used. Full thickness burns destroy the full thickness of the skin, including the nerve endings, so they are painless and have no feeling. Unless very small they need grafting. They look white or grey or charred. Partial thickness burns are painful, red and blistered.
6) More than say 5% burns in an adult (even less in kids) should be assessed in hospital. Ditto full thickness burns.
7) Clingfilm from a roll is sterile on the internal surface. It is the dressing of choice after cooling.
8) If more than 15% burns in an adult or 10% in a child, fluid loss may be a problem. If you have the equipment and skill, then iv access and colloid infusion are appropriate. Transfer should usually be to a hospital with a burns unit.
9) Dead burned skin can form a black/grey inflexible layer which can restrict breathing and circulation. In extremis, this may need to be divided (escharotomy). Bit beyond the scope of this though

 

[Gary]

Very interesting Doc, we were always taught to add a dry dressing but i like the cling film idea as that will keep the wound moist and fresh.

And if the patient dies still leave plenty for your sandwiches!

 

[Stuart]

To answer Tonys last question yes condoms make good burn dressings for hands

for full thickness burns
after cooling a burn down dont appy anything to it except flamazine
(its a cream used in hospitals) after covering the burn in copious anounts of flamazine (i hope i'm spelling that right) stick your hand in a sterile plastic bag and tape the top closed around the wrist or put a condom over it which has the advantage of being sterile and self sealing around the wrist

their is also a neat trick using a condom for chest Decompression after a pnumothorax :-D

 

[Gary]

What would the bushcraft world do without condoms and tampons?

 

[Andy]

the other good thing about cling film is that you can see the wound heeling which is a big help. vasaline is good for scoulds but it must be very clean (i keep a film pot of it just for that) i also carry sterile trianglar bandages as part of my firsdt aidd kit whichcan be loosly wrapped round it just to keep the burn clean

 

[Scott]

the other good thing about cling film is that you can see the wound heeling which is a big help. vasaline is good for scoulds but it must be very clean (i keep a film pot of it just for that) i also carry sterile trianglar bandages as part of my firsdt aidd kit whichcan be loosly wrapped round it just to keep the burn clean

Vaseline! Be interesting to hear a professionals view on this as every first aid course I have ever done stresses not to put greases or ointments onto a burn.

I have used in the past water gel dressings after the initial 10 minute cold water cooling period to keep a burn cool on the way to hospital. Any views on this? I was recommended these as a good way of minimising tissue damage post burn.