Emergency scenario

[Screaming Eagle]

Grid has gone down and medical services are severely stressed if available at all. Most clinics and hospitals are turning away anything not life-threatening plus it's pretty crazy and money is short.

Due to the sudden collapse, many people have started making do with outdoor fires. Fires have spread from small campsites to barns locally. Your spouse responded to a call from the neighbor when his barn was on fire. A burning timber fell, knocked your spouse down and the result was serious burns to legs, hands and chest.

Some of the burns are deep exposing layers of tissue with exudate already flowing. It's very painful and you're the only one around with the guts to deal with it. Plus, it's your spouse (deal with it ;-)) Your neighbor is in a panic and your spouse is in pain. Your kids are screaming and the cow is bellowing.

Use whatever resources you have available at your home.

[Abigail]

Okay, I've never had to deal with third-degree burns, which is what I think you're describing here.

 

I have experience with spilling boiling broth on my abdomen and hands. I packed the areas in ICE and kept it there...for hours...until the next day, when it no longer hurt when the ice was removed. I just kept refreshing the ice as it melted.

 

The result? A total cure; NO blisters, scarring, anything.

 

I think this worked because it lowered the temperature of the burned area, to prevent the tissue from "cooking" further from the residual heat (to explain in layman's terms why I think this worked.)

 

Now, with more severe burns I'd be quite worried about infection; I'd flush the area with as much of the cleanest cool water I could lay my hands on, in hopes of flushing out any dirt, etc. that had made its way into the burns...then follow up with the ice. I'd either boil the cloths I wrapped the ice packs in to sterilize them, or use sterile gauze to make the ice packs.

 

IF I had any antibiotics handy, I'd start them immediately.

 

I'd take this course of action as I've heard that using greasy creams or fats just hold the heat in, causing further tissue damage. Not sure if this is a wives tale or not.

 

I can only go with my own success with ICE ICE ICE....and more ICE....fortunately your scenario does not seem to include the loss of electricity!!

[Mother]

I've been considering this scene for several days. I'm going to precede my suggestions with a warning. This info is for education only. Please research it before using it. Also, all you professionals out there, don't hesitate to correct me where I'm wrong. I want to learn too.

 

First I would try to remain calm. Then I'd try to reassure my DH and try to make him comfortable, using cold/ice water on the burns as soon as possible to stop the heat and pain. I'd get him moved where he could be worked on as soon as possible because shock will be setting in very soon after the accident. I would treat for shock and perhaps, if he is able, start having him sip on electrolyte solution or a bit of salt water. I would add 1/4 tsp. of cayenne pepper to the drink and give him Bach's Rescue Remedy for shock if available ( I stock it). I would offer OTC analgesics if available or a tea of willow and possibly valarian root and St. John's Wort to give for pain and to calm.

 

I would start several vitamin C tablets disolving in cool water or use Vitamin C crystals (which I stock as well) and get someone to stir it to make sure it's dissolved. I would then use cool to cold water to lightly drench the burns, starting with the worst and making sure the others were covered with cold cloths. I would be looking for pieces of charred wood, clothing, and etc and removing it from the burn if possible, using compresses to realease them.

 

When the wound is as clean as possible without causing undue shock, I would soak guaze or very clean cloths in the vitamin C water and lay it gently on the burns as compresses. For hands and fingers I would have DH hold the burns in the water itself. It's amazing how fast it takes the pain away. (This recommended to me many years ago by an old time doctor when our son seriously burnt his fingers on the vaporizers. We used it all the way to the emergency room and the only pain he had was when he removed his fingers from the water) [at the hospital they were amazed] I would change the cloths periodically and make fresh Vita C water as needed.

 

Alternatives for Vitamin C compresses are vinegar, black or green tea, oatmeal water, or milk. You can also use: fresh ginger, calendula, St. John's Wort, Lavendar, aloe, or plantain juice or tea on first or second degree burns. If needed I would use these on more serious burns but only if I had no vitamin C or milk.

 

Milk is very healing for burns, even serious ones but the compresses have to be changed every hour or two to keep them fresh. Change all compresses often.

 

After the innitial pain is controlled and healing begins (possibly many days later) I would use a light cream using Plantain, comfrey, nettles, marshmallow, St. John's Wort, horsetail, or red clover. All or a few or one, which ever I have on hand. You can do this by steeping the herbs in hot milk for fifteen or twenty minutes and keep refrigerated or cool and use as a lotion, or you can use an oil based cream. (I believe there are recipes in the formula section of NP) Aloe Vera, if you have it, also makes a good gel for topical application.

 

While the healing is going on I would try to see that DH had lots of nutritious vegetable broths for the potassium and would push all liquids as extensive burns can be extremely dehydrating. I would try to remember that burns are very painful, even after they have begun to heal and that pain and healing takes a toll on both the body and the mind. Love goes a long way to heal the mind AND the body.

 

((( )))

[Screaming Eagle]

Okay, this is the straight up medical approach to dealing with burns. It's from Paul Auerbach's Wilderness Medicine.

 

 

1. Remove the victim from the source of the burn. If his clothing is on fire, roll him on the ground or smother him in a blanket to extinguish the flames. If the victim has been burned with chemicals, gallons of water should be used to wash off the harmful agents. If the eyes are involved, they should be irrigated copiously. Phosphorus ignites upon contact with air, so any phosphorus in contact with the skin must be kept covered with water. Do not attempt to neutralize acid burns with alkaline solutions or vice versa; the resultant chemical reaction may liberate heat and worsen the injury. Stick to irrigation with water. If clothing remains stuck to the skin and does not fall away with irrigation, do not tear the clothing away. Cut around it.

 

2. Evaluate the airway. Look for evidence of an inhalation injury: burns of the face and mouth, singed nasal hairs, soot in the mouth, swollen tongue, drooling and difficulty in swallowing saliva, muffled voice, coarse or difficult breathing, coughing, and wheezing. If it appears that an inhalation injury has occurred, administer oxygen by face mask at a flow rate of 5 to 10 liters per minute, and transport the victim to a hospital as quickly as possible.

 

3. Examine the victim for other injuries. Unless the airway is involved or the victim is horribly burned, the burn injury will not be immediately life threatening. In your eagerness to treat the burn, don’t overlook a serious injury such as a broken neck. Control all bleeding and attend to broken bones before applying burn dressings.

 

4. Treat the burn:

 

First-degree: A first degree burn, such as a mild to moderate sunburn, may be treated with cool, wet compresses. If the burn is acquired suddenly (as when a child grabs a hot rock), immediate application of very cold water (not solid ice) may help limit the extent of the tissue damage. Oral administration of an anti-inflammatory drug, such as aspirin or ibuprofen, may provide considerable relief. For severe sunburn (“lobster body”), the administration of oral prednisone in a rapid taper (80 mg the first day, 60 mg the second, 40 mg the third, 20 mg the fourth, 10 mg the fifth) may be extremely helpful. Corticosteroids should always be taken with the understanding that a rare side effect is serious deterioration of the head (“ball” of the ball-and-socket joint) of the femur, the long bone of the thigh.

 

Topical corticosteroid creams or ointments are of no benefit in treating a burn wound. Anesthetic sprays that contain benzocaine work for a few hours, but may induce allergic reactions. They should be used sparingly. If no blisters are present, a moisturizing cream (such as Vaseline Intensive Care) will help soothe the skin. Aloe vera gel or lotion seems to promote resolution of extensive first-degree burns. Burnaid first-aid burn gel (Rye Pharmaceuticals), which also comes in an impregnated dressing, contains 2 to 4% melaleuca oil and is advertised to provide relief from the pain of minor burns and scalds.

 

Second-degree: A second-degree burn should be irrigated gently to remove all loose dirt and skin. This should be done with the cleanest cool water available. Never apply ice directly to a burn; this may cause more extensive tissue damage. Cool compresses may be used for pain relief.

 

After the wound is clean and dry, cover it with a soft, bulky dressing made of gauze or cloth bandages, taking care to keep the dressing snug but not tight. If antiseptic cream such as silver sulfadiazine (Silvadene) is available, it should be applied under the dressing. An alternative is mupirocin ointment or cream, or bacitracin ointment. A nonadherent dressing layer directly over the antiseptic is easier to change than coarse gauze. Another excellent covering is Spenco 2nd Skin underneath an absorbent sterile dressing. Spenco 2nd Skin is an inert hydrogel composed of water and polyethylene oxide. It absorbs fluids (so long as it doesn’t dry out), which “wicks” serum and secretions away from the wound and promotes wound healing. Other occlusive hydrogel-type dressings are NU-GEL (preserved polyvinyl pyrrolidone in water) and Hydrogel, which can absorb up to 21/2 times its weight in exuded (from the wound) fluids. Yet another covering for a burn is a layer of petrolatum-impregnated Aquaphor gauze under a dry (absorbent) gauze dressing.

 

Do not apply butter, lanolin, vitamin E cream, or any steroid preparation to a burn. These can all inhibit wound healing, and may facilitate infections with increased scarring.

 

Dressings should be changed each day to readjust for swelling and to check for signs of infection. Be certain to keep burned arms and legs elevated as best possible, to minimize swelling and pain.

 

Blisters should not be opened, unless they are obviously infected and contain pus (this will generally not occur until 24 to 48 hours after the burn injury). If a blister remains filled with clear fluid, it is an excellent covering for the wound and will minimize fluid loss and infection. There is no rush to remove charred skin from a burn wound. As the wound matures and dressings are changed, gentle scrubbing will lift off dead tissue.

 

A victim with large areas of second-degree burns may need to be treated for shock.

 

Third-degree: A third-degree burn should be irrigated gently and covered with antiseptic cream or ointment or Spenco 2nd Skin, and a dry sterile dressing.

 

If a first-degree burn involves more than 20% of the body surface area and the victim suffers from fever, chills, or vomiting, a physician evaluation is required. If a second-degree burn involves a significant portion of the face, eyes, hands, feet, genitals, or an area greater than 5% of the total body surface area, a physician evaluation is required. Body surface area can be estimated using the “rule of nines.” For an adult, each upper limb equals 9% of total body surface area (TBSA), each lower limb equals 18%, the anterior and posterior trunk equal 18% each, the head and neck combined equal 9%, and the genital/groin area (perineum) equals 1%. For a small child, each upper limb equals 9% of TBSA, each lower limb equals 14%, the anterior and posterior trunk equal 18% each, the head and neck combined equal 18%, and the perineum equals 1%. Another method to estimate involved body surface area is the “palm of hand” rule: The surface area of the victim’s palm without the fingers represents approximately 1 to 1.5% of his TBSA. All third-degree burns are serious and should be seen by a physician.

 

Wet versus Dry Dressings

 

If the burn surface area is small (less than 10% of total body surface area), then cool, moist dressings (not ice) may be used to initially cover the burn wound. These often provide greater pain relief than do dry dressings. If the surface area involved is large, however, dry, nonadherent dressings should be used, in order to avoid overcooling the victim and introducing hypothermia. Because the skin is the major thermoregulatory organ of the body, it is difficult for an extensively burned victim to control his body temperature, so great care must be taken when wetting down such a person. If the victim begins to shiver, the cooling is too extreme.

 

 

[Abigail]

Why do they say ice can cause MORE tissue damage? I haven't found this to be the case at all. Now the ice I've used is wrapped in clean cloths or in an ice bag; I've never used it directly on the skin; is using ice directly on the skin what's not recommended?

 

More info please...

[Lois]

Ice applied directly to the skin can damage skin by freezing, frostbite is also dangerous.

For sunburns apple cider vinegar works to cool the burn and prevent blisters.

For 2nd and third degree burns I would use cloths wet with colloidal Silver, silver will help with the pain as well as being an anticeptic. If you have miracle 2 nuetralizer it will controll the pain as long as the dressing remains wet with the solution.

[Screaming Eagle]

Abigail, I think that's what he's getting at. Ice directly to a burn will stick to the skin resulting in more damage. Even with covering, it's going to constrict blood vessels which slows down the body's natural healing mechanism by interrupting the initial fluids that initiate healing. Cool water will be more effective in the longrun.

[ro2935]

Applying ice to a area of a burn on a victim can cause serious problems, ie damaging exposed nerve endings, and sending someone who already in shock into deeper shock which can result in heart attacks or strokes,

Iced water is okay if you have burnt yourself getting something out of the stove but it is always much better to use luke warm water to cool a burn down slowly.

100% neat Lavender aromatherapy oil [not been diluted in a carrier oil] has been used on burns in europe for several decades, especially in France. The oil works in 3 ways Analgesic, Antibiotic, and relaxant promoting sleep. Can also be used on cuts & diaper rash.

My brother was burnt some years ago he had second and partial third degree burns to his hands lower arms and thighs, hospital used sterile water to irrigate the wounds light sterile dressings and light bandaging to hold dressing in place, they made no attempt to remove the burnt clothing from the wound as this would have caused further nerve damage, the irrigation of the areas 4 times a day helped to slough away the damaged tissue and debri. All blisters were left alone and he had intravenous antibiotics and pain medication, when he was allowed home 3 weeks latter he still had blisters on his hands and fingers, instead of dressings and ointments his hands were placed into large plastic bags which where lightly taped, it meant that the blisters were able to drain naturally with out becoming infected, his dressings & plastic bags had to be changed 3 times a day and it was then lavender oil was used neat, healing was rapid scarring minimal, some nerve damage still exists which causes him pain in exstream weather but the good thing was he didn't need any skin grafts.

In exstream circumstances where medical help is not available the two biggest enemies for someone suffering from serious burns is first shock followed by infection. Both hard to eliminate in restricted curcumstances.

[Mother]

re2935 Hello, and welcome to Mrs. S.

 

Thank you for that information. I did know about the Lavendar oil therapy but didn't mention it as it is not something people normally would have on hand. In the past lavendar tea was used as a compress for the same reasons but it's not as affective as a tea as the essential oil. Very few 100% essential oils are usable straight without a carrier oil. Tea Tree Oil is another of those.

 

The information about the plastic bags was new to me. I know they have bandages that mimic skin specifically for burns. A friend used them for third degree burns on her hands and arms. Were these bags specifically for use on burns? It might be a good idea to stock them if available.

 

Again, thanks and I'm glad you joined us.

 

((( )))

[Screaming Eagle]

Thanks for the info ro. And welcome to Mrs S. Looking forward to hearing more from you.

 

Anybody know how to make Lavender oil?

[Abigail]

Good to know; I suppose that ice packs have worked so well for me because I was only dealing with first degree burns, and because I wasn't applying the ice directly, but wrapped in clean towels; by the time the melting ice hit my skin, it was only cold to cool water...I did find that as the water warmed the pain returned, so I was continually changing my "ice packs" to keep the melting water cold to cool for that purpose.

 

By the next day, my skin looked perfectly normal; no blistering or scarring, so I don't know how to explain the ice treatment's success other than that being wrapped in damp towels, it was insulated enough to keep the very cold temps off of the skin surface, allowing the area to be kept wet with cold water.

 

I'm glad to learn of the difference in treatment with more serious burns; I'd probably have assumed my success with ice in treating minor burns to be relevant with more serious ones. Thanks for the lesson...

 

Hopefully none of us will have to deal with truly serious burns without medical help, but knowing what to do may save lives that would otherwise be lost. Great thread!

[ro2935]

I use arroma therapy oils often so I do have a extensive stock, the one thing I do like about lavender oil is it is the only oil you can use undiluted on a new born baby without it damaging the delicate skin.

Though tea tree oil can be used undiluted it can be harsh on some peoples skin. Both tea tree oil & lavender oil can be used onscraped skin [abrahasians] and cuts I would prefer to use lavender only on a deep cut & would only use lavender on burns.

 

The plastic bags used on my brothers hands were large clear plastic and was only used whilst he had blisters that began to weep, they were there to protect the wounds from infection whilst this happened. What did surprise me at the time the plastic did not stick to the wounds. Just remembered the other reason for the plastic bags was so he can use his hands [albeit very clumsily] he was able to pick a sandwich up, and when my father wasn't around go to the bathroom, though he must of been in pure agonny unzipping his pants.

My brothers accident happened over 20 years ago, when I was training to be a nurse and my understanding that some patients are sent home with plastic bags to protect there hands from being infected when in a very raw state. Plastic skin is fabulous but does restrict movement if you can get movement back into fingers and hands it stops the skin and muscles contracting which means less physio therapy latter.

The plastic bags in question were ordinary plastic bags that had never been used before, the thickish type you would use for the freezer.I have wondered if cling film/ seran wrap could be used to hold a sterile dressing in place & keep out further debri and infection.

[Mother]

Thanks for the info. Good to know that we could use that if needed in an emergency.

 

I like aroma therapy also but tend to have trouble with some smells even natural ones. Wish I didn't as there is a lot of benefit in that therapy.

 

SE You can start learning about distilling your own essential oils here:

 

http://www.wikihow.com/Make-Essential-Oils

 

There is more information out there too if you are interested. It's fun and it's good info to put in our medicinal bags.

 

((( )))