First aid treatment of burns

Third degree burns are painless? How does that work? I undertand that the nerves of the badly burned tissue are destroyed but there's gotta be an interface between third degree and less damaged or undamaged tissue where the nerves are healthy enough to send signals but damaged enough for those signals to be pain signals. Yes/no? What am I missing here?

BTW, great post. Thanks for the info.
 
awesome post man. I could have went my whole life without seeing picture number three. great stuff to know. I think I am going to put that in my pack book tonight.
 
Thanks Darren! Lemme tell ya, if you think the pic is bad, the smell never leaves you. Never.

Joel- That is true with those burns. 3rd degree are often painless, or numb feeling due to extensive nerve damage. The pain is from other areas of the burn that are 1st and
2nd degree.
 
First you DO NOT touch the pt, untill you are sure that whatever shocked him is no longer a threat. Make sure your safe. That is priority one!!!!!!


AMEN!!!! v
 
To the OP, unfortunately your advice is wrong.

All burns should be treated by applying cool running water for at least 15 minutes, and up to 30 minutes for certain types of burns (for example, where a hot sticky substance such as bitumen remains on the wound).
 
jh205 said:
To the OP, unfortunately your advice is wrong.

All burns should be treated by applying cool running water for at least 15 minutes, and up to 30 minutes for certain types of burns (for example, where a hot sticky substance such as bitumen remains on the wound).
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for first degree burns.

for second and third degree burns the OP's advice is pretty much correct. In my lifeguard training we were trained to wrap a more severe burn with sterile gauze and get the victim to a hospital as fast as possible. There's also a very high risk of the victim going into shock, so steps should be taken to minimize that.
 
jh205 said:
To the OP, unfortunately your advice is wrong.

All burns should be treated by applying cool running water for at least 15 minutes, and up to 30 minutes for certain types of burns (for example, where a hot sticky substance such as bitumen remains on the wound).
Click to expand...

Hey jh205,

Just curious - where are you getting your information from?

After a bit of checking around, it seems that j williams is passing on info consistent with the advice given by the Mayo Clinic and other authorities. In fact, I couldn't find an online site that recommended treating serious burns with cool running water. Of course, I'm no expert. Anyway, just curious.

All the best,

- Mike
 
SaMX said:
for first degree burns.

for second and third degree burns the OP's advice is pretty much correct. In my lifeguard training we were trained to wrap a more severe burn with sterile gauze and get the victim to a hospital as fast as possible. There's also a very high risk of the victim going into shock, so steps should be taken to minimize that.
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Let's not forget the OP is a professional paramedic.
 
jh205 said:
To the OP, unfortunately your advice is wrong.

All burns should be treated by applying cool running water for at least 15 minutes, and up to 30 minutes for certain types of burns (for example, where a hot sticky substance such as bitumen remains on the wound).
Click to expand...

Uh no. You are wrong. Look it up.

I believe I said that with first degree burns, and chemical burns.
 
Mentor- You are correct. My sources for my notes on my class were takin directly from the Mayo clinic site, as well as ABTLS textbooks, a burn lecture I attended, and personal experiance from me, and a few flight medics and nurses.:thumbup:

I would not pass incorrect info along to you guys, and after reading, sitting through lectures, and talking with professionals who are very wll versed in the tx of burns, I felt comfortable enough to put it all together so to speak.

Guys dont use dry bandages on severe burns. They will stick to the burn and cause more harm then good.

However I am not a Dr. I just listen to them.;)
 
jh205 said:
To the OP, unfortunately your advice is wrong.

All burns should be treated by applying cool running water for at least 15 minutes, and up to 30 minutes for certain types of burns (for example, where a hot sticky substance such as bitumen remains on the wound).
Click to expand...

Please do not pass on information (especially medical information that could effect someones life) if you have not checked to make sure it is true. This is not a treatment for burns past a mild burn (read first deg burns). As j williams stated in his first post there are can be some extremely serious consiquences for doing this on burns worse than first degree burns.

j williams

I was wondering about using water on powder chemical burns. I thought I was always thought to just scrape the powder off with something ridged (business card, 3x5 card etc) and not to use water as it could spread the left over powder, or possibly activate it and make it worse. Ill be the first to admit I haven't dealt with many burns past friction burns, and first and second deg burns so this could be incorrect.
 
j williams said:
You are gonna need to remove the cause of the burn by flushing the chemicals off the skin surface with cool, running water for 20 minutes or more. If the burning chemical is a powder-like substance, such as lime, brush it off the skin before flushing. Taking care to avoid splashing it up at you, or brushing it into Pts eyes or whatever.
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You are correct. If the substance is a dry powder(lye etc) it will need to be brushed off first. With some substances there is a neutrilizing agent, but without knowing the substances, I would just remove the substance and flush with water, and reflush as nessicary.
 
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If I were to do more of these, what kind of things would you guys like to see? Maybe a CPR thread? Spinal cord injuries? Heat and cold related injury?
 
Very nice post J.

I would like to see some of your comments in a new thread on wound management.
I think some comments on treatment of cuts and possibly compound fractures that break the skin surface under a wilderness context would be good.

Aspects relating to wound cleaning such as wound irrigation (what to use, how to improvise), best types of bandages and again improvised bandages, commentary about frequency of cleaning dressings and how to examine a wound during dressing cleaning for signs of infection, blood poisoning. What is the decision point for seriousness of a wound (e.g. amount of blood loss, area of the injury, signs of infection etc) to lead to initiating a distress call, or what can be managed.

Thanks
 
Thats a great idea bro. I will put something together, I think that that is a very pertinant wilderness medicine discussion.
 
Hey Jake... Cool thread. Ex-NYC EMT-D, here. Quick question, elevating extremities above the heart (long-term) won't cause you to go septic, will it? I forgot a bunch of my protocols :)

For personal consumption, I still keep a large container of silver sulfadiazine at the house.
 
Not to myknowlage it wont. Purpose of elevation is to help offset edema buildup. Thats an interesting question though, I am gonna look into that. I can see as maybe a long term consideration, but for first line, I think restoring osmotic balance is a bigger concern, which is priority in the first 24 hrs following a burn, as I am sure you know. Its easy to forget burn stuff isnt it? We just dont get as many burn pts to keep us sharp on skills and protical.

Not to mention the parkland formula can be a huge PITA w/o pumps. But as for our role in the TX of burns, I feel 500cc over the course of an hour is a great number, as we arent concerned with urine ouput, and central pressures yet. We are just trying to slow fluid loss, start restoring osmotic balance, and provide barrier to infection, and pain relief. Which reminds me. Never give IM pain meds to a pt. Give them IV. If you have the means to have an IV, or access to pain meds able to give IV.
 
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