Burn Emergencies

Written by PathologyPrevention
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My town is small and quiet. I’ve been a volunteer firefighter for two years, and it was only two weeks ago that I went to my first fire. It was in the middle of the night when my pager woke me. The tone of the dispatcher’s voice clearly indicated that this time it would be for real.

At the station, I put on my gear and off we went. Our engine was the first on the scene and there it was-flames and smoke pouring out of the entire first floor. We were told by the police that there was a child still in the house.

My partner and I took in a hand line and went up to the second floor for a primary search. It was hot and the smoke was thick. We found the child’s room and started looking.

Finally, when I reached under the bed, I felt a small hand touch my glove. I quickly slid the child and clutched her to my chest. I could see through my face plate that she was breathing, but I knew I had to get her out of there fast. We started crawling down the stairs. My partner radioed for the ambulance to meet us out front.

When we got to ground level, we found that the other firefighters had put out the fire and were ventilating the smoke. I had looked out through the haze but there was no ambulance. We went to the engine, and I put the little girl on the back step.

As soon as I took off my helmet and my air mask, I could see how red she looked and how hard she was coughing. She had black soot around her nose and mouth. There were burns on both of her arms and a small area on the side of her face. Her hair was singed.

Someone handed me an oxygen tank. I took out a nonrebreather mask and gave her 100% oxygen. After my partner removed some of her clothing, we could see that there were no further signs of burns. Just as we were taking her vitals, a stretcher appeared out of nowhere. It was quickly loaded, she was put into the ambulance, and off they went.

For a while I could hear them talking on the radio, but I didn’t pay much attention. I had to get back into helping the other firefighters.

I guess I helped save a life. The fire was on the news the next day, and a newspaper article said the little girl would be Okay.

BURN MANAGEMENT

Do not attempt to rescue people trapped by fire unless you have been especially trained to do so. You could easily become a victim yourself. The first priority in the field is to prevent further injury. Make sure that you are in an area remote from the fire. Keep in mind that it can spread rapidly.

Unfortunately, early emergency care is too often administered by terrified, well-meaning family, friends, or bystanders. Sometimes even the burn patient will attempt to care for the burn. One reason why burns are so often critically damaging or even fatal is that some individuals are poorly informed about methods of care. Instead of helping, they hinder or even hurt the patient.

Remember-a Health Guardian does not provide long-term care for a burn. A Health Guardian merely cares for the burn until the patient can be transported to a hospital or burn center for thorough treatment.

GENERAL EMERGENCY CARE

  1. Remove the patient from the source of the burn. This seems extremely simple, but it is surprising how many people fail to do this. If the burn was caused by a fire, take the patient as far away as possible without inflicting further injury. Get far enough away so that the patient does not inhale smoke. If the burn resulted from the patient lying in a puddle of chemicals, take the patient out of the puddle. If the patient was struck by lightning, get the patient to shelter.
  2. Eliminate the cause of the burn. Wash away the chemicals. Immerse scalds or grease burns in cold water. If cloths are on fire, roll the patient on the ground until the flames are extinguished. Douse the patient with water and remove all clothing including items that tend to retain heat such as jewelry and shoes. Do not remove clothing that is embedded in the burn. Never cover a burn with dirt in an attempt to extinguish flames unless it is the only available option.
  3. Examine for respiratory and cardiac complications. Check thoroughly to determine if the patient is breathing and has a pulse. If the patient is still breathing, look for signs of injury to the respiratory system. Be especially alert for the following signs:
  • Wheezing or coughing as the patient breathes.
  • Sooty or smoky smell on the breath.
  • Particles of soot in the saliva.
  • Burns of the mucous membranes in the mouth and nose.

If any of these signs are present, administer oxygen and be prepared to immediately assist breathing. The patient requires hospitalization.

  1. Assess the patient’s airway, breathing, and circulation as you would for any injury. Administer 100% oxygen, if you are properly trained and allowed to do so by local protocol. Maintain an open airway. Monitor vital signs continuously throughout the treatment. The patient’s status can change suddenly. For example, smoke inhalation causes progressive swelling of the airway and breathing can become progressively more labored.
  2. Determine the severity of the burn. Decide immediately how critical the burn is and how extensive the injury has become. Take into account the extent of total body surface involved, depth of the burn, age of the patient, location of burn, and possibility of preexisting or other injury. Although it is important to determine the severity of the burn, do not delay treatment or transport to do so.
  3. Determine the history-how the burn happened, what caused it, and what has been done so far to treat it.
  4. Cover the burn with sterile, nonstick burn dressing or sheet. If less than 10% of the body surface is burned, if the skin is not broken, and if the patient is not in a cold environment, then cover the burned area with cool wet towels or compresses. Never use grease or fat on a burn. Never use ice or ice packs on a burn. Note that the use of wet dressings on a burn is controversial in some areas. Follow local protocol.

 RELEVANT INFUSIONS

 Whole Body Protection®

 The Endocrine System Booster®

 The Epidermal System Protector®

 The Immune System Shield®

The Nervous System Stabilizer®

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