Burn Treatment

[Submariner]

While it [Combat Gauze or equivalent] could be used as such, I don't think it is the best option. It may be the only thing in your IFAK, but if I was in a high threat environment I would save it if possible.

It also depends on what degree of burn it is. On severe burns, what are the chances of it leaving particulate matter in the burn? My company is trained to the UK standards of trauma medicine, and thus we love to use cling film on burns (saran wrap). We also have special burn cloths that don't leave behind lint, and sterile plastic burn bags for the hands, etc. But, our med kits are set up for major burns as often result from explosions. I would think for the average person, minor burns are the norm and probably on the hands.

I once received some 2nd degree burns to my hands and the US Army medic washed my burns with normal saline, and wrapped it with standard gauze. I think that was all he had with him, since he was using a CLS med bag.

Maybe we should start a discussion in the first aid forum on burns?

Good idea!

How are burns best treated?

[rob_s]

I'd like to know too. From brass burns on the neck & such all the way up.

[NinjaMedic]

Small burns, irrigate with copious amounts of saline or clean water, apply antibiotic ointment, bandage with sterile bandage.

Large burns wrap in dry sterile gauze and move that person the most expeditious way to the nearest burn center. I have called for helicopters less than a mile from a level 1 trauma center in order to fly them to the nearest burn center (BAMC). Big concerns are temperature management (hypothermia is a big problem with the patients so keep the person covered in a blanket) and compartment syndrome. IV fluids are important for these pt's but the worst thing you can do is give them fluids that are lower than body temperature. Also while sterile is preferred speed is the most important. The burn center is going to clean and debride the burned areas anyway and then put that person on IV antibiotics.

[cqbdriver]

What about Watergel? Any one have any experience with these?

http://www.waterjel.com/professional...urn-dressings/

[mkmckinley]

Small burns, irrigate with copious amounts of saline or clean water, apply antibiotic ointment, bandage with sterile bandage.

Large burns wrap in dry sterile gauze and move that person the most expeditious way to the nearest burn center. I have called for helicopters less than a mile from a level 1 trauma center in order to fly them to the nearest burn center (BAMC). Big concerns are temperature management (hypothermia is a big problem with the patients so keep the person covered in a blanket) and compartment syndrome. IV fluids are important for these pt's but the worst thing you can do is give them fluids that are lower than body temperature. Also while sterile is preferred speed is the most important. The burn center is going to clean and debride the burned areas anyway and then put that person on IV antibiotics.

Great post.

They make something called silvidine cream that you can slather on a burn before you dress it to combat infection but like NM said, for serious burns hypothermia is the biggest worry between the point of injury and the hospital.

[Danny Boy]

IIRC, the burn center at BAMC is kept at some swelteringly high temperature to help keep the patients from becoming hypothermic. After seeing some of the patients who have survived what appear to be some of the most horrific injuries, it is truly amazing what they are able to do there.

I was taught to clean wounds as best as possible without causing further trauma and to package them with rolled gauze and then roll them up the chain of care. We have the Watergel dressings at work, though I am yet to have a guinea pig to use on one.

[cqbdriver]

Actually, I did use watergel once when I accidently put my arm against my ATV muffler & left a quarter-size piece of skin stuck to muffler.

I can’t say if watergel did any better than the regular treatment. Only way to test would be to put my other arm against the pipe & compare the two. I decided may be next time.

[Iraq Ninja]

Many folks may not know that there is a free online version of Where There Is No Doctor. It has been awhile since I read it, and some of the material may be dated, but it is still a good source of info for austere environments.

Chapter ten has first aid and burns...

http://www.hesperian.org/publications_download_wtnd.php

[variable1]

Watergel is fine for smaller burns, but for larger burns dry sterile dressing is the best. Keep the chance of infection down, and conserve the PT's body heat.

[onado2000]

Depends on the type of burn and % body injury. In the field the key is to get the critical 2nd (blistered skin) or 3rd (full thickness) burn victim to a hospital asap. So first thing is to make sure the burning has stopped! Maintain ABCs and hemodynamic stability as with any other emergency trauma/medical call. Facial burns are also emergent situations due to swelling around the airway. These patients also need to be transported to a critical care area. Maintain airway and watch for shock, access large bore IV, keep pt. warm and NPO.
Silvadene cream is used on dead tissue to prevent bacterial /fungal infections on new skin growth (the silver prevents pathogens from proliferating in wound). There are many other treatments for burn victims; which ever is the latest & greatest will be used. Im a RN, I worked in critical care and in the burn unit. Here is one treatment used on a 2nd & 3rd burn victim; bath of warm water w/ Epsom salt, betadine & Mylanta (liquid).