[Sca-cooks] Treating burns- was Re: kitchen accidents

[Saint Phlip]

On 6/22/06, Stefan li Rous <StefanliRous at austin.rr.com> wrote:

> For you first aid folks, Phlip?, should the water be just cold
> without ice in it? Should you avoid using ice by itself or ice in the
> water?

The idea of using cold water for a burn is to stop the initial
burning. Like a roast, the body politic keeps burning until the temp
is neutralized. Ice water is ideal, initially, because it stops the
burn FAST, but anything fairly cool will help.

There are difficulties, however- if the burn covers a large area, too
much cold water can send the person into shock. As a general rule, if
you get a burn bad enough that you jump into a swimming pool ;-),
don't stay in very long.

Ice water is actually not ideal, other than for the first couple of
minutes, stopping the burn. As a Chirurgeon, when I ice an injury,
it's ice in a baggy, then a layer of paper towel, then the injury,
because you don't want to give the pt frostbite, particularly not at
Pennsic in August ;-0. Ice is useful because it remains cool at a set
temperature for a decent length of time, and is relatively easy to
package, but the ideal would be a tub of cool water, large enough that
it will act as a heat sink. It's also helpful if you can elevate the
injury above the level of the heart. However, it's not necessarily
convenient to wander around with a 5 gallon or so bucket, particularly
not help over your head ;-). And, the part of the instructions the pt
never seems to hear, is soak or cool for 10 minutes, then stop for 10
minutes. Since they never seem to hear that, the layer of cloth or
paper towel prevents them from overdoing. We forget that ice also has
a numbing effect, allowing you not to notice you're giving yourself a
second injury ;-)

A hose or a faucet with running cool water is good, too, but one
consideration is avoiding peeling the flesh of the injury away from
the person. One way to do that is to have something between the water
and the injury to deflect the force of the spray- putting your hand in
the way of the spray and letting the injury get the water that is
gently dripping/trickling off the hand will wash and cool the injury
without blasting the flesh off of it.

The way the EMTs and Squads will treat a serious burn in by wrapping
the person in a sterile dressing and cooling with sterile water, but a
clean dressing (say, a sheet) and reasonably clean (say, tap) water
will do as good a job until the person gets to advanced burn support.

When I'm teaching smithing, one of the things I teach my students is
to immediately dunk the burn in the slack bucket (bucket of water I
keep by the forge to cool steel quickly), and I explain to them that
there's nothing in it that will poison them, for all it looks murky.
There's just borax, rust, and charcoal ash, none of which are
poisonous or likely to trigger an allergic reaction. I also keep a
second bucket of clean water a bit further from the forge, not only to
get/, but because it will also stay cooler- the slack bucket will get
heated up over the course of a day.keep the injury and the injured
person away from the forge.

Getting back to specifics, when Aeduin had the pitcher of ice water
handy, that was as ideal as he could possibly do under the
circumstances. When the burn got hot, the ice water cooled it off
quickly. I wouldn't have wanted him to soak in it for more than a
couple minutes. Perfection, of course, would have been to get away
from the situation, get the burn treated properly, and relax and maybe
drink a cold drink, worry about things tomorrow ;-)

> Recently when the electric window in my car got shut on my
> thumb, I tried the glass of ice, but couldn't keep my thumb in the
> ice for very long at one time. My thumbnail is still nice and dark
> blue. I thought it would be a stripe of blue but it just keeps
> getting bigger. :-)
>
> Stefan

OK, you did the right thing Stefan. Particularly with your diabetes,
I'd be very concerned about the ice messing with your blood
circulation. The idea of applying ice to an injury is to slow down the
body's response to the injury, and minimize the swelling, which if
excessive, can produce an additional trauma by itself. Rather than
ice, ice water, in for a minute or two until the pain stops or is
considerably reduced, then out for a few minutes, then back in for a
few is the way to go. One of the big things about dealing with a
trauma of any sort is to listen to your body. If the treatment becomes
more painful than the injury, stop the treatment, and, if you feel
it's serious enough, get professional medical treatment.

As far as your thumb, part of the problem is that the thumbnail
prevents the injured flesh from expanding in that direction, so the
bruising has to go somewhere, and that's back to the body's response
to the trauma causing more trauma in itself. Same sort of thing that
happens in a concussion, when the brain swells and has no place to go,
or in a horse hoof, where the swelling there has nowhere to go. But,
Stefan, I think you'll live- just keep an eye on it, and seek medical
attention if it suddenly seems to get worse.

-- 
Saint Phlip

Don't like getting old? Beats the Hel out of the alternative.

The purpose of life is not to arrive at the grave, a beautiful corpse,
pretty and well-preserved, but to slide in sideways, thoroughly used
up, totally worn out, proclaiming, "Wow! What a ride!"