Burn
It took some time to post another blog on Emergency. I have been busy with my licensing exam in Australia and I was not able to concentrate on writing at that time,
After a long pause since my last post, I thought of writing about an important topic which I came across at work.
This is Burn injuries and this post is mainly on children's burns, which I think would be helpful for the general crowd,
I was working at the Paediatric (Children) emergency department and a child approximately 6 8 months old was brought into the emergency following a burn injury. The triage nurse categorized the Child into CAT 2, (Which means a doctor should attend to the patient as soon as possible) took to the cold water shower and put the child into the cold water.
Importance - cold water will reduce further thermal injury and it will help to heal the already damaged tissue. Ideally, this should be done immediately after the burn and the water should be flowing and cold. Same time it is important to remove the clothes or the coverings worn which help to reduce the heat. But should be careful when doing that as some cloth materials can stick to the burnt skin and if try to remove forcefully it can damage further. So leave them for health staff.
It recommends washing with cold water for 20min and it would be beneficial if done at the earliest possible rather than rushing to the hospital unless it is life-threatening.
So, after the initial cooling, then comes to calculation of the percentage of burning. It includes the calculation of the surface area of the burn. The following image shows how to calculate the surface area
Then the thickness of the burn
Superficial - where only the upper part of the skin is involved - Painful and almost no scarring when healed
Partial thickness - Up to the middle layer of the skin - Can cause scarring
Full-thickness burn - Great tissue loss and no pain due to the damage to the nerves
In children if it is superficial and the surface area <10% can send home with a follow-up for dressing. but if it is more than 10% and involves hands and feet, most parts of the neck, face and circumferential burns, then need to take a specialised burn unit opinion
If the surface area > 15 - 20% doctors will start on IV fluid to replace the water in the body, also will apply Bactigraft (Vesline-like mesh impregnated with antibiotics) to cover the burn,
So, the burns can be minimal, none life-threatening and can be life-threatening and disfiguring. Especially in children, it is devastating to see how they suffer. It can change the whole future of the child. Therefore, parents need to be careful and look after their children from danger. Common reasons for childhood burns I have encountered are listed below
Spilling of hot water kettles or boiled cooking onto the body
Accidentally bathing the child in extremely hot water without checking
Touching hot surface by the child
Protect the children and keep them away from danger.
Remember the cooling area always after a burn!!!