Burns in the woods

[mrcharly]

There is a lot of discussion about treating cuts, but I don't see much about burns. I reckon most of us know to pour clean cold water constantly over a burn, but what next? Say if help is hours away?

I scalded myself with the contents of a kettle when I was 16. On the farm by myself. 2nd-degree burns to about 2sqr feet of my body, weeks in hospital.

A big 2nd degree burn is, erm, impressive. Think of skin, with gobbets of fat stuck to it, peeling off like steamed wallpaper, blister the size of a hand filling with yellow liquid in minutes.

 

[Melonfish]

ideally you need to keep 2nd degree burns under wraps, i.e. cling film. this stops the area loosing moisture in a pinch a plastic bag could possibly do the trick too
for minor scalds and burns i always carry germaline, oddly i use it an awful lot as i'm always burning my bloody fingers

 

[devonclarkey]

try to carry burn spray or flamazine if you can hope this helps

 

[lab72]

I tip cold then warm water on burns and do that for while .

 

[John Fenna]

Cool, cover - evacuate!
Any blister over the size of a 50p coin needs looking at by a professional....
If help is hours away get moving ASAP!

 

[Smith28]

I've heard many things about using Vaseline on burns, can anyone put this down simply for me?

I've heard it helps, but I've also heard it doesn't because it's a barrier, not a moisturiser.. Confused.

 

[resnikov]

Cool, cover - evacuate!
Any blister over the size of a 50p coin needs looking at by a professional....
If help is hours away get moving ASAP!

Is that an old 50p or a new one?

 

[v-ness]

This is good advice:

Cool, cover - evacuate!
Any blister over the size of a 50p coin needs looking at by a professional....
If help is hours away get moving ASAP!

I've heard many things about using Vaseline on burns, can anyone put this down simply for me?

I've heard it helps, but I've also heard it doesn't because it's a barrier, not a moisturiser.. Confused.

Please dont put any creams on anything but the most superficial burn- after it has cooled down. Moisturiser is good to aid healing and to reduce scar tissue, but creams on open wounds, which include burns are usually not a good idea.
I carry some clingfilm in my FAK, it folds down small and could be a lifesaver.

Cheers
Ness

 

[Barn Owl]

I carry burn gel and burn plasters for minor burns and scalds and they do work well.

Anything larger or classed as 2nd degree, as John says.

Never used vaseline on a burn or scald personally.

If out and you've no 'clean' water,remember and cover the burn with a waterproof barrier before cooling with the water you have.

 

[treefrog]

I get with water-jel dressings and can't recommend them enough. A couple of 10x10 dressings should find their way into any camp kit.
http://www.spservices.co.uk/product_info.php?products_id=1456&osCsid=j231qbjtd964nn6he2g6sgpk75 (no connection etc)

 

[daryl]

Burns

Well Johns advice was spot on.

The application of any 'potions or lotions' other than watergel or burnshield is a big no no. The use of creams to moisturise or reduce scarring will be advised by the recieving ED or burns unit so forget about that until reaching definitive treatment.

Cling film is a great burns tool however to points to remember when using.
1) cool the burn first,dont apply to an uncooled burn as it can in fact melt causing bigger more serious issues.
2) remember where possible to discard the first few layers of the roll to ensure maximum cleanliness before application
3) tear and apply in strips and dont wrap around limbs or chest as this could lead to circulatory restriction or respiratory difficulties.

Burns, whatever there area or severity = cooling with water, lemonade, milk or other ph neutral fluid etc. and where possible keep as clean as possible.
If severe or extensive, Remember Danger first, no good getting yourself burnt, Airway, ensure this is maintained , treat for shock, patients with burns lose massive amounts of fluid, leading to shock which is impossible to reverse without advanced skills and kit.
Lastly consider hypothermia, especially in children, that amount of cooling over a large area of the body on top of the loss of fluids will result in an increased risk of hypothermia.

 

[WeThePeoplexfbm]

i use burn gell ^^ but few month ago i went camping in summer was about 37 summer hot and walked around for 1 day without a shirt then went home and next day my back red and blubblein XD so pain full


---
Skipp

 

[Ronnie]

My family alway use aloe vera 99% gel on all burns with remarkable results. Run under cold water to take the heat out, then slap on the aloe liberally and leave to dry on. We keep a tube under the sink and one in the family sized FAK.

I've never used it on a really serious burn. Looking at the research, there are a lot of contradictory and often poorly designed studies with differing results. However, a meta analysis by Vogler & Ernst (1999) suggest Aloe Vera does help burns heal faster - including 2ND degree burns.

*.pdf copy of the research here:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1313538/pdf/10885091.pdf

Problem with aloe is that you can't patent it, so there's not much in it for the drug companies to promote it

 

[mrcharly]

I'm inclined to follow the advice of the trained people. Clean water or watergel only on 2nd degree or worse burns.

 

[Totumpole]

Being a Doctor I think Daryl has pretty much said it all.
The one thing I would add is burns to the face/neck/mouth/lips, singing of eye brows and nasal hair, canrbonaceous sputum (coughing up black stuff) are signs that there could be burns to the airway, which will compromise the airay extremely quickly (due to swelling), if this is the case they need urgent urgent urgent evacuation, these are the kind of people who may even need the old bic pen to the throat in a properly rural/emergency setting (if properly trained of course - please please please dont go stabbing anyone in the throat because I said so - I am most certainly not saying so).
Also don't burst blisters, they may do so in hospital, but in the field you want them intact as they still offer some kind of a barrier to nasties - most people who die with signifiacnt burns will die of sepsis (ie bugs rampaging around the blood stream causing multiple organ failure amongst other things).

As to what Ronnie is saying regarding aloe vera - I think yes, but any open wounds/blister I would avoid anything but burn gel in the acute setting. Cooling followed by clean clingfilm for anything with broken skin/blistering. I certainly swear by aloe vera for sunburn. I have fine Scottish extremly pale complexion, and burn easily - ie burt quite badly yesterday - yes in April!!! - I keep it in the fridge at home in summer, lovely cooling effect on the sunburn. In terms of prevention of sunburn, I'm sure I'm not alone in my haterd of suntan lotion. I tend to use Reismanns P20 (an oil that applied once lasts all day, is waterproof, but stains clothes) or Piz Buins 8 hr range is probably a bit nicer and perfectly effective for the average day in the UK (it does last all day, even after a swim).

Good thread, definately a topic worth covering. I cannot recommend first aid training highly enough, especially if you are going to be rural (ie far from help)

P.S. Just for those of you wondering about burns classification. 1st degree burns (aka superficial) = redness of the skin, painfull (involve only the outer layer of skin - epidermis), 2nd degree burns (aka partial thickness) = redness, blistering, exudate (oozing fluid), PAINFULL (involve the epidermis and dermis), 3rd degree burns (aka full thickness) = white leathery appearence, painfull at edges but no sensation in affected area (all sking layers and some subcutaneous tissues affected), 4th degree burn (full thickness with injury to muscle) = describes burns so deep they involve underlying muscle.

 

[ex member coconino]

I was on an outdoors-focussed first-aid refresher course at the weekend, so this is... er... fresh in my mind.

Apart from the usual stuff such as checking for hazards and other wounds, the advice is as per several folks above:

Priorities:

1. Cool the burn
2. Keep the burn sterile

The first priority is to cool the wound under running water for ten minutes (even if the only water available is a muddy stream, immediate cooling trumps being sterile), failing that, use whatever is to hand; milk, coke, or other cool liquid is better than nothing.

Remove any rings, watches, wristbands, which may cause constriction if the injury swells.

Cover the cooled burn using a sterile non-adhesive dressing and cover that with cling film, if available. Cling film can be used as the primary dressing as it won't stick to a cool burn and is likely to be sterile if unopened, but if there is any doubt, it is better to dress with a known sterile dressing and use the cling film to wrap over the dressing to keep dirt out.

• DO NOT touch the burn
• DO NOT burst any blister
• DO NOT use any creams, ointments, balms, etc.
• DO NOT attempt to remove clothing which has stuck to burn (apply dressing over stuck clothing).

Immediate medical treatment is essential if:

• the burn is larger than a 50p (or one inch square)
• the burn is to the palm of hand or sole of foot
• the burn is to the groin or above the shoulder
• the patient is a child.

Depending on the severity of the burn, other general considerations include to check the patient every few minutes for stress reactions (‘shock&#8217, and not to leave the patient alone.

EDIT: It probably goes without saying, but "don't touch the burn" also means don't try to remove ash, cinders, etc. which don't come away with the cooling water.

Also, Totempole's point (see message above) is really useful about checking for indications that there may be damage to the airway.

 

[_mark_]

Don't forget your pain killers as burns can be agonizing!

 

[The Lord Poncho]

I badly scalded my hand in an office accident a few months ago (basically I had a bit of a brain fart and washed my hand under a wall mounted water boiler). After running it under cold water for a good 30 minutes (and some phone based cajouling by the wife- she enticed me by telling me she knew a really attractive nurse who worked in the hospital!) or so I drove a short distance to the local minor injuries unit which happens to be part of the hospital that is one of the leading burns places in the country. They covered the scald with petroleum jelly soaked gauze (basically sterile Vaseline) - several layers, and then loosely bandaged over the top. As soon as the gauze was applied the pain pretty much disappeared instantly. I think they told me it was due to the air being occluded. I went back and they replaced the dressing with a same stuff a few days later, than after about a week I took it off. They gave me a tube of Vaseline to keep the skin moist thereafter basically to stop the dead skin peeling for as long as possible to allow healthy skin to grow underneath it first.

So in an emergency and if I was a number of hours from help, once I had cooled the burn, I would probably consider a loosely applied dressing covered in a thick layer of Vaseline if push came to shove.

But with the disclaimer that this treatment was given to me when my skin was unbroken- I’m not sure it would apply if the skin had already cracked- i don't know.

I was always taught in first aid not to apply any creams etc for anything but the most minor burn, otherwise once you get to hospital they would have to scrape the cream off first to inspect the burn- which sounds fairly unpleasant!

 

[Totumpole]

Don't forget your pain killers as burns can be agonizing!

very true!

 

[Paul_B]

Long time since I took first aid training but IMHO it is common sense not to apply any creams to any open skin in a first aid situation unless its those minor grazes you get as a kid. My understanding in burns it doesn't help and A&E need to remove what you put on before treatment anyway. That's for the more serious burns of course. I have burnt myself in camp a few times but only up to the blister stage and I find its easier just to get on with it after a short cooling spell with clean water. So far never had anything more serious than an open blister from burns. <touches wood after probably cursing myself to a nasty burn on next trip>

Also in industrial situations a lot of burn creams / sprays are not allowed these days. Heck you can't even use eye wash in a lot of companies. I guess that all is different as the first aider would be prescribing if using those items. I guess that is another consideration for the first aider anywhere to consider before applying anything other than dressings and clean water.

Good thread this. Always good to get good first aid advice from people and a forum like this will always have someone highly trained like a paramedic or doctor. I wonder if there are any other first aid related threads on this forum. Could be worth a kind of archive of good first aid advice however proper training is more important and I guess a site collating advice is probably not wise for them. Afterall there is no way online you could confirm someone who gives advice saying they are a paramedic with 15 years experience is really what he or she says. Other than if you have some knowledge and it sounds right advice to you.