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Busting the myth of treating burn injuries

Avinash Singh Sudan, Sept 14, 2013, DHNS :

Applying ointment, oil makes matters worse for victims

Doctors say a lot of fluids should be administered to burn victims

Keeping cool is important in case of a fire. One should not panic and should try to follow the universal ways of combating fire as prescribed by firefighter and doctors — stop, drop, roll and cool.

‘Stop’ running or else it will fan the fire, ‘drop’ to the ground, ‘roll’ over to put out the fire, and pour water on burns to ‘cool’ them off.

Also, one should not do drive recklessly while taking a burns victim to a hospital. “A delay of 30 minutes to an hour is immaterial,” says Dr R B Ahuja, head of department of burns and plastics surgery at Lok Nayak Hospital.

There are two types of common burns — flame burn and hot liquid fall, especially children become its victim.

“Cold water is the best remedy for any type of burns, but never use ice as it can freeze tissues, which can cause more damage. We always prescribe intermittent cooling, when the burns is hot one should apply cold water. And one must be careful that it doesn’t cause hypothermia. The earlier sign of the disease is shivering,” says Dr Kuldeep Singh, senior consultant, plastic and reconstructive surgery, Apollo Hospital.

“One can cool smaller burns for long hours. But major burns like 50 per cent burns is difficult to cool off as the risk of the patient getting hypothermia is high,” he adds.

Doctors advice people not to apply any cream, ointment or oil on the affected area. “One should cover the burn with a clean cloth, and take the patient to a hospital. Creams or any kind of ointment are to be avoided as they mask the burnt area. It gets highly difficult to assess the depth of the burn, which mars treatment,” says Dr Karoon Agrawal, director of burns and plastic surgery at Safdarjung Hospital.

In the case of eye burns due to hot water, wash the eyes with copious amount of tap water for half an hour. “But if a chemical has gone into the eye then don’t splash water onto the eye. Water can drive chemicals further deeper. There is an eye drop called diphoterine, which can be useful in such cases,” says Dr Kuldeep Singh.

One should not try to remove synthetic clothes because they stick to skin. “It is advisable to cool the clothes off and then remove them,” he adds. “In case of electrical shock burns, an electrocardiogram test is a must as it verifies whether or not the current has passed to the heart.”

Physicians across the city are of the opinion that people in general are not aware of first aid when it comes to burn wounds.

“They arrive here after having taken wrong medications, which only makes treatment more difficult. Apart from toothpaste and ink being the common wrong form of ointment applied by them before coming to hospital, I have come across patients who apply mud and even cow dung. All this only ends up increasing infection and compromising the care we could provide. The rule is to pour only water, wrap the wounds with a clean cloth and bring the patient to hospital,” says Dr Agrawal.

People are advised to be careful while using electric home appliances like an iron box or electric cooker. “We need to ban the use of LPG cylinders and move on to piped gas connections. For the past three-four years, LPG has been one of the most common causes of serious burns. In the last one year alone, we had over 200 confirmed cases of these burns. In fact I would call them kitchen bombs,” adds Dr Agrawal.

Doctors say a lot of fluids should be administered to burn victims. “Water loss is maximum in the first eight hours of the burning. It is difficult to save vital organs of patients if they are brought to the hospital eight hours after the accident. So, while administering fluids, care should be taken to bring them to hospital soon,” says Dr V K Tiwari, professor and consultant at the burns department of Safdarjung Hospital.


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