What You Should Know About Burns
IT’S hard to believe, but in some years nearly 12,000 Americans die of burns, and almost 100,000 are burned seriously enough to be hospitalized. “Although most people don’t realize it, this is actually an epidemic,” notes one burn expert. The June 1979 Reader’s Digest made the startling claim: “Burns now rank as the main cause of death for those under 40, and the third-leading cause of death for all age groups.”
You may think it will never happen to you, but statistics point to the real possibility of your being a burn victim. And if you are, it probably will happen suddenly, without warning. What should you do? Can you do something to minimize, or possibly even nullify, the damage?
Yes, you can.
Cold for Burns?
An editorial in the July 1976 Burns magazine observed: “Many burns cases arrive in hospital with little or no proper first aid. The evidence continues to mount that adequate and immediate cooling of burns is the single most beneficial procedure in or out of the hospital.”—Italics added.
Until the 1960’s, first-aid literature generally ignored this simple treatment. In fact, many persons would tell you that you should not put cold on a burn, because it will drive the heat in farther. Even today many don’t realize the importance of immediately cooling a burn. Somehow it just isn’t emphasized. Explained one burn victim: “At the burn center the staff would talk to patients a lot about prevention of burns and about first aid, but not a word, that I remember, was said about using cold water or ice.”
Interestingly, in 1960 Dr. Alex G. Shulman wrote in The Journal of the American Medical Association that the use of cold for burns was “known to the ancients but seems to have been ignored by physician and layman alike. Although scattered references in the literature are unanimous in praise of this form of treatment, it is not generally used today. Indeed, most physicians say ‘it isn’t done,’ although no one quite knows why.”
At the time of their accident, many persons did not know of this first-aid measure. Some have since wondered whether their injuries would have been so severe if such first aid had begun immediately. A recent issue of Family Safety notes: “Cold water stops the destruction of tissue that can continue long after the burn is received.”
The Value of the Cold
Back in 1966 the Awake! magazine brought to public attention the value of cold for burns.a Quoting Drs. Omero S. Iung and Franklin V. Wade, it explained: “When a burn occurs, not all the damage is produced at once. The pathological process continues. . . . We believe that the cold application can slow down and even stop this sequence of events.”
Also in that Awake! magazine, Dr. Stephen R. Lewis’ successful method of treating burns was reported. He said: “Our general plan on the small burn where it involves just a hand or lower extremity is to simply put them in ice water for fifteen minutes. This should relieve the pain and generally does. . . . Take them out in fifteen minutes, and put them back in and out, until the pain completely disappears out of ice water. This usually occurs within a period of about three hours using ice.”b
In the months after this article was published, Awake! received letters from appreciative readers who had applied this treatment with beneficial results. A mother from California wrote:
“On a Sunday my son decided to weld the shock absorbers on his car. The hydraulic cylinders got too hot and exploded, covering the whole top of his body with boiling oil. My first thought was that article. I remembered that cold water was the best, so while my husband kept running cold water over him, I looked the article over quickly to verify it. Then I called the doctor. . . .
“He didn’t give me any other suggestions as to treatment. . . . So we kept putting the ice-cold towels on him, as he was still in shock and the heat was radiating from him so much that the towels would be hot in a minute. To make a long story short, the next day he looked horrible, with huge blisters all over his face and arms. But in one week he had all new pink skin; it was unbelievable. I know the cold water had a lot to do with it.”
Another letter received was from a couple in Michigan. The wife describes:
“As my husband was mixing the last batch of mashed potatoes on Sunday [during a convention of Jehovah’s Witnesses], he spilled scalding water on his chest, face and arm. His upper clothing was removed and the brothers, using the information in the ‘Awake!’ article on burns, packed ice on the burned area. They kept this up for quite a period of time. I drove him home and continued the ice and cold-water treatment until the pain left. All that was left for the doctor to do was check the area.”
The quick application of the cold evidently arrests the progress of burns and prevents them from developing into deeper, more serious wounds. As Dr. Shulman wrote: “My experience indicates that, whatever the subsequent management may be, those patients who receive initial ice water treatment fare better than those who do not.”
In severe burns, however, caution in using this treatment is required. Too much cold to large areas of the body can bring the body temperature down too much, causing shock.
Emergency Fluid Replacement
If medical help isn’t available within the half hour, to prevent shock from fluid loss a burn victim should be given a solution of salt and baking soda to drink. Mix one teaspoon of salt and a half teaspoon of baking soda in each quart of water. This solution will approximate the kind of fluid the victim’s body is losing.
In the past, blood transfusions have been recommended to counteract shock in burn cases. However, the medical textbook Current Therapy 1972 states: “Except in those patients who have associate injuries responsible for direct blood loss, whole blood is unnecessary.”
Fine Progress in Treatment
Back in 1963 the Industrial Medicine and Surgery magazine observed regarding extensive burns: “The accomplishments have been reflected chiefly in the prolongation of life, and not in the over-all survival. The mortality rate has not changed significantly in the past 50 years.”
For many years the problems encountered in treating burn victims seemed unfathomable. Patients usually died regardless of the efforts to help them. Thus few doctors were inclined to devote the time required in caring for burn patients, and, sadly, burn research was practically ignored. Until 1960 the only place in the United States equipped to handle the badly burned was the Brooke Army Medical Center in San Antonio, Texas.
Today up to 200 or so of the more than 7,000 hospitals in the U.S. have burn units. In addition, there are about 15 specially equipped burn centers where a large team of burn specialists are available. Burn victims today can be grateful that significant strides have been made in treating burns, and that there is a good chance that a well-equipped treatment facility is nearby.
In the mid-1960’s a major breakthrough was made in controlling infection in burn wounds. A dilute silver nitrate solution was introduced that inhibited bacterial growth, without damaging living tissue. About the same time new creams containing silver sulfadiazine and other sulfa compounds also began to be used successfully in combating infection. The December 1978 Burns magazine notes that, in China, vegetable extracts of a complex nature are applied to burns, and that these have a good antibacterial action.
Fine progress has also been made in recent years in managing burn patients’ unique nutritional needs and in replacing their fluid losses.
Improvements, too, have been realized in methods of skin grafting. Skin taken from uninjured parts of the victim’s body can now be greatly enlarged by perforating and stretching it, and then applying it as a mesh over the burn. To provide temporary covering of the burned area, pigskin or skin from human cadavers are commonly used. Also, amniotic tissue is being used as a dressing for serious burns, and progress is being made in constructing an artificial skin from animal tissue.
With the progress that has been made, even persons with deep burns over 50 percent of their body now have a good chance for survival if treated in a facility equipped to handle burns. But how much better it is to avoid being a burn victim! Burn experts say that 50 percent or more of all burn accidents could be prevented. There are some simple precautions that we can all take.
First of all, if you are a smoker, it would be wise to stop smoking. The January 1976 Burns magazine observed: “Matches and tobacco have been pointed out as the commonest cause of fire.” And the acting director of a burn unit, Dr. Carlos Silva, said that the single most frequent cause of severe burns is smoking in bed. Explained one burn victim: “At the burn unit where I was treated at least three or four of the 18 patients had been burned while smoking.”
Yet statistics indicate that fire is not the cause of most burns. Hot liquids are. And scald victims are very often small children. Most of their burns, however, could be prevented if hot fluid had always been kept out of their reach, if they had not been left alone with hot bath water, if the handle of a pan containing hot liquid had not been left protruding over the edge of the stove, and so on.
One wise safety measure would be to adjust your water heater so the water from faucets will not scald anyone. The United States government last summer made it unlawful for water in commercial buildings to exceed 105 degrees Fahrenheit (41° C). Following that precedent would not only conserve precious energy but perhaps prevent a serious burn accident in your home.
Basically, it is a matter of forethought. When you enter a public building think of how you will get out in case of fire. People almost invariably try to leave the way they came in, resulting in a jam-up, and death. In Chicago’s Iroquois Theater disaster many years ago, of 10 available exits, only three were used—575 died!
What about your own home? If there were a fire there tonight, how would you get out? A window is usually the best escape route, especially when you are awakened at night. A fire fighter advised: “When you get to your room tonight, close your eyes or put on a blindfold and try to find your way over to the window. Then see if you can open it.” In case of fire, your life may depend upon your being able to do it quickly.c
If all of us were more conscious of preventing burns, and knew how to treat them immediately if they occurred, fewer persons would become serious burn victims.
a Awake!, July 22, 1966, pp. 12-16.
b Burns—A Symposium, 1965, compiled and edited by Drs. Leon Goldman and Richard E. Gardner.
[Blurb on page 18]
Shock can result from too much cold to large areas of the body
[Blurb on page 18]
Give burn victim a drink of baking soda and salt in water if medical treatment is not available soon
[Box/Pictures on page 19]
TO PREVENT BURNS
Do not smoke in bed
No handles over edge of stove
Do not turn hot-water heater too high
[Picture on page 17]
Apply ice water to burns quickly