Cooking gas fires and burn awareness

Decades ago we entered the ‘space age’, but on the burn front we are still in the ‘stone Age’ especially in the developing and underdeveloped countries. Our forefathers discovered flint, we discovered petroleum, and natural gas- packed it and marketed it, but did we make it safe to use?

Not really!!+
Every year thousands of children, wives, husbands, fathers and mothers get burnt from cooking gas fires. The most common cause of fire is from a gas leak which catches fire from any source. Thousands are disfigured, mentally destroyed and physically handicapped from burn and undergo severe pain and suffering during years of rehabilitation.

We spend millions trying to make cars run faster, while our roads get smaller and congested as the number of cars on the road increase every year.

Is this logical??

The advent of globalization has its benefits. But price wars on products have led companies to make cheaper products, ultimately compromising on quality. We now use substandard products be it clothing that catches fire or electric wires that burn when the load increase. This trend must stop; quality must be standardized and not compromised if burn injuries and others are to be prevented. Companies involved in this field have a moral responsibility to make their product safe or at least support researches to find ways to make their products safe.

New technologies that will help to reduce burn accidents will need to be developed. We should install Gas leak detectors, smoke detectors and fire detectors in every house or place that use gas for cooking to help reduce the incidence of burns from cooking gas fire.

‘National burn day’ must become an ‘international burn day’. Schools, colleges, universities, shops, companies and all non-essential activities must stop on this day. Each and every individual must realize how burns occur and how it can be prevented.

Political games must rest for this day and for once politicians must join hands and minds and work on burn prevention and burn management strategies. On this day, the senate, the congress, the governors, all politicians and President Obama himself should talk and work only on burns. Burn awareness must culminate in a ‘burn awakening’.

If this is a dream, O God- please let it come true!

asktheburnsurgeon@yahoo.com

Burn area estimation or percentage of burns.

4) Dear burn surgeon, my son-in-law who is 34 years old was admitted to hospital with 22 % burns. Doc, is this a major burn and is it life threatening?
charulata s
sri lanka+
Dear Charulata,
You have raised three important issues:
1) What does percentage burn mean?
2) Why do we need to calculate the percentage of burn?
3) How do we calculate the percentage of burn.

1. What does percentage burn mean?
If we imagine and spread out the entire skin of our body it will cover 0.2-0.3 m2 while for an adult it will cover 1.5-2.0 m2 or 1.75 square meters approximately.
If we say that the face or the chest was burnt we will not have a clear idea about how much area is burnt, hence the area of skin burnt is mentioned in percentage as a standard for comparison. The entire skin area of the body is that is burnt is referred to as TBSA or total burn surface area.

2. Why do we calculate the percentage of burns?
Calculating the percentage of burns tells us if it is a minor burn, moderate burn or a major burn.

Minor burn- less than 10% burn area in children
-less than 15% burn area in adults
-burns that do not involve the head , feet, hands or perineum (genital and anal area) are included in this group

Moderate burn- burn area of 10-25 % in children
-burn area of 15-25% in adults
-2nd degree superficial burn of head, hands, feet or perineum are also included in this group

Major burn- burn involving more than 25%TBSA
others that are included in this group:
-full thickness burns more than 10% TBSA
-deep burns of the hands, feet, head, or perineum
-patients who have inhaled a lot of toxic smoke and suffer damage to lungs (smoke inhalation injury)
-high voltage electrical burns
-chemical burns

As the percentage of burns increases, so do the problems faced with management and healing of the burn wound. With increasing are of burn, more fluid is lost from the body and replacement in the form of intravenous fluids becomes a necessity. Thus children with more than 10% burn area and adults with more than 15% burn area will need to be admitted to the hospital for intravenous fluid administration. Furthermore as the percentage of burn increases, the rate of complications, sepsis or infection and period of recovery all increase. The availability of skin for skin grafting also decreases. Thus knowing the area of burn is extremely important before we start to treat the burn itself.

3. How do we calculate the percentage of burns?
The simplest way is ‘the rule of nine’ by wallace i.e. each part of the body is 9% or multiple of nine.



Head - 9%
Each upper limb - 9%
Anterior trunk – 18%
Posterior trunk – 18%
Each lower limb – 18% x 2
Genital area – 1%
Total =100%




This works well in adults but newborn, infants and preschool children have larger head, smaller body and lower limbs. The Lund and Browder chart accurately helps to calculate the burn are in these patients.

Lund and Browder Chart






If the area of burn is small and does not include whole parts of the body one can simply use the palm of the patient as representing 1% and calculate the burn area. For e.g. five palms that cover the area of the burn will mean 5% burn.
It is important to use the palm size of the patient and not your palm size!!!!!

Therefore charulata, a 22% burn is a moderate burn and generally should not be life threatening unless there is an associated serious inhalation injury to the lungs or there is uncontrolled infection.

Dear Burn Surgeon,
Can you please tell me about the first aid for burns and how to avoid burns in general?
Susan A.
California.
Watch out for my next blog for the answer!!