Friday, September 24, 2010

Burn videos links on the web (how to treat sunburns, electrical burns, road accidents and burns, infection and burns, how to treat minor burns and scalds, first aid and minor burns, plastic surgery and burns, MRSA, antibiotics)

Dear Burn surgeon,

I found your website very informative. I saw a number of burn videos on YouTube but I was confused as there are no explanations many times. Could you suggest some good videos and advice?

Katie Jones,

Barbados

Dear Katie,

Thank you very much for appreciating our site. Asktheburnsurgeon is specifically written in a manner that both lay persons as well as burn professionals will understand burn management and is aimed at creating burn awareness and simplifying burn treatment in the community. There are a number of burn related videos available on the web which can be helpful. We have put together a few links below- and included our thoughts and comments on the video.

(Asktheburnsurgeon has no financial or other interest in the video links displayed on this page)

Electrical burns

There are two types of electrical injuries

1) caused by electrical flash

2) caused by direct electrical current

The electrical flash burn causes a burn injury, and in this type of accident the electric current does not touch or pass through the victim’s body. A flash or flame only affects him and he can be treated as a flash/ flame burn victim. On the other hand, in the direct electrical current injury patient, the electrical current passes through the body and this patient must be admitted and monitored in a burn ward as he may manifest problems and complications associated with direct electrical injuries even where no apparent injuries are evident. This is because the electrical injury affects the heart and severe changes in heart rhythm (arrhythmia) can lead to death if the patient is not kept under observation. Further other injuries like muscle damage and myoglobinuria (release of muscle protein in urine) which can block and damage the kidney may occur. Again, muscle damage may lead to compartment syndrome (tissue edema or swelling which causes reduced blood flow and ischemic injury).

Staffs who work with electrical lines and devices must be careful to avoid burns. Rescue officials have to make sure that all electrical currents have been switched off and it is safe for both the rescuer and the victim. Backup, ambulances and first aid experts in CPR, burns and injury managements must always be available in any rescue effort, if mishaps are to be prevented.

Electric burns will be discussed as a full article in a later issue.

Asktheburnsurgeon+

‘Wonder why some people make offensive comments at others misfortunes’

The following video link shows a rescue official getting electrocuted while trying to rescue a person who is on top of a high voltage electric pole.

http://www.youtube.com/watch?v=BtQtRGI0F2Q&feature=related

HOW TO TREAT SUNBURNS

has already been explained in our previous blog

http://asktheburnsurgeon.blogspot.com/2010/09/how-to-treat-sunburns-management-of-1st.html

The following video link tells you how to take care of sunburns.

1.How to protect your kids from sunburn

http://www.youtube.com/watch?v=4eyRQWwHZl8&feature=channel

2. Child Care & First Aid : How to Treat a Sunburn

http://www.youtube.com/watch?v=fon8W-hOCW8&feature=related

3. How to Treat a Sunburn

http://www.youtube.com/watch?v=4NPNS9lj73I&feature=related

Road accidents and burns.

http://www.youtube.com/watch?v=L1akPA1BxSI&feature=related

This video link shows a movie clip scenes where multiple road accidents occur simultaneously. To avoid accident and burn injuries, please read our previous article.

24 tips from asktheburnsurgeon on-How to avoid road accidents and burns at

http://asktheburnsurgeon.blogspot.com/2010/07/24-tips-from-asktheburnsurgeon-on-how.html

First aid and minor burns

This video link tells you about the first aid management of minor burns. Please read our detailed article on first aid and burn prevention before you follow other links

FIRST AID IN BURNS-FLAME BURNS, SCALD BURNS, CHEMICAL BURNS AND ELECTRICAL BURNS
http://asktheburnsurgeon.blogspot.com/2010/01/first-aid-in-burns-flame-burns-scald.html

Burn Prevention

http://asktheburnsurgeon.blogspot.com/2009/12/burn-prevention-1.html

watch?v=VZ3ImVUFT48&playnext_from=TL&videos=PSywr2Wk35E&feature=rec-LGOUT-exp_stronger_r2-2r-10-HM

asktheburnsurgeon+

Thursday, September 23, 2010

How to treat sunburns? (Management of 1st degree burns)

Dear burn surgeon, last weekend we spent a long time on the beach and my daughter had sunburn on her face. Now the skin is peeling off and I am wondering if we did not treat her well and is she going to have a scar?

Mrs Mabel

California.

USA

Sunburns is usually a first degree burn and does not need special physician care as first degree burns does not cause fluid loss and is not included in the calculation of burn percentage for fluid resuscitation. The patient usually has been exposed to sunlight for a long time as on the beach. The skin shows redness and when you press your fingertip on this area, there is blanching (skin becomes pale and pink again). The outermost layer of skin (epidermis) is intact but red. If there is blistering of skin then this is a 2^nddegree superficial burn and the management will be different as we have seen before..

Management of 2nd degree superficial burns- (2nd degree burns)
http://asktheburnsurgeon.blogspot.com/2010/01/management-of-2nd-degree-superficial.html

However patients with sunburns may have severe dehydration and should take plenty of fluid orally like water, juices or oral rehydration preparations. For small areas of sunburn, one should cover the area with a piece of cloth soaked in cold water. This will ease the pain and one can combine it with regular analgesics like ibuprofen, paracetamol, aspirin, diclofenac sodium etc. For burns that are extremely painful, a local anaesthetic like xylocaine can help. Avoid aspirin in children. For larger areas one can take a cold shower or soak in a bath tub. In children, this should be avoided for fear of hypothermia (abnormal lowering of body temperature). This can be followed up with applications of mild lotions or Aloe Vera preparations, or moisturisers. One should wear light and loose cotton clothing to avoid irritation of the burn area.

To avoid sunburns one should use a sunscreen with a SPF (sun protection factor) more than 25. If you are a fair complexion person, use one with an SPF greater than 45 to prevent sunburns. This burn usually heals in a week’s time.

First degree burns do not cause a scar normally and as the healing takes place the damaged epidermis may peel of slowly revealing the new epidermis underneath. Protect this new skin from sunlight by using a sunscreen and avoid direct bright sunlight for a few weeks.

So don’t worry Mrs. Mabel, your daughter should be fine by God’s grace.

Asktheburnsurgeon+

Thursday, September 16, 2010

Burns in the OR and how to avoid them.

Doctor my wife had back surgery and the next morning the nurse while checking her incision asked her how she burned her buttock because she had large blisters on it. She said she hadn't burned her buttock. The blisters burst that evening and they treated her with topical ointment. They kept her a 2 days longer then they had originally told her she would be able to go home. I took her to the family doctor and he just wasn't sure but thought they were 2nd and 3rd degree burns and prescribed Silvadene ointment which seemed to help it heal faster.
They won't give a explanation of the blister other then to say she scooted on her buttock and they were bed sores. She had these less then 24 hours after surgery and only was lying on her side in the bed.

Please give us your opinion.
Thanks for your help Sir,

J.B.

Dear Mr JB,
Thank you very much for your letter. I am sorry to hear your wife had a possible burn in the theatre. From the history it appears that this resulted after the operation. Whether it occurred in the theatre or afterwards in the ward prior to being noticed the next morning is difficult to say.
If it is did occur it the theatre, there are a few causes that can lead to this clinical presentation:-

1. Allergy to the scrubbing agent

Some patients are allergic to the skin scrubs or antiseptic that are used to clean the skin prior to surgery: like betadine , hibiscrub or cetrimide solution.
I have seen quite a few of these in some unfortunate patients. However they are usually 2nd degree superficial burns- with blistering on the following day and often tend to heal with conservative treatment i.e. dressings and local wound care.
Patients going to the OR must specifically be asked for any allergy to chemical and scrub agents.

2. Bedsores/ pressure sores.
Sometimes the patient is put in a particular position during surgery and due to the long hours of surgery pressure areas may show redness and blistering. Often this pressure area is superficial and tends to heal well with local wound care. Surgeons and OR staff must take great care to monitor pressure areas and change them if possible or provide extra padding.

3. Thermal Burns.
Electrocautery is used during surgery for the purpose of cutting tissue and coagulating blood vessels to control bleeding. When a monopolar cautery is used a cautery pad is applied over some part of the body to complete the circuit for the device to function. If for any reason there is a malfunction a burn may result over the area and skin pad to which it has been applied. If this is discovered early the burn may be superficial but often this is noticed when the pad has been removed after surgery and by this time the burn is normally a deep burn as every time the surgeon uses his cautery, probably the skin gets a burn. Deep burns of this kind often need surgical excision and skin grafting to heal the wound.

4. Thermal burns for the O.T lights.
In the past the lights used in the operation theatre generate a lot of heat and focusing the light on a area of skin for a long surgery sometimes resulted in a burn. In some patient who had a sensitive skin it formed a 2nd degree burn while in others it resulted in a 1st degree burn akin to a sunburn.
In recent times the quality of the OR lights have improved significantly and rarely does one see a burn for this source.

5.Thermal burns from materials used during surgery
Sometimes accidental burns can result from any hot materials used during surgery. If hot water is used for any purpose such as to soften a thermoplastic elements or otherwise and falls accidentally on the patient, a burn can result . This depends on the type of surgery and techniques used there in. However this is quite rare as surgeons and OR staff are extremely cautious when it comes to procedures that can cause burns in patients. High speed drills and mechanical devices should be used with care to avoid friction burns.

6. Lasers.
The use of laser can sometimes result in burn on the patients depending on the skin sensitivity, type of laser , intensity of the laser, the laser machine and the surgeons experience. Laser machines should be used carefully and always a test patch should be carried out before the complete procedure is undertaken.

7. Sticking tape allergy.
Many patients show allergy to skin tapes that are applied after the surgery is over. Prior history and allergy to skin tapes should be asked for. Similarly use tapes that are hypoallergenic and light on the skin. However these appears as redness or blistering when the tapes are removed and settle down and heal with local wound care.

I have put together a number of circumstances that can lead to burn like presentation in operation theatre. However surgeons and OR staff are well trained and take great care in preventing accidental injuries to patients entering the theatre. I hope that this reply is used only for educational purposes and is not for purposes of litigation or otherwise. Creating awareness among patients and medical professionals will help decrease these unfortunate OR incidents.

Asktheburnsurgeon.+

Saturday, September 4, 2010

Is the abnormal becoming the ‘norm’(al)?

When Edmund Hillary and Sherpa Tensing scaled Mount Everest in 1953, it was glorious moment in the history of mankind. Human abilities were pitted against nature, in a test of strength, determination and grit. In their success we rejoiced and applauded them and transformed them into heroes overnight. Over the past few decades human values, customs, traditions and perceptions have changed. In my youth, riding a bicycle meant going round the country side and enjoying the beautiful scenic views, the fields, the mountains, meadows, waterfalls, and lakes. We came home refreshed and ready to take on the next day. Ask any child today, what bicycle he wants and he will reply- one which can go up a mountain terrain or down the stairs, kerbs, planks and more. Simple old fashioned fun has been replaced by adventure’? To design a vehicle or device that will go up or down a mountain is ‘normal behaviour’, but to take a bicycle, motorbike or car and attempt this task is insane and abnormal even if it is disguised as an ‘adventure sport’! Abnormal venture promoters must be discouraged but the spirit of adventure must prevail within normal limits.

In the old days, pets were kept for fun- the pets had fun, the keeper enjoyed it and the people around admired the pets. This was supposed to be the principle and norm. Pets then were cats, dogs or birds that were safe and adorable. Visit any pet shop today and you will feel like you are on a safari- snakes, spiders, garials and others that will frighten you and make sure that you will never visit your friend who has one of them. Today’s TV programs on wild animals, show men playing with crocodiles, elephants, komodo dragons and snakes- we who encourage them and cheer them are responsible for their mishaps and deaths.

The Guinness world records have slowly turned from the normal to abnormal. For why should a man walk on his hands when he has legs or why should a man lie distressed in a tub of snakes when he can lie peacefully in bed? We have started to be abnormal to create records and society has started to promote these records- or abnormal events.

In the Roman era gladiators killed each other in an arena where spectators cheered. It took us some time to do away with this inhuman and abnormal sport. In present times we still have remnant of this sport – Boxing – where boxers attempt to bring their opponents down by hitting them. We stand around and enjoy this barbaric bloody sport, little realising the pain and suffering they go through and the brain injury which they suffer that will last a life time.

When Steve Irving died from the barb of a sting ray in Australia, it was a signal that the world ignored. We watched, shocked, petrified and guilty. Wild animals are supposed to live in the wild. We are part of their food chain. To take a tiger, a lion, a snake or any wild animals and try to live in harmony with it is wrong and ‘abnormal’ and can be likened to taking a guest to KFC and asking him not to eat the chicken!

For those who believe in religion, God made Adam and Eve to care, love, support and procreate. God did not make two Adams or two Eves. For the atheist, science confirms that men and women were made to be with each other, the anatomy supports this fact and if it were not so, man would have become extinct.

In 1993, when bill Clinton tried to lift the ban on homosexuals serving in the army through his ‘don’t ask don’t tell’ policy, he was attempting to legalise and normalise the ‘abnormal’. Since the evolution of mankind the ‘abnormal’ has always survived on the periphery. Our forefathers knew it but ignored and often turned a blind eye to it, but never accepted it as normal. Hitler used his mental abilities to wipe out a part of the human race but with the same Einstein solved the mysteries of the universe and unified the many branches of science with his ‘theory of relativity’. When rulers and nations join this band of accepting the ‘abnormal’ as ‘normal’ the end result can be catastrophic.

The use of alcohol in medicine, as an appetizer or accompaniment to food, or at a party can be considered normal but to get drunk everyday, loose ones senses and end up doing all sorts of things that one does not remember in the morning- has become the ‘norm’. Simple old fashioned partying has been replaced by drink, drugs and sex.

Promiscuity, alcohol, drugs, prostitution, gambling, homosexuality and more- we are promoting as the ‘norm’ and our children have begun to accept them as the normal. Artist paint with blood and body fluids and promote them as ‘art’. We have legalised prostitution in the hope of protecting our women. But did we really achieve what we aimed for? Perhaps we pushed more of them into this arena.

Cloning has been a dream for many scientists. Cloning of cell, tissue and organs is beneficial. Many diseases that cannot be treated successfully can be cured by replacing the cells, tissues or organs themselves. Dolly proved that cloning an animal was possible but showed the world that we understood very little of the many abnormalities- physiological and anatomical that would occur in this process.

Our scientists are attempting to clone human beings- they did not perfect this technique in animals?

Do we want to create abnormal babies and then decide whether they should live or die? Who gives us the right to play the terminator?

Creating ‘scientific wonders’ and ‘medical first’ has been a craze among our learned scientists. But to let a woman deliver at the age of 63 years and face the possibility of her dying at anytime in the near future leaving behind a motherless child, borders on the absurd. Besides we are nowhere with our creams, lotions, capsules and elixirs in our quest for living eternally.

As scientists, we sometimes plagiarise, copy research work, and put ourselves in papers we never contributed to: did we stop for a moment and think- what are we doing?

Scientists should be scientific and follow normal and accepted scientific methods. Their work and research must culminate into something that is not only scientifically accurate but also socially and morally acceptable.

As businessmen prosper and their businesses flourish, their principles change from normal to abnormal- for the men who make 5%, 50%, 500% or a 5000% profit on the same item they sell, all strongly believe that they are doing legitimate business.

Where do we draw the line which separates business and cheating?

Can we apply the same standards to the medical profession? We would definitely be charged with fraud and cheating!

A child is born innocent, but as he grows up, he observes that the evil and corrupt prosper, they become powerful, suppress the meek and appear successful. He begins to think that this is the ‘normal’ way of life. His thought processes and actions function is this direction. Unless he is made to realise the truth and learn to filter the right from the wrong, the normal from the abnormal, he will end up being part of the cesspool of corruption. In our fast life results and goals are stressed upon, the path is ignored. We need to teach our children that along the way we need to support and encourage our colleagues rather that to put them down. The path we take is as important as achieving the goal.

For what did Ben Johnson achieve? Though he won the race, he lost everything that he appeared to have gained.

For what did Saddam, the dictator of Iraq, gain when he plundered his nation and massacred his opponents? Cornered in a rat hole, he was hung like a criminal.

When bill Clinton became the president of the United States of America, he achieved the ultimate goal that few people could dream off. As he sat in power in the white house, he indulged in an ‘abnormal affair’ that destroyed his career and reputation and put him to indescribable shame.

Our forefathers lived in the wild; they were lawless but realized that normal values had to be set up if they and their future generations had to survive. They established a society based on these values, the normal was separated from the abnormal, so that every individual in the society knew when something seemed wrong. We are reversing the cycle, going downhill, from civilised to uncivilised, from culture to cultureless, from normal to abnormal; in vain did our forefathers struggle!

This trend has to be changed and the responsibility lies on the rulers of this nation, on the teachers, on the parents and on each one of us; to turn around tell our folks and children- let us do the normal, if not for us, for our future generations to whom we are accountable. We are living in an era which has the best of everything: from the first invention- the wheel to the best invention-electricity. We have travelled afar from the Stone Age to the Space Age, from unknown to the known, from darkness to light.

Let us not destroy what we have gathered so far in our journey through time. If we start discouraging the abnormal, the idea will sink into our kids; though it will take time, the results will be acquired, slowly but surely. Let our conscience be our judge.

We must act now!

Good must overcome the evil,

Right must replace the wrong,

Normal must replace the abnormal.

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Pages

Friday, September 24, 2010

Burn videos links on the web (how to treat sunburns, electrical burns, road accidents and burns, infection and burns, how to treat minor burns and scalds, first aid and minor burns, plastic surgery and burns, MRSA, antibiotics)

Thursday, September 23, 2010

How to treat sunburns? (Management of 1st degree burns)

Thursday, September 16, 2010

Burns in the OR and how to avoid them.

Saturday, September 4, 2010

Is the abnormal becoming the ‘norm’(al)?

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Friday, September 24, 2010

Burn videos links on the web (how to treat sunburns, electrical burns, road accidents and burns, infection and burns, how to treat minor burns and scalds, first aid and minor burns, plastic surgery and burns, MRSA, antibiotics)

Thursday, September 23, 2010

How to treat sunburns? (Management of 1st degree burns)

Thursday, September 16, 2010

Burns in the OR and how to avoid them.

Saturday, September 4, 2010

Is the abnormal becoming the ‘norm’(al)?

your donations serve to pay two young hardworking lads who constantly update this site.....

MAKE MONEY

Blog Archive

Followers

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