Oh, I hope these cookies are done. Ow! Roy: Now let's talk about burns. Generally speaking,
there are three degrees most prevalent: first, second, and third-degree burns, third-degree
being the most severe and life-threatening. First-degree burns are characterized by a
superficial burn that's normally red and painful. The second-degree burn then develops into
a blister, while the third-degree burn is a full-thickness burn, sometimes noted even
with charring all the way down to the bone. The way we treat the burns is exactly the
same. Remove them from the source of the burn, A. B, cool the burn with water. And C, cover
the burn with dry sterile dressing whenever possible and get the patient or the victim
to the hospital. The bigger the burn, obviously, the more the complication. This is a fairly
large-size burn and we can see blisters, some popped and some not popped. The way we treat
a second-degree burn in this case is by actually cooling the burn, which we're going to show
in just a moment. The third-degree burn will be the same exact way, but we really need
to expedite getting this person to the hospital. If they had a burning agent that caused that
severe of a burn, we have to be thinking about what else might be going on. Was it involved
in a house fire? Did they get scared and inhale an enormous amount of heat? The singeing of
the nose, the mouth, there's soot on the tongue, means that they could have possible inhaled
that heat blast, and now we're going to be dealing with some swelling of the airways
in a short amount of time. So will they actually be in respiratory distress within the next
few minutes? These are all considerations we need to think about as we're looking at
the overall management of a burn patient. We also need to be thinking about the fact
that the larger the burn-- in fact, when it starts to cover percentages of the body--
this person is losing a lot of fluid, and they're also losing their heating and cooling
system. So the fact that we've already cooled them down with water, and the fact that they
are already wet, probably, if we had to put their clothing out with water, means that
they're also going to be running into hypothermic events, and that's something we need to be
mindful of the whole time while we're treating the patient, as well as looking for signs
of shock-- pale, cool, sweaty, and they might be losing consciousness. Now let's cover the
treatment of this specific burn, which is first and second degree. As we said before,
we want to make sure that we check the patient for any life-threatening complications: breathing
problems, decreased level of consciousness. If that happens, we're going to call 911 right
away. In this case, she's fine. She touched her hand to a hot item, and so it's isolated
just to the top of her hand. First and second degree, big blisters but not super-duper big
blisters, not the full arm, so though she's going to have some things to think about here,
it's not something that I'm going to be thinking life-threatening. In fact, in most cases,
even severe burns, as long as they weren't effected through respiratory, they're not
life-threatening in the first six, eight, ten, twelve hours of the actual injury. It's
all the later complications that start to occur like hypothermia, loss of fluids, and
so on. So in this case we're dealing with pain management, really. The cold water's
going to help anesthetize the skin. It's going to help bring some soothing to that area,
but as soon as we take it out from the water it's going to start to hurt again. So we need
to expedite getting this person to the med center, or even better yet, probably to the
emergency room where they might have a burn center available to treat it appropriately,
to reduce the chances of infection, and to help the patient with pain management. I'm
going to cool this underwater regardless of the degree of the burn until the tissues are
fully cooled and the burning has stopped. Now contrary to what might have been taught
in the past, we're really simplifying this down to one treatment: cover after we've cooled
it with a dry sterile dressing whenever possible and transport the patient to definitive care.
I'm still going to be watching this patient for signs of decreased level of consciousness,
signs of shock, and signs of complications with their breathing, but for the most part,
this is what we're talking about, and keeping this clean, keeping it minimally agitated,
not popping the blisters, and getting them to definitive care, is the idea when it comes
to burns.