>> All right, so I have a story.
Bonnie works in a ceramics and so
they put everything in a kiln, right?
And so it gets super super hot like
thousands and thousands of degrees.
Normally it's pretty clear when they're unloading
a kiln, but for whatever reason
she looked over and there was like
a brick in her way so she reached over,
picked up the brick, realized it was 2000 degrees,
[gasps]
realized that it needed to go,
and just and in that moment you're like,
[escalting in tone] "a bah bah bah bah bah!"
And then you're just, she's fine,
she was fine. >> Yeah.
>> Everything's fine. >> Oh!
>> And then she just [imitates flame].
[laughter]
>> All of a sudden, Pink Floyd album cover.
[laughter]
>> I'm just picturing her eyes, just,
blink blink
and just smokes
as she's holding this brick.
-- CC BY REV MODIFIED BY BIZARRE MAGIC -- ♪ [upbeat guitar] ♪
♪ [vocal swells] ♪
[diagetic sound fades in]
♪ [triumphant chord] ♪ >> robot voice: Part four.
Burns and hyper slash hypothermia.
>> All right Daniel, Jenna, thanks for joining us today
we've got some EMTs here. >> I'm Brian.
>> Hi Brian, nice to meet you. >> Good to see you.
Good to see you, good to see you, good to see you.
>> You guys are going to be talking about sick burns.
>> Jenna: Yep.
>> The whole first, second, and third degree burns
I had to learn about when I wrote my book,
The Professional's Guide to Fire Eating,
but you were saying that you don't use
that classification anymore. >> Right.
>> You don't say sick burn, super sick burn, and your mama?
>> Right, a first degree burn
is now called a superficial burn.
>> Okay.
>> A second degree burn is a partial thickness burn
and third degree is now a full thickness burn.
>> Okay, so superficial, partial thickness
and full thickness. >> Jenna: Yes.
>> Now are the distinctions between those
and first, second, and third still pretty much the same?
>> Yeah.
>> So, only the labels, the labels
are just more descriptive now.
>> Jenna: Right.
>> So a superficial burn, if I remember correctly,
is largely thought of as like a sunburn.
>> Yep. >> Here, in fact we simulated
one over here.
Like this, right?
So, you're out for too long and this can happen from flames
the same way it does from the sun right?
>> Yep, yep.
>> So it doesn't go too deep, it doesn't do like
nerve damage or do any longterm tissue damage.
What separates this one from, say, a second degree burn?
>> Brian: Ahh!
[Brian and Jason yell gently]
>> Jason: Where I've spilled ice cream on myself.
>> Brian: It does look like that!
>> Jenna: [laughing] A little bit! Partial thickness, it blisters
and can ooze pus or blood, usually clear pus.
>> Okay so you can get scars from this
but you're not getting any lasting nerve damage
or something like that. >> Right.
>> I like the distinction, the clarification with the names.
Because superficial does imply that it's only
the outermost layer of skin that's being damaged
and that everything's going to be just fine,
you're not going to have any scars or anything.
Partial thickness, it does imply that it gets
from the epidermis down to the dermis.
>> Yes. >> And that you're going to have a little bit of damage,
possibly some scarring.
The real stuff is when like
you're cooking your flesh, right?
>> Right, right.
>> Which is--
>> Full thickness.
>> Full thickness, that-- >> Bam!
>> So- >> That's definitely just
black smudge on your body.
>> Jason: Well, I had this for industrial night at Elysium
I was going to get all gothed up and go, but--
>> So, it'll char first and then it'll get almost like
a yellowish tint because it will burn through
the epidermis, the dermis, and then you'll get into the fat-
>> The muscle tissue. [gasp] >> -and the muscle, and the bone.
>> Can we talk about spontaneous human combustion‽
Because like this thought that bodies would just
randomly explode or whatever, they found dead people
this is back in the 70s and 60s or whatever,
they would find just a leg gone
and just a charred stump there,
and they couldn't figure out, like,
"I guess it's something called"
"spontaneous human combustion!"
Later on, researched figured out that
with the cotton blankets people had on them
and they were smoking, >> Yeah.
>> They would fall asleep,
the smoke would burn into their body,
the fat of their leg would wick into the cotton,
and basically the whole thing became a slow-roasting candle
that would consume their flesh.
>> That's nightmarish.
[laughter]
>> You're welcome. >> I love it.
>> Don't smoke, kids.
>> Yeah, please don't smoke.
>> How do we treat each of these?
When you come onto the scene, the first thing you do
is I guess assess what type of burn you're dealing with?
>> Yep. >> Do you touch burn victims and figure out like,
"Hey can you feel this?" or...
>> No. >> Like when you're doing meat
and you're like okay.
>> Yeah, yeah exactly! [laughter]
>> How done, how done is it?
>> You my friend, are well done!
>> So, you come across someone with a first degree burn
like Brian's that needs treatment.
[adopting what might be an Irish accent?] >> A little baby, "Oh, I was eating some fire,
"and all of a sudden I burn my arm."
>> Do you just like give him a little kiss
on his arm and hand him a sucker and then send him on his way? >> No, no.
[laughter]
>> Well, officially we treat all patients the same-
>> Jenna: Yes. >> -and all injuries with the same
amount of respect and caution.
>> So what do you do when you see someone
that just has a first degree burn?
>> It depends where the burn is and
it depends on how much of the body is burned.
Usually, a first degree burn will heal on its own.
We don't really do much, you're welcome to put aloe on.
That is not EMT advice, we don't carry aloe in the trucks.
[laughter]
>> Just let the healing take care of itself
on a first degree burn, you want to be comfortable.
>> Jenna: Right. >> Maybe put like a cool rag on it or something.
>> Right, right.
>> But then you get this, you get some blistering,
you get a little bit of nerve damage maybe,
you get some bubbly nasty flesh.
>> Yeah. >> What do you do when you see
a second degree burn?
>> So, honestly...
>> You put a bandaid on it, you put a bandaid on it!
[Brian laughing]
>> Jenna: You can put a dry sterile dressing on it.
>> Jason: Dry sterile dressing?
>> Yes. >> So you wouldn't put like Neosporin
or anything like that? >> No.
>> Like antibiotic cream, or anything? >> No. >> Really?
Is this as a preventative to keep it from
getting contaminated with bacteria or whatever?
>> Yeah. >> Or... ? Basically, you just don't want it to get infected.
>> Right. >> Essentially.
>> But again, back to the body
just has to do its body thing.
>> Right.
>> Man, that's the disturbing part,
is like, you read some stories,
the guy who wrote the book Predictably Irrational
had such severe burning on one of his arms
that at one point, he was flat out given the choice
like, "Hey we think you'll have a better quality of life
"if we just chop that off."
>> Jason: Oh god!
>> And he said, "No," and so instead he's spent
years and years and years stretching his skin
and doing physical therapy.
>> That's impressive. >> And now as an adult
a behavioral economist, he actually says,
"Yeah, I don't know, I think I probably
"would have been better off just chopping that arm off."
>> Jenna: Oh! >> Jason: Oh god!
>> Like it's pretty wild, it's amazing.
>> That's insane.
>> Okay, so you don't have like an ax on you
where you're like, you see someone-
>> No, no, no, no, no. >> -with second degree burns and you're like,
"Got to go!"
>> No!
>> Well, you just don't know until it takes
years and years to figure all that stuff out.
>> We don't do field amputations,
that's for like the go-team
or the trauma team that can fly out.
>> Do you ever contract with any
freelance amputation specialists?
>> What‽
>> Or anything like that?
>> I did not know that was a thing.
>> Yeah, we'll talk afterwards.
>> Okay! [group laughing] >> My card.
>> Yeah, I don't want to brag, but...
>> Does anything change when you get to,
again, what did you all it, full contact burn?
>> Full thickness.
>> Full thickness. >> Yeah.
>> I don't know, I don't know about this whole
giving up the one, two, three, like-
>> Jason: You don't like it?
>> I can remember one, two, three.
>> It's more the medical field that has changed that.
Your average person can still say,
you know, first, second, or third degree burn,
and we'll know what you're talking about. >> Okay.
This is the kind of thing you're going to see
in the middle of like an automobile fire
or something where somebody's trapped
and it's actually burnt through their flesh.
>> Right, or a house fire.
>> Oh, jeez. >> Yeah.
A full thickness we might actually test
to see if you have a pulse, if you can move,
if you can feel, because of possible nerve damage.
With burns that are more serious,
you definitely have to loosen clothing.
If there's any constricting articles like jewelry,
you need to take that off because there can be swelling
and you don't want to, you know, lose a finger
because your ring stayed on there.
>> Oh that's a thing that can happen!
I hadn't considered that.
>> Swelling. >> Oh my god,
this is one of those moments
where it's like, you know, the person--
the victim is thinking like, "Oh, I hope I'm okay!"
and you're thinking like "Well, let's save that finger,
"let's save that wrist, let's just--"
>> Jenna: Yeah, yeah. >> Oh my god, that's horrific.
>> Yeah.
>> Okay, so, remove the jewelry,
and what, do you just wrap it up, or?
>> It depends on where at all you're burned as well,
because if you get full thickness burns
over a large percentage of your body,
you're actually dehydrated.
>> Especially your chest. >> Well, if you get them
around your chest, you can actually get it to where
the skin is too tight for your chest to expand.
[gasp] >> Oh wow. >> And you can suffocate.
>> So, you have to go to the hospital
and they'll actually make cuts.
>> So that you can breathe?
>> So that you can breathe.
>> So, they will lacerate your burned skin-
>> Daniel: Absolutely. >> -so that your chest can expand.
>> Oh my god. >> Yeah, getting a burn,
especially a severe one is nasty recovery.
>> Yeah, no, I saw Darkman, and the exchange it just,
it didn't, I don't think that-- I don't think it's even...
>> At what point do you call 9-1-1 for a burn?
Like, how do you know the difference between,
because we talked about my wife picking up a brick
and her fingers burning because she didn't realize
it was 2000 degrees, like at what point
do you know that you've got to go visit somebody?
>> Third degree definitely.
If it's a huge portion of your body, definitely.
>> If you see anything charred or blackened-
>> Right, right. >> Then go see
a medical professional immediately.
>> If you start to lose sensation
or you start to get cold because full thickness burns
actually burns off a lot of that protective layer
and you can actually get hypothermic,
and you even get dehydrated. >> Wow!
>> Really?
>> Yes.
>> And what about the nasty second degree slash
partial thickness burns?
>> Honestly that's personal preference,
>> Yeah. >> -if you feel like
you're starting to, again, lose sensation
or anything like that, if you're worried,
you might want to call for medical help.
>> But like this business is just baby stuff.
>> Yeah. >> Just you know,
rub some aloe on it, don't bother the EMTs.
>> Or, as a fair person, I love Solarcaine.
>> But it's not necessary for recovery
or anything like that, >> No.
>> That's just your personal comfort. >> That's comfort. >> Yeah.
>> It all turns down to like, either
your body will fix it or not.
You mentioned hypothermia, is that,
now obviously I don't expect most of us to have
massive burns over our body to cause hypothermia
but tell me if this is true. I heard once
that you could get hypothermia in water
as warm as like 80 degrees.
Like, just if you spend enough time in water
lower than your body temperature
at some point your core gets cold enough
and it becomes a problem, is that a real thing?
>> Absolutely. >> Yeah.
>> Really? Wow.
>> So you could sit around in like 80 degree water,
the human body is 98 degrees,
and so it's only a mere 18 degrees lower,
and you could still suffer from hypothermia from that?
>> When your core temperature becomes 95 degrees
or lower it is considered hypothermic.
>> What do you do when you encounter
someone who is hypothermic?
>> You slowly warm them.
You passively warm them. >> Brian: Do you give them a hug?
>> If they have wet clothes on,
immediately take them off,
because that will keep them cold. >> I assume the wet clothing thing is, you're still
getting a bunch of evaporation,
so they're continuing to lose temperature,
and I guess this would also apply to heat stroke,
where one of things that I dialed in on
when I read up on this stuff was,
remember that your body is just
a soup of liquids constantly moving around.
>> I'm picturing just a sock full of vegetable soup.
[laughter] >> That's your body!
There's a gizmo somebody made that was like
a cuff that you put your arm into.
When you get somebody out that's hypothermic
and its like, I don't know, 140 degrees or whatever,
but warm enough that as the blood comes in
it gets warmed up and then it spreads
to the rest of the body, and that made a huge difference.
Or likewise, on heat stroke, they say put a cold compress on--
you know, by your carotid artery, because your soup liquids
are running through your whole body,
taking the cooled down stuff.
Is there anything to that or am I misremembering stuff?
>> So, hypothermia,
if you have heat packs
or like a heated blanket or something like that
that would be considered warming passively.
If you have heat packs, even if it's just
those little hand warmers,
you would put them on the neck. >> Brian: Where the blood is,
where the body soup lives!
>> Right, but you can also put them in
your armpits. >> Brian: Yeah.
>> And the groin, because those
are where your major arteries are.
>> Those are the parts you want to save.
[laughter]
>> My pits and my bits.
>> My pits and my bits!
>> Got to save the pits and the bits.
>> "Doctor, I just need you to save my pits and my bits!"
Does that apply both for heat stroke and hypothermia?
Or are there different--
>> Yes, there are three stages on the way to heat stroke,
so there's the heat cramps,
as long as they're not nauseous you try and give them water,
and they need to sip it they need to not chug it.
>> Where do the heat cramps attack?
[laughter] I think of them as like enemies.
"We're the heat cramps!
"And we're coming to get you."
>> So, they can attack anywhere.
[laughter]
>> At any time, you're never safe.
>> At any time!
Like if you're out mowing the lawn
and you're out, like, and you have a big place...
>> Heat cramp could be hiding behind a holly bush!
>> Because you're in one position the whole time
and you're out and it's really hot
and you're not drinking any water, that's a big part of it--
>> So dehydration is a big part of it. >> Dehydration is what causes
the heat cramps. >> So this is all stage one
of being hy-per-thermic, right?
>> Jenna: Hyper. >> "Hyper" is too much and "hypo" is too low.
>> Yes. >> So hyperthermic versus hypothermic.
>> Yes, and the second stage is the exhaustion,
where you're going to be a whole lot sweatier,
you can start to get confused, you can be nauseous.
>> That's usually when I start sweating
I just get confused and nauseous.
>> Oh I just realized, you're teeing me up,
because at stage three like you stop sweating, right?
>> Yes. >> Is that a real thing?
>> Is that stage three? >> Yes, that is a real thing.
>> I heard about that in an X-Men comic
which is where I learned most of the things
that carry me through life.
>> No that is real. >> But its totally true,
you just stop sweating? >> That is real, yeah.
>> And likewise, with hypothermia I believe there's
a point at which you think you're terribly hot--
>> Jason: Oh, yeah!
>> And you'll start taking off your clothes, right?
>> Yeah, you think you're warm because
your body has basically given up.
>> Daniel: Yeah.
>> Holy cow! >> I read about the Russians that
disappeared at Dyatlov Pass decades ago,
they found them completely disrobed
out in the Russian mountains,
>> Yup, yup. >> amid snow and everything,
because they think hypothermia, freaked out,
took all of their clothes off, and died out there.
>> Holy cow. >> So, if someone
stops shivering, and it's really cold out,
and then they get sleepy,
you need to warm them up
as soon as possible, and one of the quickest ways
to warm them up is your body heat.
>> Yeah, so get your body on their body.
Maximize that surface area, too.
>> Jenna: Get naked, honestly. >> Jason: That's actually
a great technique. >> Get naked.
[laughter]
>> Oh, so, both people to get naked?
>> Yeah. >> Because you see that in movies and stuff.
>> Wait hold on, you're not even joking,
this is a real thing? >> No, I am not joking.
>> Oh that's wonderful! >> We're not going to do that
in the emergency medicine side. >> Right.
>> I notice that you're not- [cross-talk]
>> Both of you get naked and crawl into like
a sleeping bag or something like that?
>> Yeah, yeah. >> And they just absorb more of your heat?
>> Okay, I thought that was some sort of myth
>> No, that's real. >> or something that
creepy people used to get other people naked.
>> All right, now that we've opened this can of worms,
what about peeing on a jelly fish sting?
[laughter] Is that a thing? >> I mean that's not something we do!
>> You encounter a jellyfish in the wild- [cacophony swells]
[static]
>> First, second, and third degree,
those terms are out, now it's superficial, partial-
>> Thickness. >> Thickness,
full thickness burns,
pretty much with burns there's not much
you can do outside of make somebody comfortable
and protect them from getting an infection, right?
So, on this stuff you're not going to worry about it
maybe put some aloe, Solarcaine.
For this googly-eyed one, you're going to, what?
Just protect it from infection?
>> Yeah, you can put aloe, or Solarcaine,
I would stick to the aloe though,
because that's a little bit more moisturizing
whereas Solarcaine has alcohol in it.
>> And finally with the charred, the full-thickness burn.
>> Call 9-1-1, because there's a good chance
that you're going to get dehydrated
because the moisture will just
evaporate right out of that.
>> Meanwhile, on hyperthermia and hypothermia,
I would say starting at the extremes,
be very worried when all of a sudden
it becomes opposite day.
>> Yes. >> When all of a sudden
people are taking off their clothes
because they're hot when it's cold,
or not sweating when it's super hot.
>> Yep, yep. >> That's when you get super, super scared.
Remember that the body is a vegetable soup in a sock.
>>> ALL: Yep.
>> Make sure to apply either warmth or cold
to the parts that circulate and maximize surface area.
We're EMTs now! >> I think so.
>> We did it, we did it. >> Pretty much, we're good.
>> Thank you, thank you. Congratulations, congratulations to us.
>> Thanks, thanks. >> We did great.
Congratulations. >> Yeah congratulations
to you, thank you.
>> As always, your phone number is 9-1-1.
>> Yes.
>> Call it any time, just if you want to chat, it's great.
>> No. >> No. I love that.
[group laughing] >> Please do not.
[affecting disappointment] >> I love the--"no."
>> Not even as a joke, Brian... >> Don't do that.
>> If you want to learn more about
how to protect yourself in any kind of emergency situation
talk to your local fire department or your EMTs.
Are they really that friendly?
Are they cool?
>> Absolutely. >> Oh yeah.
>> Okay, so you could just show up and you're like,
"Hi, I want to learn more about being safe."
>> Yeah! >> And I guess they're all like,
"I guess there's no fires right now, so."
>> They're going to be like, "Modern Rogue?
"Yeah, get out."
[laughter]
>> Outside of that, [melodically] thank you.
>> Jenna: Yeah.
>> That was a bad ending, that's...
[imitating] >> Thank you.
That's how we end them all now.
>>> Thank you!
>> Jason: Seeing this drippy white goo though-
>> Brian: Yeah?
>> Jason: -reminds me of my idea, that is,
[proudly] brilliant.
[rising laughter]
>> Brian: Best part of the last 10 seconds was Bryce's
attempt to control himself!
[laughter] >> Jason: Really, maybe the worst way I've kicked off a conversation.