"pre-treated" burn victim

[SpongeDude]

Just tying to get some feedback-

You pull onto a scene where a pt. was burned (1st/2nd)degree on a good portion of his body- The person who got there before you tried to help and put burn creme onto the affected area. Is your next move to "wipe" the cream off and begin cooling the area? What is the easiest way to get teh creme off without further damaging the pt.?

[Ridryder 911]

First do the patient no harm... if it is not harming them, then I would leave it on. If it is 1'st degree, it won't really matter. The chances of you causing the more pain, and contaminating is greater. After the patient arrives in ER they will cleanse the area, and probably do some debridement as well as some SSD and tetanus, dressings.

Why temporary attempt to cleanse the area and cause pain to have it redone in a few minutes?...

Be safe,

R/R 911

[MedicMal]

so would the best thing be to just leave it on?

thanks,

MedicMal

[Ridryder 911]

I think I described yes.. leave it on, let them clean it off in ER...

R/R 911

[Doczilla]

I wouldn't mess with it. Any harm to be done by the burn cream has already been done, so wiping it off won't help, and as Rid pointed out, it's better not to further contaminate or damage the area or cause more pain. Just leave it there and treat as you normally would. It will be debrided in the burn unit or OR if needed.

'zilla

[Connie31079]

Rid, you crack me up sometimes!

I'm sitting here, laughing my ass off at your reply......"I think I described yes".....that's hilarious!

Thanks!!!! I needed a good belly-laugh today, you just gave it to me.

I'm currently in hour 15 of a 24 hr shift, and it's been nuts, almost wanted to cry a few times today, so a laugh was badly needed!!!!!

[skinut2234]

I hear what you all are saying but isn't the first thing you want to do is "cool" the burned area?

Would it not be in your best interest to wipe it gently off and then continue cooling with water?

[Dustdevil]

Is the patient on fire, or what? :?

Seems like every text I have seen in years very clearly says "dry sterile dressings."

If you have an isolated, minor burn area, then cooling is a valid option. However, removing cream would not be part of the plan. However, when you describe "a good portion of his body" being burned, attempts to cool the patient are likely to result in profound hypothermia. Not a good idea. Morphine would be a much better plan.

[Doczilla]

Once the burning has stopped (and by the time you arrive, it has), there is no benefit in cooling the skin. In fact, there is greater danger in hypothermia, since the skin's regulatory mechanisms are lost. Burn texts conflict in their recommendations as far as wet vs. dry dressings, but the practical and prudent thing to do is use dry dressings in the field. In hospital, it's dry dressings or moisture-control gel dressings over the silvadene.

'zilla

[Juice]

I have taken burn creme/ointment out of the first aid kits at work (30+ kits). People seem to think they should throw burn creme on right away when that can do more damage in the first half hour or so. The creme holds in the heat. A dry, sterile dressing is the best course of action and to help cool the burn, an ice pack on and off will help alleviate some of the pain. If the creme is already there, I would put a dry, sterile dressing over it to keep out contaminates and if the pain is too severe, maybe and ice pack on/off.

I do still have burn creme in the safety office and allow employees to use it on small burns or healing burns with a clean dressing. I have found that they respond well to triple antibiotic ointment instead of the cremes.

My .02