Use of normal saline for burns

[0586215764]

I have a burning question. pardon the pun. when you are treating a burn is it ok to use normal saline from like an iv bag to help cool the skin. obviously you would use sterile water or any water for that matter, but one of the girls i work with said that the saline will burn them. i called a burn center and they said because its isotonic it wont burn. either way i would love an answer to this and settle the argument.

thanks alot!!

[Chief1C]

Does it matter? Both, our bottles and IV bags are .9% Sodium Chloride. I prefer to use NaCl for irrigation, when covering broken or damaged tissues. I'll use sterile water to flush away dirt, etc, however. It is easier to obtain the bottles, locally, where as the IV bags would have to be ordered. We keep bags of NaCl in our burn kits, just because they fit better than bottles.

[chbare]

Depends on the type, size, and depth of the burn. You could send your patient into hypothermia if they have major burns.

Take care,

chbare.

[CBEMT]

Depends how much BSA is involved.

Over 10%, you shouldn't even be thinking about irrigation.

[kevkei]

Depends how much BSA is involved.

Over 10%, you shouldn't even be thinking about irrigation.

Sure you should, you need to stop the burn process.

[AnthonyM83]

I think the original question was for burns that you will be irrigating, plain water versus NaCl, whether from bottle or IV...

[Ridryder 911]

According to American Burn Association, you are to only stop the "burning process", this does not mean to "flood or irrigate" to produce hypothermia. Sterile water, saline both or either can be used, even clean "tap water" if that is the only fluid possible to "stop the burning process". Saline usually feels "cold" to burn patients instead of "stinging".

R/r 911

[Dustdevil]

It sounds like a case of "a little knowledge is a dangerous thing" with this girl. :?

I suppose she has the smallest bit of an insignificant point, but not one that is applicable to the situation you are describing. Ever get sweat in your eyes? Did it sting? Yep, it did. So I can see how she might logically (but erroneously) infer that saline would "burn" on unprotected skin. That is giving her more credit than she probably deserves though. She probably just heard this from some other moron and decided she'd wow you with her super knowledge by repeating it, without any real knowledge or education on the subject. And, of course, "burning" is not the same thing as a stinging sensation, so I hope that she was referring to that sensation, and not a physical process.

But the eyes are not the same thing as skin, even damaged or interrupted skin. Consequently, a more appropriate (although still very rough) analogy to the sensation of burned skin would be that of mucous membranes. So, try this; put some saline in your mouth and tell me if it "burns" you. Of course it doesn't. And your mouth isn't even on fire to begin with. So now, with that in mind, do you really think that saline is going to burn your already burning skin? Probably not.

The only skin you should be pouring water or saline on is those that are still hyperthermic or in the burning process. At that point, it is impossible to cause any more burning (or even stinging) with saline than is currently taking place (assuming the saline hasn't been sitting all day in a closed up truck in Texas summer weather).

Saline or water in a bottle or a bag works equally well, so the container issue is merely a matter of personal preference and, of course, cost.

Plus 5 for an intelligent question, and for asking for opinions from other sources before taking some co-worker's word as gospel!

[JeniF371]

Gee, great question!

I actually learned something today....

[AnthonyM83]

+5 for actually taking the time to callup the burn center, too