Burns — Mohan Rangaswamy

Burns

Burn injuries are unfortunately very common and can be devastating. Treatment of major burns is challenging and involves large dedicated teams usually headed by plastic surgeons. Dr. Mohan Rangaswamy is fully trained to treat burns but due to organizational reasons, does not treat major burns now. Burn can be caused by heat such as flames or hot liquids or steam [called thermal burns], explosive gas or sparks [called flash burns], electric current [electrical burns], chemicals such as acid or alkali [chemical burns] or by radiation. The informative section on burns is under development but a very important social message is given below.

All thermal burns injuries are due to transmission of heat from superficial layer to the deeper layers of skin. This damage can be reduced by removing the heat source [burning clothes] and by IMMEDIATIELY cooling the area for 5-10 minutes by cool water. The water should be cool not necessarily cold. Ice is not needed. Pour cool water continuously to remove all heat from the damaged area. Time is of essence; cooling must BEGIN in SECONDS to stop the heat from going deeper. This is more important than running to get medical attention or for antiseptics. In fact antiseptics are not needed in the early treatment of burns. It is more important to cool than feel the urge to apply something. After cooling, the part can be covered by a clean sheet and then and only then the victim is to be taken to a medical facility. Do not put anything on the burn but cooling gel packs are very good for pain relief. A surgeon or a plastic surgeon is best equipped and trained to treat burns but if none is available; any doctor can render initial treatment.

Pouring large amounts of water also helps to dilute chemicals so can be used in chemical burns as well. It is not necessary to look for specific antidotes in the beginning, but always try to identify the chemical and inform the medical practitioner about it. This information is useful later on.

In electrical burn the victim must be removed from the electric source taking care that the rescuer does not get electrocuted. Further care of the thermal component is the same as above but an electric burn victim may suffer from heart rhythm anomalies and may in fact have a cardiac arrest. If so this takes precedence over cooling.