Wilderness: Burns (cont.)
Treat burns in the following ways:
- Cool the burned area with moist, clean, cool cloths.
- Rinse with tap water, and clean with soap and water.
- Apply a layer of
cream (Silvadene) morning and evening. (Do not use Silvadene near the eyes.) Cover with gauze dressings. Clean off all Silvadene cream with soap and water with each dressing change.
- Blisters may rupture. Remove the dead skin with sterile scissors and tweezers.
Flush chemical burns with water until all burning pain has stopped. Remove all contaminated clothes.
Oral antibiotics are usually recommended to prevent infection. If infection develops, continue antibiotics for at least
five days after all signs of infection have gone away. Let the doctor know about any drug allergies so the right antibiotic can be prescribed. Some oral antibiotics can cause sensitivity to the sun, so use a sunscreen (at least SPF 15).
- Pain may be relieved with 1-2 acetaminophen (Tylenol) every 4 hours or 1-2 ibuprofen (Advil, Motrin) every 6-8 hours.
- Patients with facial burns, evidence of potential lung involvement (for example, soot in mouth), circumferential limb or torso burns, 20 or 30 burns of 10 % or greater body surface burns may require specialized treatment that address the various needs such as airway protection and function, fluid loss and hydration problems, pain control and other burn-related problems. This specialized treatment(s) are usually instituted in conjunction with several specialists in a Trauma center.
Scott H Plantz, MD, FAAEM
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