Posts Tagged ‘treatment’

What to do if…

Two days back, my grandmother burned herself while opening a pressure cooker, and it was a nasty burn. Her face and hands were scalded. I am writing this for many reasons. First is to tell what to do in case of a burn, though there are many other places where you can find it, and when somebody really needs this info, they are unlikely to hit this blog. Anyways, immediately, I poured a lot of water over her, not bothering about the clothes getting wet. THIS IS THE MOST IMPORTANT STEP. Water cools off the skin and prevents further damage from the heat. Do not worry about the blisters, they are not bad.

I knew how to treat a burns patient, but having a casualty in the family is different, and this feeling is what I wish to share. I immediately understood that it was not a trivial injury, as the temperature in a pressure cooker is even higher than boiling water, accompanied by steam, it is very damaging. So, here cooling the skin immediately with running water plays a role as the deeper layers are salvaged.

I assessed the situation and immediately sent my mom to get a cream (silver sulphadiazine). She brought a cream which had aloe vera and another antiseptic (chlorhexidine) along with Silver Sulphadiazine. 

After drying her with a clean cloth, I gave her a pain-killer (combiflam – ibuprofen+paracetamol), and gently applied a thick coat of cream wherever I thought the burns existed. Here, it should be kept in mind that apply a thick layer of cream as it prevents drying and protects against infections adequately. The pain reduced. Regarding pain, pain is present in 1st and 2nd degree burns, not in the worse 3rd degree. So, presence of pain denotes that the nerve endings are intact.

Next came the question of antibiotics. I gave her a broad-spectrum antibiotic (augmentin) to prevent infection, repeating it 12 hourly. My grandmother could hardly sleep the whole night. In the morning, I saw that her face was swollen, and blisters had appeared all over. I researched and asked my friends. Blisters should not be pricked. I cleaned the area thoroughly with a cotton soaked in boiled and cooled water, and re-applied a thick coat of silver s. cream. The aloe vera keeps the area moistened and assists healing. She also had burns and blisters on her lips, which were painful.  She was on semi-solid diet, and multivitamins.

The third day, I knew that I had to remove the dead skin, and the blisters, as now was the time for new skin to regenerate, and the dead skin attracts bacteria, causing infection. I used the same pressure cooker to sterilise few things- cotton, napkins, knife (though I didn’t use it). I put some savlon in boiled and then cooled water, and soaked the cotton in it. Now, gently, I cleaned the cream I had applied. The dead skin started peeling off, and beneath it I could see pink areas. I cleaned the whole face and arm thoroughly. Cleaning has a procedure- You have to wipe the skin in a single direction, away from the wound, and not using the same cotton again on the wound. This way, you reduce the bacteria present on the wound. Gradually, I removed skin tags from all the blisters, and now, whole of my grandma’s face had denuded pink skin. She was a dear one and I felt sad for this happening. She had not taken a bath for 2 days, and I thought she should change her clothes and wash her hair and body. She took a bath, and now I could assess the whole condition. The situation seemed under control. I dried her face and arm with the sterilised napkins and then applied a thick coat of Silver s. cream. 36 hours had passed. Meanwhile, she was continuing with the antibiotic and multivitamins, but no pain-killer was needed.

Also, I gave her a strong anti acidity drug (pantoprazole) as burns are a stressful conditions, and in such cases, stomach ulcers are very common. Her diet was semi-solid and without spices, so that she could swallow it easily. She slept all day, and was tired of sleeping. I took an appointment of a burns specialist, but won’t go there today. maybe tomorrow, when she is better. The fear of going there is from infections, specially Pseudomonas aeruginosa, which plays havoc in burns cases, and which was very common in the hospital I worked, or every hospital for that matter, as it is resistant to most antiseptics and antibiotics. The indication that it has attacked is the presence of greenish pus in the would. My grandmother is recovering well and I hope she gets better within a week.

I realised that it is different when you treat someone close, but I won’t say that a doctor should treat everyone as if they are his family, at least emotionally, because then he looses rationality and gets weak in his legs. One should be compassionate and considerate, but also emotionally stable, so as to do justice to the profession, to self, and to the patient.