SCALD, FLAME, AND ELECTRICAL

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(Photo by Cullan Smith on Unsplash)

Why the title? Well, you guessed it. Here`s how you get burned.

FLAME

Flame burns are the most common admissions to the center. Misuse of fuel and flammable liquids like kerosene and flame accelerants are as common. Young males are the most common group. In our setting, we have flame burns because some people get gasoline from the gasoline store and sell them in the sari-sari store. Sometimes they get so careless that the gas ignites causing them to burn themselves. In western countries, we have gasoline burns when a car ignites and people are caught by the fire.

SCALD

Scald burns occur when a heated liquid comes in contact with the skin. In young kids, the most common cause is when they pull a hot liquid on themselves. Hot water or hot milk or hot soup is very common.  Or when an older sibling or adult will give them a liquid that is hot. We have to be very careful when we know that an adult does not do it on purpose like in child abuse.

For adults and older kids, improper handling of oils or appliances is common.

In 33% percent of cases in the US is from scald burns. It is rare that scald burns go sour but they do. In the US they account for 100 deaths a year.

ELECTRICAL BURNS

This is common in our setting now. You have males ages 20-40 who get burned because of tv antennas. They try to put the tv antennas in their proper place. But then they forget that there are live wires from the house. They touch these live wires and get burned.

In westernized countries, 1/3 of burns occur inside the house. This happens when children stick their fingers into plugs or electrical receptacles.

Right now as we speak, there are 3 electrical burns in our burn center. All males climb the roof.

There are four types of electrical burns.

  1. This first one is when you  electrical burns caused by touching electrical wiring or improper use of electrical equipment.
  2. Arc burns- This is when powerful electrical currents arc through the air. I heared a patient say that he was flying thru the air.
  3. Thermal contact burns is when the electricity starts a fire, and there are  explosive materials also in the room.
  4. Flash burns

Flash Burns

Are caused by electrical arcs that pass over the skin. When heat from a nearby electrical arc causes thermal burns but currently does not actually enter the body, the result is a flash burn. Flash burns may cover a large surface area of the body but are usually the only partial thickness.

When you have been burned, when do you get admitted to the burn unit?

(From the Advanced Burn Life Support Providers Manual)

  1. Second and third degree burns greater than 10 percent TBSA (Total Body Surface Area); inpatients younger than 10 or older than 50 years of aged
  2. Second and third degree burns to greater than 20 percent TBSA in all other ages
  3. Third degree burns greater than five percent TBSA in patients of any age
  4. All second and third degree burns with the threat of functional or cosmetic impairment to the face, hands, feet, genitalia, perineum, or major joints
  5. All electrical burns, including lightning injuries
  6. Chemical burns
  7. burns involving inhalation injury
  8. Circumferential burns of the extremities and/or chest
  9. Burns involving concomitant trauma among which the burn injury poses the greatest risk of morbidity or mortality.
  10. Burns in patients with pre-existing medical conditions that may complicate management and/or prolong recovery, such as coronary artery disease, lung disease, or diabetes

Now I have taught you to triage. EASY?

NO. The team captain ( the most senior physician with training on triage) has to do it while the rest follows.

And before I forget. Patients with stevens-johnsons syndrome or those with toxic epidermal necrolysis or tens also are admitted here. Let me tell you about SJS or tens another time. It will take me another hour or so to do that.

So we can talk about SJS, tens, inhalation injury, and triage on my next vlog. See you and try not to get burned.

Michelle Marie P. Aportadera M.D.
Plastic Surgery
Diplomate in General Surgery
Master of the Arts Hospital Administration
Administrator, RD Aportadera MD SPMC BURN CENTER

Published by rdaspmcburninstituteph