Letter Re: How to Survive a Serious Burn

Hello,
Dr. Koelker presented some great information on surviving a serious burn. One significant issue that wasn’t fully discussed that is potentially more serious in the short term than fluid replacement. If you were to happen upon someone who suffered a serious burn and you determined it was safe for you to proceed and get your hands on the patient, you must verify that the patient has a good airway, i.e.: Can they or are they breathing? If they are making painful noises or yelling you know they do because otherwise they wouldn’t be able to use their voice. However, with burn patients, you can suddenly lose that good airway due to swelling in the mouth / throat [/bronchial tubes]/ lungs. Check the patient for burn marks, redness (or black) and swelling on the face, nose and mouth. Look for burned facial hair and eye lashes. Check the ears for the same. If indications are there, you have to be aware that swelling may close their airway. You won’t know if the patient inhaled whatever it was that was burning or just very hot air. If the airway suddenly closes, you will know it because they won’t be able to speak or breath. The patient will also change color. It will happen quickly.

If the patient is to survive, you have to intubate or get a nasopharyngeal airway, (NPA), aka nasal trumpet) inserted. The NPA may not work because it reaches only so far through the nasal cavity. If the swelling extends beyond the length of the NPA, then it won’t work. Most people don’t walk around with NPAs, intubation equipment or emergency cricotomy (aka crico-tracheotomychric) know how. Phoning 911 is your best option. Another option is to get some basic training. Not that basic training will have you doing cricotracheotomys in the street but at least you will know what’s happening; what to watch for in patients and the patient scene; and you will be a better rescuer.

Remember this also: When dealing with infants, toddlers, and children, everything happens faster and they can’t compensate and hang on like a mature adult. Training is available, just do an Internet search. If time and funds are an issue, buy yourself a book on trauma medicine that is meant for EMTs and paramedics. You will understand most of it. Good Luck. God Bless America. FL Pete

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