Treating Burns

[Transparent]

I've been wondering for a while about this - what's the best way to treat burns? Everybody seems to say something different. Some people say a plunge in cold water works. My father told me to never put cold water onto a burn. He's worked in his family's restaurant business for a good portion of his life, so that's pretty convincing. I'm still not so sure about the effectiveness of either one though. Any help?

[Pan]

I always run cold water over the burned part and then, if it still hurts, tear off part of a brown paper bag, if available, trickle some cold water on it, and wrap it around the burned part. I understand that the tannin in the brown paper helps to reduce the severity of the burn.

(Disclaimer: I'm only a Doctor of Music. Take two eighth-notes and call me in the morning. )

[bleachboy]

I'm no doctor either, but my wife has also told me before not to run cold water on a burn. Whenever I burn myself, I run to my wife like a whiney baby for help. This also happens if I see a huge bug. I am kind of a sissy like that.

Anyway, she always prescribes holding the burn under tepid or maybe even just-slightly-warm tap water for a minute at least. Honestly, this usually does the trick. The pain disappears and I don't notice it again until the next hot shower or handwashing or whatnot.

Obviously, serious burns should be treated by a professional.

[Pickles]

Soak in Cool Water

Soak in COLD water

Just don't use BUTTAH. Everyone seems to agree on that. It makes sense to put something emollient-like on a burn though. They didn't have neosporin when our Grannies were getting kitchen burns. I can't find a reason why NOT to put butter on a burn...except maybe it's a breeding ground for bacteria and not very sanitary--especially if you keep licking it off.

[Mayhaw Man]

I head for the cold water tap immediatly.

Then to the aloe vera plant in the kitchen window (or what used to be the kitchen window )

Bad ones get the triple antibiotic.

Never had a really bad one, but I would head for the emergency room it I did. Not only do they produce scars, but burns are particularly prone to infection.

[spoonbread]

Ice and/or ice water is the best thing. To follow up on that, after you have ice for a sufficiant amount of time, use silver sulfadiazine, it is the best for burns.

[Pickles]

Ice and/or ice water is the best thing. To follow up on that, after you have ice for a sufficiant amount of time, use silver sulfadiazine, it is the best for burns.

You should never put ICE nor ice water directly on a burn. It can cause frost bite to the area, and make matters worse. See the links I posted.

[andiesenji]

I have had grease burns on my arms and plunged my arms into cold water to which ice was added to heep it cold and I kept my forearms immersed for several hours. I have only minimal scarring.

When I was doing a lot of sugar work I often had burns and always alternated between ice water and cool water. No scars.

The only burn that I ever had that was a problem was one that happened in a restaurant and I was treated by paramedics. They wouldn't let me put ice water on the burn. It left a large scar on my right calf which later needed plastic surgery.

Last winter I tipped a pot of split pea soup and some spilled over my left hand. I immediately plunged it into ice water and got the sticky soup off my skin. I kept my hand in ice water for several minutes then alternated between cool and ice water. I only had one little blister on the web between my thumb and index finger.

[BettyK]

I was frying some chicken the other day and my right arm got "decorated" from shoulder to wrist. Applied some Band-Aid gel without much effect. Next day went to the drug store and bought some Vitamin E ointment (30 IU/g). It stopped the blistering and a week later the marks are almost gone. Put some on an older burn mark and it's completely gone too. Great stuff.

[John Whiting]

Vitamin E indeed. Adelle Davis was recommending that half a century ago. For a painful but not serous burn (a threat of blistering) we take a couple of Vitamin E capsules, immerse the burn in cold water for a few minutes and then, if it's still painful, prick a vitamin E capsule with a pin and squeeze the liquid onto the burn, leaving it open to the air. It works. It also helps in the healing of cuts.

[jsolomon]

<Put on remote medical professional hat> Okay, folks, here are my understandings of steps to reasonable burn treatments.

Disclaimer: If you are not reasonably healthy with no acute or chronic infections, or you have a substandard immune, blood, or skin system integrity, stop reading NOW.

1: Stop the burn. If this is a thermal burn, remove it from the heat source and attempt to quench the heat of the burned part as quickly as possible. Yes, that means that I find the suggestion to not use ice or ice-water as horseshit. A couple of minutes of icewater bath or ice massage is NOT going to cause frostbite in a healthy adult human. For chemical burns, dial 911 and follow their instructions.

2: Protect the burn. A deep burn (second or third degree) is going to seep fluid. If you can keep the wound dry and wick away the fluid, do it. The best thing I have come across is telfa pads or something similar. They don't stick to the drying serous fluid. A good triple antibiotic, or aloe, or silver sulfadiazine ointment is appropriate at this stage.

3: Treat swelling and pain. If you must continue with your work, be aware that a large burn is going to have a large swelling response. If you have a watch or ring or other circumferential jewelry, remove them. Keep them off. Do not allow the swelling to strangulate the wound. Apply ice intermittently for the first 24 hours. 20 minutes on, 20 minutes off.

4: Seek medical assistance. For very bad burns, they do need debrided. Get in touch with a medical professional. Answer their questions about the nature, size, and description of the burn. They may advise you come in for definitive medical treatment.

If the burn is larger than the area of 2 hands, go to the doctor. If the burn is on the head, face, neck, or genitals, go the the doctor. If the burn is completely around any digit or limb, go to the doctor.

What I have described here is reasonable first-aid. If you have questions about the burn, seek medical assistance. If you follow these, you are at your own risk. But, please, keep your wounds clean. I hate septic patients.

Edited July 25, 2004 by jsolomon (log)

[Transparent]

Well, I guess cold water does the trick. I'd rather not use ice though - just in case. But, I wonder where my dad got the soy sauce idea from.

[KateW]

I always run cold water on them and rest them on something cold for a second (like a freezer door or a cool stainless steel counter) every few minutes if they keep burning. We have burn cream at work that works well. When I worked at Ruby Tuesday, someone said pickle juice works but I never really tried it.

[GG Mora]

Just a few experiential recommendations:

Item 1. Cold water works. Several years ago, I spent some time assisting a glass blower, and on one very hectic afternoon, I mistakenly grabbed the business end of the blow-pipe. Yup. The end that had recently (not just, thank goodness) been in the blazing hot yellow-orange glory hole. Part of what saved me was my quick reaction time, as in, it didn't take me long to realize my error and let go of the damned thing. The Supreme High Dude In Charge was filling a bucket with cold water in no time flat and had my hand plunged into it before I really knew what had happened. For the next hour and a half, I kept my hand in the bucket, refreshing the cold water as necessary. The skin was pretty well seared and it hurt like hell (ibuprofen helped that), but the next day there were no blisters and the burn cleared up in a week with no scarring.

Item 2. Aloe vera works. In my haste to pre-sear a bunch of racks of lamb as service was coming on, I flopped batch three into the grease-filled skillet a bit too enthusiastically and ended up with boiling hot lamb fat up my thumb and onto the side of my hand. I had enough time to stand with my hand under cold running water for about 5 minutes, but that wasn't really practical to continue during service. We kept a bottle of aloe gel in the walk-in, so I filled a small ramekin with it and kept it on my station. Throughout the night, I kept applying the gel, liberally, to the burn. As soon as it would start to dry, I'd apply some more. The skin was pretty well seared and it hurt like hell (ibuprofen helped that), but the next day there were no blisters and the burn cleared up in a week with no scarring.

Item 3. Vitamin E oil is excellent for the healing stages of a wound. After surgery on my wrist a few years back, I started applying vE oil several times a day once the wound was "sealed". At my one-month follow-up, the surgeon had to ask when he'd done the surgery (he was a little spacey, but an excellent surgeon nonetheless) because what he saw was consistent with a 3-month old scar, not a one-month old freshie.

Just my 54¢.

[balmagowry]

Second the motions re aloe vera and Vitamin E oil (I too used the latter on a surgical scar and it made an enormous difference).

As for minor burns, I don't know exactly how effective this is or why (though I suppose it might come under the heading of protecting the burn?), but I remember from my childhood that my grandparents' housekeeper always applied corn oil ("Oil-Mazola," as she called it - generally the only type of oil she'd have handy) and flour. Then again, this is the same woman (a Chilean indian, i.e. Mapuche, I assume) who used to put half a raw onion on her head to keep her from crying when she cut onions - and this long, long before any of us read or saw "Like Water for Chocolate." Can't remember whether I've ever mentioned this before: we learned this because one day my grandmother walked into the kitchen and found Isabel cutting up onions, tears streaming down her cheeks, half-onion on her head; of course my grandmother asked her "Isabel, why do you have an onion on your head?" and Isabel sniffled and replied "to - sob - keep me from - sob - crying!"

But the Oil-Mazola/flour poultice seemed to work pretty well.

Edited July 25, 2004 by balmagowry (log)

[Anna N]

I think it essential to qualify the kind of burn. In the case of third-degree burns then I would say cover it not at all unless you have a sterile dressing at hand - seek immediate medical attention.

A second degree burn that is less than a few square inches, and is on an ADULT, can probably be safely treated with cold water or ice. A child should be taken for medical assistance.

A first degree burn to a very small area , the kind most of us have to contend with, can probably be treated with whatever makes you feel better.

The problem with butter, as I understand it, is that people would slather it on third-degree burns - these must be debrided (all of the burned flesh scraped away) and that butter has to go - the pain and agony of the debriding is made even more agonizing when surgeons have to scrape off "home-remedies".

Not a doctor - but some years as a RPN and medical tech.

[FistFullaRoux]

Mom is a registered nurse, I was an EMT (in a former life) and all I have to add is,

what jsolomon said. It's the right thing to do.

Although I think most people would go screaming for a doctor with genital burns, without much prompting.

Edited July 25, 2004 by FistFullaRoux (log)

[john@thebar]

<Put on remote medical professional hat>  Okay, folks, here are my understandings of steps to reasonable burn treatments.

If you aren't a trauma physician, then you must have stayed at a Holiday Inn Express last night! Thanks for the knowledge. Posts like yours are what makes eG. such a pleasure. I've been involved in the F&B industry in some form or fashion for over 30 years now and I've heard all the lore about what to and what not to do in response to kitchen burns. Your post both makes damned good sense and is very well written: great stuff!

PS: I've never seen the word circumferential before, can't wait to use it sometime.

Edited July 26, 2004 by john@thebar (log)

[Pickles]

Aw heck...let's just do what Gus Portokalos would do. Spritz some Windex on it.

[dumplin]

I was working at a locally owned fast food place that had a tempermental sandwhich grill. The thermostat was broken, so it was up to over 500 degrees. We used it to brown hamburger rolls. I was reaching across the surface of the grill to grab something behind it (very small restaurant) and my portly manager wedged me on top of the grill right as the lid slammed down. My right forearm was plastered onto the oily surface, and I couldn't get off of it. I finally got him to move so I could get out of the grill. I had a large second degree burn on my forearm. I ran cool water over it. I then wrapped sterile wet gauze over the wound. When I got off work, I went to the drug store and got burn cream and these cool little plastic wet bandages for burns. I didn't scar, but sometimes in the cold, that area turns red.

[fiftydollars]

Although I think most people would go screaming for a doctor with genital burns, without much prompting.

I think that if my doctor had genital burns, and this was somehow made known to me, I would definitely make a run for it...

[jsolomon]

If you aren't a trauma physician, then you must have stayed at a Holiday Inn Express last night! Thanks for the knowledge. Posts like yours are what makes eG. such a pleasure. I've been involved in the F&B industry in some form or fashion for over 30 years now and I've heard all the lore about what to and what not to do in response to kitchen burns. Your post both makes damned good sense and is very well written: great stuff!

PS: I've never seen the word circumferential before, can't wait to use it sometime.

Thanks!

Step right up, folks! If you are part of a Medical School Admissions Committee, I'm unsigned!

[Varmint]

Having spent an evening in the urgent care center after my doctor wife refused to treat my second degree hand burns, I will confirm that jsolomon's advice is very sound. I used this course of treatment, and 10 days later, my hand is sufficiently healed that I'll be able to play golf on Friday!!!

Oh, Dr. Mrs. Varmint didn't really refuse to treat me, she just wouldn't prescribe me the pain meds I wanted for that first night! Thus, the urgent care visit. Thank heavens for percocet!

[Susan G]

PS: I've never seen the word circumferential before, can't wait to use it sometime.

Then let's not begin the discussion on eschar and escharotomy (for those really nasty burns)!

[TheFoodTutor]

I work in a restaurant, and every time I get burned, I'm amazed at the variety of foodstuffs I'm told to slather on the affected area. Sugar, mayonnaise, butter, peanut butter, cheese. . . and all this advice is given to me while I have a can of some sort of burn spray in my hand.

I usually choose the burn spray.