Burn Care

Tuesday, May 11, 2010

Thermal Burns: Most of these burns are from hot water, hot drinks, hot grease, heating grates, and cigarettes. Usually the burn is first degree (reddened skin without blisters) or second degree (with blisters). Neither of these leaves scars. Second-degree burns take up to 3 weeks to heal. A third-degree burn is deep and leaves areas of scarred skin. During healing it usually needs a skin graft to prevent bad scarring.

Chemical Burns: These burns are from lye, acids, caustic cleaning agents, or other tissue-damaging chemicals splashed on the skin. They usually heal like a sunburn in about a week. These burns always need to be evaluated by a physician.

Electrical Burns: These burns originate from a source of electricity such as an electrical outlet. These burns can cause permanent disfigurement of the face, mouth or hands. They always need to be evaluated by a physician.

FIRST AID
Thermal burns. Immediately (don’t take time to remove clothing) put the burned part in cold tap water or pour cold tap water over it for 10 minutes. If you are outside, the nearest garden hose should be used. This will lessen the depth of the burn and relieve pain. If the burned area is large, cover it loosely with a clean sheet. The covering will keep the burn clean and reduce the pain.

Chemical burns. Remove all contaminated clothing and rinse off the exposed body parts. Instructions for treating burns may be found on the container. If so, follow them. If not, wash away the chemical with large amounts of water for at least 20 minutes. Don’t rub the skin during the rinse. Don’t apply any burn ointment because washing it off will cause pain. The best way to do the rinse is in a tub or shower. If the burn area is large, cover it loosely with a clean, damp sheet.

Electrical burns. If the electrical current is controlled by a wall switch, turn it off. If not, pull the child away using a non-conductive material such as a board or wooden chair. Do not use bare hands. If the child is not breathing, call 911 and start CPR.

HOME CARE
Treatment. General measures for caring for a burn include keeping the area clean. Soaking in a tub or applying warm compresses at least once a day may be recommended by your physician. During this time, all the dead skin from the area should be gently removed.

BURNS
Children usually require the burned area to be bandaged if the area is subject to being bumped or rubbed. An antibiotic cream called Silvadene is usually recommended, and is applied before the area is bandaged. Many burns will need to be seen daily by the physician for bandage changes and debridement.

Pain. For pain, give acetaminophen every 4 hours or ibuprofen every 6 hours for at least 24 hours. Burns can be very painful, and sometimes the physician will prescribe a pain medicine. It may be necessary to give the pain medication one hour before changing the bandages or going to see the doctor.

Diet. If the child has an extensive burn, try to increase the protein intake while the healing progresses. Proteins are the “building blocks” needed for repair. High-protein foods include meat, poultry, fish, eggs, milk, cheese and beans.

CALL YOUR CHILD’S PHYSICIAN IMMEDIATELY IF:
• Child develops a fever of 101.5°F.
• Pus accumulates in the burned area.
• There is pain, redness or swelling in the tissue surrounding the burned area.

NOTIFY YOUR PHYSICIAN IF:
• The burn starts to look infected.
• The burn isn’t healed within 10 days.
• You feel your child is getting worse.
• You have other questions or concerns.

Bee Stings

Monday, May 10, 2010

Stings by honey bees, bumble bees, wasps, or yellow jackets are frightening. Over 95% of stings are by yellow jackets. These stings cause immediate, painful red bumps. The pain is usually better in 2 hours. However, the swelling may increase for 24 - 48 hours. Multiple stings (more than 10) can cause vomiting, diarrhea, a headache, and fever. These symptoms are caused by a toxic reaction to the large amount of venom in so many stings. They are not the symptoms of an allergic reaction. Allergic reactions cause difficulty breathing, difficulty swallowing, passing out, hives, or swelling in skin areas other than where the sting occurred.

HOME CARE Treatment. If you see a little black dot in the area of the sting, the stinger may still be in the skin. (Only honey bees leave their stingers.) Remove the stinger by scraping it off. If only a small fragment remains, it will come out on its own. Then rub each sting for 20 minutes with a cotton ball soaked in meat tenderizer and water, or with a slurry of ground-up aspirin tablets. (Avoid the area around the eye.) This will neutralize the venom and relieve the pain. If you do not have any meat tenderizer, apply an aluminum-based deodorant or a baking soda solution for 20 minutes. If it still hurts, massage with an ice cube for 10 minutes. Give acetaminophen or ibuprofen immediately for relief of pain and burning.

Prevention. Some bee stings can be prevented by avoiding gardens and orchards and by not going barefoot. Insect repellents do not protect against these stinging insects.

CALL YOUR PHYSICIAN IMMEDIATELY (or CALL 911) IF BREATHING OR SWALLOWING IS DIFFICULT.

NOTIFY YOUR PHYSICIAN IF:
• The swelling continues to spread after 24 hours.
• Swelling of the hand or foot spreads past the wrist or ankle.
• You have other questions or concerns.

Poison Ivy

Friday, May 7, 2010

With spring here, many people have started to get poison ivy. Here is some information on the appearance, cause, course, treatment, contagiousness, and prevention of poison ivy. We've also included recommendations on when to call your doctor.

Signs and Appearance:
• Redness and blisters
• Eruptions on exposed body surfaces (e.g., hands)
• Shapes like streaks or patches
• Extreme itchiness
• Onset 1-2 days after the patient was in a forest of field
CAUSE
Poison Ivy, poison oak and poison sumac cause the same
type of rash, and are found throughout the United States.
More the 50% of people are sensitive to the oil of these
plants.
EXPECTED COURSE
Poison Ivy usually lasts 2 weeks. Treatment reduces the
symptoms but doesn’t cure the disease. The best approach is
prevention. The sores should be dried up and no longer itchy
in 10-14 days. In the meantime, cut your child’s fingernails
short and encourage him not to scratch himself.
HOME TREATMENT
• Cool soaks. Soak the involved area in cold water or
massage it with an ice cube for 20 minutes as often as
necessary. Then let it air dry. This will reduce the
itching.
• Steroid creams. If applied early, a steroid cream
applied to the skin can significantly reduce the itching.
• Antihistamine. A non-prescription product such as
Benadryl taken orally also helps reduce itching.
CONTAGIOUSNESS
The fluid from the sores is not contagious. However,
anything that has the poison ivy plant oil on it can cause the
rash for about a week. This includes the shoes and clothes
the patient last wore into the poison ivy area, as well as any
pets that may have the oil in their fur. Be sure to wash them
off with soap and water. The rash usually begins 1 -2 days
after contact.

PREVENTION
Learn to recognize these plants. Otherwise, avoid all plants
with three large shiny, green leaves. Wear long pants when
walking through areas that may contain poison ivy. If you
think there has been contact, wash the exposed areas of skin
with soap several times. Do this as soon as possible, because
after 1 hour it is of little value in preventing absorption of
the oil.
CALL YOUR PHYSICIAN IMMEDIATELY IF:
• the face, eyelids, or lips become involved
• the itching interferes with sleep
• any large blisters develop
• the rash becomes open and oozing
• signs of other infection, such as pus or soft yellow
scabs are seen
• you have other concerns or questions

Apple Per Day - Allergies

Hello, welcome to the newest video in the Apple Per Day series, exclusively from Righttime Medical Care. In the latest installment, Dr. Graw discusses allergies, primarily of the outdoor kind, what to do to prevent them, and how to respond in the event that allergies may become an issue.


In springtime, when the first blossom occurs on a tree or a flower erupts, those of us who are allergic start to experience the symptoms of allergies. The symptoms can occur through the summer when the grass pollens erupt and into the fall with ragweed, and might not stop until winter when the first hard freeze occurs.

Winter allergens include dust, dust mites, and mold. Spring allergies are primarily associated with flowers and tree pollen.

Spring allergy symptoms are pretty easy to recognize – the sneezy, itchy, scratchy symptoms we all know. Most people complain of itchy and burning eyes, sniffing and sneezing and nose scratching. Some people may develop wheezing and coughing symptoms. You may even develop a crease on your knows or bags under your eyes from all of the congestion.

When the symptoms persists and are not improving with home remedies like over the counter antihistamines and eye drops, its time to see your physician. The physician will try to determine which allergen is causing the problem – is it an early spring blossom, a grass pollen, ragweed or all of them? They may use a skin prick test or complicated, but very modernized and easy to interpret, blood tests to determine the allergen responsible for your symptoms.

The number one treatment for allergies is avoidance. Your doctor may tell you to move to another part of the county. Obviously, that’s not practical. Secondly, they may recommend testing and evaluation of an allergy shot regiment. They will describe that to you and it can be life saving and important to take those allergy shots if you are severely affected.

What can you do to avoid allergies? If the pollen is heavy and can be seen on your dark car, you should probably close the windows, stay indoors with the windows shut and run your air conditioning. If you go outside, use cool compresses on your eyes if they are itching, try over the counter eye drops with antihistamines, try an antihistamine that makes you less drowsy and do not try to drive until you have taken the first dose and have determined if it will make you sleepy. Finally, sleep in an environment where you do not have the pollen continually bathing into the nasal mucosa, which can be stimulated by the allergens to cause the release of chemical mediators that lead to the other symptoms of itching, sneezing and coughing.