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Fires and burns are one of leading causes of household injuries. Simple things can be done to prevent or decrease these risks of fires and the resulting burns which include:

  • Have a proper escape plan in case of an emergency.
  • Make sure that a smoke detector is installed and it is working properly.
  • Check the smoke detector every year.
  • Make sure that you have a working, fully charged fire extinguisher.
  • Make sure that your water heater is set to 120 degrees or less to avoid scalds, install radiator cover, and isolate exposed steam pipes.
  • Fire places and burning candles should never be left unattended, dispose of cigarettes, and matches carefully; never place anything that may burn near a water heater, space heater, stove top, or near a furnace,
  • If a kitchen fire occurs, don’t panic, know how to handle it and put it out. For oven fires, close the door and turn off the oven. For a stovetop fire, use a lid to smother it.
  • Children should be taught never to play with matches, lighters, or gasoline; they should never be allowed to handle fireworks; never leave young children alone; place pots on the rear burner of the stove and turn the handles inward out of the reach of children; make sure that the stovetop is clean as residue grease can catch fire; make sure that the stove is turned off when you are finished; children should be taught what to do if they smell smoke of hear the smoke alarm.
  • Never place electric cords under rugs or bedding. Heat or sparks from these cords may cause a fire.
  • Always check electrical cords for signs of wear and replace cracked or frayed cords to avoid shock and fire. Don’t overload outlets or power strips, and cover unused outlets with plastic plugs.
  • When dealing with chemical substances, protective clothing should be used; all chemical substances should be stored in tamper proof containers out of reach of children; chemicals should never be stored in food or drink containers; different products that contain toxic chemicals should not be mixed together as they may give off toxic fumes; avoid using potentially toxic substances in the kitchen or around food.
  • If your clothes are on fire, stop, drop and roll.
  • In case there is a fire in a building, you should move to the floor where the air is cool and clear because hot air carrying harmful gasses will rise up.
  • Know the emergency phone numbers for your area. In most places it is 911. Teach children the emergency number and post it near each phone.

This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.

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Laughter is free, it has many positive effects on the physical and mental health and no known negative side effects. Laughter binds people together, infact it’s the shortest distance between two people.
A team of researches from the University of Leeds, UK, found laughing habits in people suffering from wounds can accelerate healing compared to using advanced technology.

The effect of laughter may include:

  • Laughter stimulates the release of endorphines, when the endorphins level increase in the brain, the pain perception decreases leding to a decrease in pain.
  • When we laugh, the diaphragm will move leading the blood to move more smoothly throughout the body icreasing the ability of the body to use oxygen and this may lead to faster healing of the wound.
  • Laugh raises the activity and number of natural killer cells (NK cells). NK cells are cells attack and play a major role in rejection of viral infected cells and some types of tumor cells. NK cells are part of the immune system.
  • Helps prevent heart disease ( astudy done in the University of Maryland Medical Center)
  • An increase in Immunoglobulin A (IgA) antibody which help to fight upper respiratory tract infection. There are five types of Immunoglobulins in our body (IgA, IgG, IgM, IgE, IgD).
  • An increase in immunoglobulin G (IgG) antibody, they are the most common type of antibodies in our body and play an important role in fighting viral and bacterial infections, they also cross the placenta (the only Ig that has this ability) and help in protecting the fetus.
  • An increase in immunoglobulin M (IgM) which are the first antibody type produced in response to an infection.
  • An increase in T helper cells, therse are the cells attacked by HIV virus.
  • An increase in gamma interferon which regulates the body’s ability to turn on the immune system.
  • An increased in in complement 3 which is part of our immune system that helps antibodies pierce through infected or dysfunctional cells inorder to destroy them.
  • An increase in number and activation of T cells as well as an increase in the ratio of helper/suppressor T cells.
  • An increase in the number of B cells, they are the cells which make all the immunoglobulins.

The effect of laughter on stress:

  • Lowers dopamine level which is associated with elevated blood pressure.
  • Lowers epinephrine.
  • Lowers growth hormone level in the blood.
  • Lowers cortisol level.
  • Lowers other stress hormones.
  • Lowers blood pressure and heart rate after initial short rise.
  • Reduces anxiety and fear.
  • Relaxes our muscles.
  • improves mood.

A stronge immune system is important in burn wound healing. Laughter boosts the immune system and increases the number of immunoglobulins which help fight infections. Infection is the most common complication of burns and is the major cause of death in burn victims. Make use of this easy to use strong medicine as it will not only make you happy, but will make everyone around you happy, it’s contagious.

This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies
See also The effect of stress on the skin, Burn wound care at home.

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There is no treatment that can cure and remove keloid scars 100 percent. Patients who have family history of keloid scar or previous history of keloid scar have high possibility of keloid recurrence more then others. Keloid scar may be treated by one or more of the following methods:

Surgery:

It may be the most effective way to remove large keloids. Surgery can be used by itself or with other treatment methods to decrease the possibility of recurrence as there is a possibility of keloid recurrerence an example is using surgery and steriod injection into the keloid scar or using surgery and other treatment methods to decrease recurrence rate.

Laser therapy:
Laser treatment is healpfull when the keloid scar is thin as the laser bean works on the surface of the keloid scar, it’s less effective when the keloid scar is thick. Your physician will discuss with you the best method of treatment of your keloid.

Cryosurgery therapy:

Cryosurgery which is freezing of the keloid scar is usually used for small scars only as it causes freezing of the scar and as a result blanching of the skin underneath the scar.

Radiation therapy:

Radiation therapy can be used alone as a treatment method but is more effective within 7 days of after surgical keloid removal.The risk of developing cancer from radiation is small as the radiation device used for this treatment emits smalllow radiation dose.

Creams, Pasts and Gels:

Creams, Gels and Pasts are most effective when the keloid scar is newly formed but still its effectivenes is limited even with newly formed keloid scars.

Silicone sheets:

Silicone sheets can be taped on to the keloid scar. You need to wear the sheets constantly for several weeks or several months.

As keloid scars differ in shape, size and causation from one person to another, the response to treatment also differ among different individuals therefore what might work for one person may not work for you and vise versa.

The combination of two or more treatment methods is usually more effective than using one method by itself and the recurrence is less when combining two or more methods together.

This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.

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It is a medical procedure in which a tube is placed into the trachea to open the airway, remove blockages and to provide oxygen, medication or anesthesia. It may be attached to a machine called a respirator that will breathe for the patient while the tube is still in place. Airway control and mechanical ventilation are often necessary in the treatment of severe burn injuries.

Swelling in the upper airway is a major concern in any person with a burn injury. Swelling may lead to acute respiratory insufficiency, in children the airway is smaller therefore they are more prone to develop airway obstruction from burn. Swelling and damage to the airway may be caused by inhalation of the gases and fumes caused by combustion and/or the effect of heat on the tissue (see smoke inhalation). The extent of the damage to the airways is not directly related to the severity of skin burns and in some cases it may become the greatest therapeutic problem in a gravely burned patient.

Although obstruction of the upper airways caused by edema (swelling of the tissue) may happen acutely, it may not be present until the edema is sufficient enough to produce clinical evidence of impaired airway patency which may take 12-18 hours. Therefore it is important to monitor the patient for any difficulty in respiration even though the patient may not have any problems initially.

Extensive face and neck burns increase the risk of airway compression and the need for early endotracheal intubation. Deep face burns may lead to airway obstruction due to intraoral edema which will in turn decrease the clearance of intraoral secretions and impair the protection of the airway from aspiration. Deep neck burns will increase the risk of airway compression and the need for early endotracheal intubation due to the external compression of the larynx by the swollen neck.

A decision will be made by the treating physician after initial assessment as to whether or not the airway can be managed safely without an endotracheal tube. The treating physician will also make the determination of how long the patient will be intubated and when the tube is taken out depending on the condition of the patient.

When the patient is intubated, he/she may stay in bed for a prolonged period of time, this may increase the risk of developing Deep venous thrombosis (see Deep venous thrombosis part I, II) which is the main cause of pulmonary embolism, these patients are given prophylactic measures to decrease the risk of deep venous thrombosis (medications and compression devices). Make sure that these devices are worn all the time and if they are disconnected (to walk or visit the restroom), make sure that they are reconnected when the patient returns to his/her bed.

This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.

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Burned patients need all the support they can get from family, relatives and friends. A burn injury is one of the most painful traumas a patient can ever experience.

One of the major concerns and challenges a burned patient faces is infection, (see wound infection). Burn centers have strict guidelines regarding infection control, depending on the patient’s condition. When visiting a patient with burns, you should know the visiting hours and the number of visitors allowed which may be limited depending on the patient’s condition.

Visitors may be required to wear a gown, mask, cap and gloves when visiting the patient. The nurse will give you instructions on the protective clothing to decrease the risk of infection. Look for any signs outside the patient’s door that will tell you if you have to wear these protective garments when entering the patient’s room. It’s important to follow these instructions. You have to wash your hands prior to entering and after leaving the patient. Avoid visiting the patient if you have an active cold or an infection and inform the nurse about it if you do visit.

For children to see the patient, permission may be required from the nurse. They may also have to wear the protective garments as well. It’s important to keep a quiet atmosphere while visiting the patient. It is also important to know the resting period of the patient, the treatment periods and burn team round periods to avoid as you may be asked to leave the burn unit during these times.

Although it’s hard to see your loved one suffering, it’s important to keep a positive attitude in front of the patient encouraging him/her and raising the patient’s spirit.

This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.

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It is a surgical procedure, in which a hole is created through the front of the neck and into the windpipe (trachea). A breathing tube (trach tube) is placed directly into the trachea through the opening to help the patient with breathing and to remove secretions from the lungs.

The condition that necessitated tracheostomy and the overall health of the patient will determine how long the tracheostomy will stay. A tracheostomy is usually temporary but some patients may need them for a longer period of time or even permanently.

Patients of all ages may need tracheostomy. It can be done on an emergency basis such as when there is trauma to the neck or on an elective basis. The type of anesthesia used for the procedure is general anesthesia.

Indications:

Among the conditions that tracheostomy may be used for:

  • Airway injuries from smoke, steam or chemical burns.
  • Congenital (inherited) abnormality of the larynx or trachea.
  • Neck cancers that affect breathing.
  • Severe face or neck injury.
  • Severe allergic reactions or infection.
  • Airway blocked by a large object.
  • Spinal cord injuries.
  • Long-term coma.
  • Patients who need to be on ventilators (see Mechanical Ventilator part I, II) for more than 1-2 weeks.

Risks associated with tracheostomy may include:

  • Risks related to anesthesia such as reactions to medication.
  • Risks related to surgery such as bleeding and infection.
  • Scarring of the trachea.
  • Blockage of the tracheostomy from dried secretions and mucous.
  • Nerve damage.
  • Failure of the closure of tracheostomy after the removal of tube.

A therapist will work with the patient once the tracheostomy is mature to regain the ability to swallow normally. Some patients may need swallowing tests to make sure that they can swallow safely before starting normal swallowing. During the period where the tracheostomy is maturing, patients will be fed by other methods such as through a vein or through a tube that goes through the mouth or nose to the stomach.

As for talking, a speech therapist will work with the patient after the maturity of the tracheostomy to help him/her to use his/her voice clearly; one of the options is to use a speech valve that is attached to the tracheostomy tube.

When there is no longer a need for tracheostomy (temporary one), the tube will be removed eventually and healing will occur leaving a minimal scar.

Some Patients will be discharged home having a tracheostomy, they and their families will be taught how to take care of their tracheostomies at home. These patients should adhere to the safety precautions that they were taught such as exposure to water. It is recommended that a tracheostomy opening be covered by a loose covering when the patient is outdoors.

This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.

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Intentional burns are less frequent than accidental burns but can happen. They are either burns that are caused by the person to him/herself or burns caused by one person to another one. Children and elderly are susceptible to abuse by burns. In children scald and contact burn injuries are the most common type of intentional burn injury. These injuries have a higher death rate than accidental burns and require a longer stay period in the hospital. Elderly cases are reported with much less frequency than children due to embarrassment or fearing that the person who is causing the injury will repeat it again. Things that raise a suspicion of abuse are:

  • The story given doesn’t go along with the injury that happened.
  • Giving different explanations about how the accident happened.
  • There are multiple injuries and this is not the first one.
  • The shape and location of the injury may give an indication that it’s an induced injury.

For elderly people suspected to have an induced burn injury, they should be reported. For children with suspected abuse, a call should be made to report it to the police, child protective services, and /or a doctor. If you are the one who is exposed to the injury you should look for help. If you are taking care of a child and you can’t control your anger seek help. If a person you know is the one who is exposed to the insult than try to seek help for him/her.

If a person is causing burns to his/herself, a psychological evaluation and treatment may be needed.

This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.

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One of the challenges that a burn survivor faces after discharge is the reaction of society to his/her scars. According to George Pessotti a burn survivor and the author of Reasons for Living, “most people mean no harm when they stare or ask questions. They’re simply curious; they want to know what happened to you for different reasons”

The face is the mirror of the person, the first thing that most people look at when they see a person is the face, and it gives clues about the person like background, age and mood. Scarring of the face after a burn injury may lead to psychological and social difficulties for the patient.

Burn survivors deal with scars differently, each will cope with it in his/ her own way, some will try to move on with life and forget what happened as much as they can. Others will isolate themselves from the community, live their lives in the shadow or turn to drugs and alcohol.

In addition to the physical trauma some have to deal with the loss of their home, income and may be grieving the loss of a family member (in the fire). It’s not uncommon that the patient may experience different emotions like anger, anxiety, fear, frustration, self guilt and depression. The road to recovery may be long but there will always be light at the end of the tunnel. Patients are encouraged to speak with family, close friends, attend support groups, and seek counseling if they need it.

The human brain works in an amazing way. Positive thinking can lead to better coping skills and decreased negative stress. If you put positive thoughts in your brain the results will be positive and vice versa. Simply focus on the solutions and not the problem as the problem has happened and can’t be changed but the solution is in your hand. When you see people looking at your scars in a strange or suspicious way, explain to them what happened.

This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.

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Is a surgical procedure involving the removal (sanding) of the damaged top layer of the skin using a specialized instrument called a dermabrader. This procedure is used for scars as well as other skin conditions such as wrinkles and tattoos.

Dermabrasion improves the appearance of the scar or other skin abnormality as a new layer of skin will replace the skin that has been treated. This procedure won’t entirely remove the scar or other abnormality but it will improve its appearance by softening the edges of the scar or other lesion.

The procedure can be done in a surgeon’s office or in an outpatient surgical facility. After the procedure the skin will be swollen, red and tender. Swelling gradually subsides within 2-3 weeks. You may feel some burning, itching, aching or discomfort for a while after the surgery. Pain medication, antibiotics and anti-swelling medications can be prescribed. Ointment and special dressing will help speed the healing process and your physician will give you instructions on how to care for the wound. Healing usually occurs within seven to ten days.

At first the new skin that is formed is pink in color but will gradually return to its normal appearance. The skin pinkness will largely fade within 2 to 3 months. The new skin should closely match the surrounding skin when full color returns. You can resume your normal activities within 2 weeks. Any activity that can cause injury to the area that has been treated should be avoided. You should also avoid sports for 4 to 6 weeks. Sun protection is also important to avoid pigment alteration. Avoid exposure to sunlight both direct and indirect for at least 6 months and use sunscreens on a regular basis when outdoors.

Skin color changes in the form of increased pigment (darker) or decreased pigment (lighter) after treatment is one of the complications of dermabrasion.

You should contact your doctor if:

  • The redness and swelling persists in the treated area as this could be a sign of a scar forming.
  • There is discharge or yellowish crusting as this may indicate an infection.

This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.

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Skin is a sensative organ that has many functions among which is the protection of the body against external harmful enviromental factors. The skin may be damaged when it comes in contact with a hot object. The severity of the burn depends on the intensity of the heat and the duration of time heat is applied.

Hand and finger burns are usually common and are caused by the accidental touch of boiling water or hot objects. Most of these burns are not dangerous but they are of heigh priority becauase of the functional importance of the hand and fingers therefore they have to be treated as soon as possible to avoid serious complications. Burns to the fingers can be first, second or third degree burns.

  • First degree burns are superficial were there is redness and blisters of the skin.
  • Second degree burns are partial thickness skin damage with blisters present.
  • Third degree burns are full thickness skin damage where the skin is leathery and white in color.
  • Fourth degree burns are the same as third degree burns but with damage to deeper structures such as tendons, bones and joints.

What to do if your fingers are exposed to a burn injury:

  • Be calm and hold the fingers under cool water (not cold water) such as putting the fingers under running cool tap water or soak them in water in order to reduce the heat. Avoid treating the burned fingers with ice as this may lead top frost bite.
  • Separate the fingers and cover them with sterile and clean dressing or bandage.
  • If there is pain then use pain medications to relieve pain and swelling. Pain medications are not recommended to be given to children as it may affect their liver.
  • Apply moisturizers or burn ointments to the affected area which will help in keeping the area moist.
  • Keep the burned area elevated to reduce swelling.
  • You can use home remedies to treat simple burns like honey after the skin has cooled down (see Home burn remedies).

Precautions and prevention:

  • Aviod using butter, oil and ice while teating the burned area, butter and oil may prevent heat from escaping the wound leading to elevation of temperature. Ice may lead to frost bite.
  • If the affected area is blackened, completely blistered or the burn spread on more than 2-3 inches in area then you should seek emergency medical treatment as this may indicate a second or a third degree burn.
  • Contact your physician immediatly if there is any signs or symptoms of infection of the burned area like fever, increase redness, increase pain, swelling, tenderness, foul smelling discharge ( see wound infection and Burn wound care at home).
  • You should be careful while handling hot objects that may cause burns.
  • Follow safety measures while using any electrical device, heater or oven.
  • Keep children away from any source that may cause them burn or injury such as hot water, stoves, heaters, electrical cords, fireworks ( see Fire prevention and safety)
  • Water heater temperature should never be set more then 120 degree.

This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.