Diwali 2019 is here with all the sweets and lights. It is that time of the year when you see lights everywhere and your houses are loaded with sweet boxes. Every year it is advised to celebrateeco-friendly Diwali without crackers. The increasing pollution levels especially during Diwali cause many problems. Bursting crackers during Diwali can also result in cracker related burn injuries which can be trivial or sometimes with huge mass burn fatal casualties. Prevention of the burns by using safe methods to burst crackers is the only way to make our Diwali joyful and injury free.
What to do after cracker related injury?
1. Steps for minor burn injuries
First put the burnt part of body under running water for 5 min. Immersing the injured area under running water will cause a reduction in the temperature of the burning substance, and reduce the impact of the burn on the skin. This will also provide relief to the person. However do not use ice or ice cold water to the injury. There is a common myth that holding the injury under running water will cause blebs (blisters), however this is not true. Blebs will anyway happen as it is the natural process of burn injury.
2. Eye injury
Eye injury due to cracker is an emergency and may lead to blindness if not treated properly. Irrespective of the severity of the injury all eye injuries need immediate evaluation from the eye specialist to give adequate treatment.
3. Flame burns
There is also the likelihood that a spark may catch onto a person’s clothes and build into a larger fire. In such cases, the following steps must be taken –
- Pour buckets of room temperature water onto the person and extinguish the fire as soon as possible.
- Once the fire is extinguished, remove the clothes from the person as quickly as possible. It is crucial because the contact of the burning/burnt clothes has to be removed from the body.
- Do not use a blanket to extinguish the fire. Once the fire has been extinguished with water, and old clothes are removed from the person, then you can use a warm blanket to ensure that the person’s body does not go into a hypothermia.
- A blanket should not be used to extinguish the fire because when you wrap a person with a blanket, the temperature inside continues to increase and causes more burn damage to the person
- Transport the patient to the nearest emergency department as soon as possible
It is also useful to kept 3-4 buckets of water ready in case a burn injury occurs.
4. Inhalational injury
Although inhalational injuries are rare in cracker burns as it happens in open spaces, sometimes there is the possibility that the patient suffers from inhalation injuries that arises out of breathing in the fumes that come out of fire.
Similar situations arise in large cracker production units. Within 3-4 days of inhaling these toxic fumes, a person can develop ARDS – acute respiratory distress syndrome. These type of injures are dangerous to life and should be treated aggressively in hospitals.
When there are fires in enclosed spaces, and since the situation is stressful, a person may tend to take in more breaths than normal. It is more likely that the person will breathe in more toxic fumes in such situations. Even 1 minute of breathing like this can cause damage to the lungs.
If there is any suspicion of inhalation injury even though burn injuries are less, such patients must be admitted to the hospital immediately. Some signs of an inhalation injury are singeing of the hair, burning, swelling or redness around the lips and nose.
Criteria for admitting a burns patient to the hospital
1. More than 20% of surface area burns in adults and more than 10% surface area burns in children
2. Any chance of inhalation injury, i.e. close spaced burns, irrespective of the percentage of burns
3. Facial burns need to be admitted – greater chances of inhalation injury
4. Hand burns and genital burns
5. Elderly patients, infants, diabetics and hypertensive patients must be taken to a doctor for evaluation and need admission to the hospital for at least 24 hours
Points to keep in mind:
1. Any burn injury requires time to heal. There is no need to apply any antibiotic ointment on the superficial burn wounds.
2. A simple moisturizing lotion will also help the injury to heal.
3. Blebs (small blisters) are a natural formation on a burnt skin which occurs due to water collecting between the burnt later and the new skin underneath. These can be left alone and will go away on its own. Sometimes doctors will puncture the bleb and drain the water and dress the injury.
4. To dress or not to dress? Sometimes applying a dressing on the injury is better than leaving the injury open because it brings comfort and relief from the pain to the patient and keeps the injury safe from external hazards. The doctor will take a call on whether dressing is required.
5. Patients should liberally take painkillers to deal with the pain unless they are suffering from kidney or liver dysfunction. This will help manage the pain and reduce swelling.
Always seek medical advice in such situations. Do not take such burns lightly. To avoid such serious conditions and to preserve the environment it is advised to celebrate a eco-friendly Diwali without crackers. Avoid burning crackers and also ask others to do the same.
(Dr. Madhusudhan G., Lead and Senior Consultant – Plastic Surgery, Aster CMI Hospital)
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