Burns knowledge, 90% of people dont know how to treat burns properly

[GLC]

Apparently 90% of people dont know how to treat a burn?

University of NSW surveyed 7000 people and only 10% knew the full treatment.
Thankfully 80% knew to cool with water, but most did not know to keep the burn cool by continuing the flow of water for 20 minutes, or to remove clothing not attached to the skin from the burn site.

My guess is that a fair amount of the people who were surveyed were people who had elected to "save time" by completing a 1 day course rather than looking at the amount of subjects within a first aid course and realising the simple maths that it takes longer than 5 minutes to cover a topic properly.

[Burnsy]

I agree, plenty of people don't treat me properly

On a serious note though this is something everyone should make sure they have knowledge on.  My wife recently dropped a cup of black tea in her lap and it ended up with her spending the night in the Burns *Ambos and nurses had great fun with her surname) Unit at RPH, who would have though a cup of tea could cause such damage, I certainly would not have believed it if I had not have seen it.

The scariest thing to me that came out of this is how a small child's skin would react to the same heat.  Our passtime puts us in a high risk category for burns, especially in children.  Diligence is the best form of prevention but make sure you do know what to do just in case.  Interestingly the QLD Parks and Wildlife list burns to children as one of the reasons they have removed fire pits from many national parks - nanny state at it's best there!!

[Patr80l]

Good point.
Treatment of burns can be summarised as "Cool & Cover".
The deeper the burn, the longer you need to cool it.
The other half of the deal is to cover the burn with a sterile (or clean) non-adherent dressing.
Worth remembering; after you discard the first layer on the roll, Glad Wrap is sterile and makes an ideal burns dressing for larger areas.
By the way, a Level 1 First Aid course HLTFA201A (which would normally be taught in one day) includes treatment of burns.
Dr Greg.

[Bird]

Sort of on the same tact, but what I find interesting is that people with First Aid Certs are not kept up to date with changes in methods. My club ran a Level 2 + more course recently and there was so much that had changed since the last course, most left confused.

lots of ... no we dont do it that way anymore...

They have everyones info thats registered, why not send updates to their registered people every 3-6mths.... Email would do if snail mail is too expensive.

[Mungoman]

Used to be 10 minutes of running water...that's inflation for you.

[Mace]

"people with First Aid Certs are not kept up to date with changes in methods."

Good point. Couple of issues tho.

There have been many changes in First Aid Practises over the past few years.  We have over 60 First Aiders in our workplace.  I told them all that if your Qualification is an old "First Aid Level 2", then you need to retrain, as the cirruculum for that course is over three years old (out of date).

The new "Apply first Aid" (what would have been delivered at your training Course, lost) has to be also supplemented by Defib Training and Anaphylaxis, Asthma & Epilepsy courses to be fully operational.

Although no one (to my knowledge) has ever been legally held accountable for delivering "out of date" best practice first aid assistance, I wouldnt want to be the one who was.

The bottom line:  deliver any assistance you can within your limits of competency.  Seek assistance when needed.

The second issue is the update/renewal trigger.  Training organisations (such as my employer) do have records of who did what, when, but it is up to the individual (in the absence of any centralised register) to ensure their competencies are up to date.  Medical Staff, nurses, etc, are required to do this as part of their vocaional competencies on a regular basis.  If you arnt employed in the industry (or have an industry  role, such as a workplace first aid officer) the importance of renewing quals isnt as great. Its not the training organisations role to ensure follow up training.  Not sure what the answer is.

Hopefully, people from the general public will keep putting their hand up for such training, as its a tremendous skill to have.

Cheers all,

Al.

[Patr80l]

"I told them all that if your Qualification is an old "First Aid Level 2", then you need to retrain, as the cirruculum for that course is over three years old (out of date).

Apply First Aid is still often referred to as "Level 2" even if not technically correct.   Some might have done Apply First Aid courses recently and the course would be up to date, even if the instructor referred to it as "Level 2".   

Changes tend to be evolutionary rather than 180 degrees but its still worth doing a course every three years or so.   (CPR needs to be every 12 months to keep your skills up.)    Most of the changes tend to be towards making things simpler and easier to remember.

[Mace]

"Changes tend to be evolutionary rather than 180 degrees but its still worth doing a course every three years or so.   (CPR needs to be every 12 months to keep your skills up.)    Most of the changes tend to be towards making things simpler and easier to remember."

Yeah, partly agree.

Our Workplace stance is that if the curriculum changes, we build the update into the annual CPR course.

The main issue (as lost has identified) is the number of people who let their skills competencies lapse by 5 - 10 years.  Unfortunately, Training organisations arnt going to send out free updates, we,re now in the business of making money, not community service.

cheers.

[rastus]

As Patr8ol stated, Glad Wrap is a very good "temporary" sterile burns dressing and is now standard on all Victorian Ambulances for that purpose, it is also carried by 99% of campers.

As long as it is applied ALONG the limb or burnt area and not wrapped around the burnt area, as this allows for swelling (which will happen). Once applied you can still cool the area with water over the Glad Wrap.

Very good basic first aid

cheers rastus

[GLC]

We send out reminders every 12 months on cpr as it is the situation that changes most often.  The 10 minutes was never to my knowledge part of the standards as I can remember the 20 from first aid courses in the 70's and 80's.  The reason we dont go over the 20 minutes is that we need to ensure that we dont over cool the area, if the burn is so serious that it will need recooling of the area then it is more important that the person is in medical care and not ours:)

I agree that it is important for people to be kept up to date on changes and where a major change occurs our students are notified where possible, but the 12 month rule is normally sufficient, when you do a CPR update our trainers run through any other changes.

As for the legal on a person who hadnt updated.  in Morrabbin Melbourne, a person took a fall avoiding a forklift, the first aider with an expired cert did what he could and said the person was ok to continue, 2 hours later the person collapsed and an ambulance was called, the person died from bleeding within the cranium, the first aider was not charged however the management and company received fines in excess of 200,000.  the reason why the first aider was not charged is the good samaritans act introduced to Victoria in the mid 2000's.  The first aider did all he could remember to do, it was the boss that had the responsibility to ensure the first aider was properly trained.

[GLC]

amaso I disagree, first aid is a community service, every dollar we make above cost goes back into the community via discounted kits for community groups.  I might not get rich from looking after the community but I will sure as hell be able to offer a proper course when we dont worry about the profitability of those courses.  Perhaps why we still do run a 2 day course instead of those sub standard 1 day courses.

[Mace]

From my memory of that incident, the first aider provided what assistance he could and the staff member then refused further treatment or ambulance assistance becasue he felt ok.

The Business owner became liable because he failed to dake due care of his worker - ie, call the ambulance or ensure he received medical treatment.

Its a minefield out there. ! !

[GLC]

Amaso I dont recall any mention of the refusal in the court paperwork but you may be right.  either way the court documents were very clear that it was because the first aid from a current certificate holder was absent.  the certificate had expired by some length as well, so it couldnt be argued as an over sight

[Mace]

"amaso I disagree, first aid is a community service, every dollar we make above cost goes back into the community via discounted kits for community groups.  I might not get rich from looking after the community but I will sure as hell be able to offer a proper course when we dont worry about the profitability of those courses.  Perhaps why we still do run a 2 day course instead of those sub standard 1 day courses."

Dont get me wrong - Im talking tounge in cheek here.  first Aid provision is definetely a community service, just that all training provision isnt!

Difference is not for profit vs fully fee recoverable training providers.

Agree that Apply First Aid should be prefered over  Basic Life Support.

Good to see  the thread has got some followers.

cheers.

[GLC]

hopefully means that people care about learning a little about first aid:) considering we have a Quack, an ambo and a couple of trainers perhaps a questions and answers page might not be too bad, that way we can keep people updated?

[Mace]

Sounds a great idea.

I actually do WHS (for a large training provider), but keeping first aider currency for staff is a big task of my role.

Its an undervalued skill - not shure if it is, but should be fully tax deductible for any member of the general public who has

[GLC]

must admit just got an update through and I cant help feeling a little cynical, NSW University conducts survey about burns, Adelaide University just rewarded a $429231 grant to look into burn management?  hmmmm where did that metal colander go? The voices

[GLC]

unfortunately only tax deductible where it is work related, first aid kits can be written off against some health insurers but not sure on first aid training, we dont even get subsidised unless we enrol them into a full course and then just let them do the first aid component and drop out, which we dont do by the way, know a few who do though.  Probably why I am always looking at ways to subsidise individuals out of my own pocket.

[Patr80l]

Hi, Quack here. (and a first aid trainer, private first aid medic and with a fair bit of forensic experience too).
Is seems like the First Aider who did the best they could, within the knowledge that they had, couldn't be criticised, although if they were the designated first aid officer that would be a different matter as they should have maintained currency.
As far as paying for community services is concerned, that is an interesting issue.   The largest first aid provider and training organisation is largely staffed by volunteers.  Unfortunately they are falling behind the private organisations who have become more professional and more reliable.   The company I work for providing first aid services gets a lot of new clients who have found the black & white mob unreliable.
Clean water is a community expectation, but we still pay for plumbers.

[Muso]

I did my Senior First Aid certificate and let me tell you, as a recipient of a serious burn to my shin, after jumping thru a wall of flame (burning fibreglass), and watching my 40 foot catamaran and its 11 years of work gone in less than 30 minutes, I was so numb and "out of it" that it didn't occur to me or any rescuers to use cool water.

I spent 2 weeks in hospital having skin grafts to my leg.

[GLC]

Hi Quack, got to be careful or I might start to call you that forgetting your pat8rol:)
The black and white mob are perhaps more highly financed by state and federal interests than any other group.  They are also the favourites of the undereducated as to what a good training facility should represent.  Unfortunately they have gone more and more after the dollar, what respect I had for them is starting to fade:(  Stupid thing is I was one of them for about 20 years.  Lots of great arguments with the white and red mob about the governments favouritism.  These days I think it needs a bit of a shake up, it needs to really try and use the Millions they receive from the Government to start a campaign around first aid kits in every car and first aid training for every new driver.

Muso that is no good, losing the cat is terrible (bike rider here so know the pain of watching your creation crumble, the body pain comes later) the treatment for good first aid is drilled in until it is second nature for a lot of first aiders, pitty they didnt simply grab the garden hose and cool your leg down, would have done a world of good.
 

[Kit_e_kat9]

I just completed my Active First Aid (Cert II) course today. 

Yep 20 mins for burns .... cover and cool.  We were left with the impression that all first aid to a refresher at 12 months, 24 months and the whole course again at 36 months.  Works for me.

Just remember that First Aid means just that ... first assistance on site ... to stem bleeding, keep blood circulating, apply assisting measures really ... anything more technical wait for a professionally trained ambo or doctor to arrive.  First Aiders are NOT trained professionals but ARE trained in the VERY basics. 

If it keeps you alive it can't be all bad.

Kit_e

[morgue]

It also helps to know what catergory of burn it is, for example 1st Degree, plus the % of burn.
Yes but generally, cool and cover...but and there is but

When the skin starts to come away from the body and epidermus is exposed....cool and very loose wet cover...not dry cover...wet / very damp.

Also for the minors up to cat 2...good old 100% Allo Vera  gel, kept in the fridge or esky...works wonders.

Case in point...bloke at work, burnt his palm by putting it on a hot exhaust muffler, squeezed a heap of 100% pure Allo into a bag, shoved his hand in it,  then tapped up the ending.

Doctors kept the bag on for 24hrs....palm / hand good, no blistering, no scarring.

 

[DeLuxHiLux]

As Patr8ol stated, Glad Wrap is a very good "temporary" sterile burns dressing and is now standard on all Victorian Ambulances for that purpose, it is also carried by 99% of campers.

As long as it is applied ALONG the limb or burnt area and not wrapped around the burnt area, as this allows for swelling (which will happen). Once applied you can still cool the area with water over the Glad Wrap.

Well, it USED to be our primary burns dressing until we ditched it in favour of "Burn-Aid"


Comes in Face shape, big and small etc etc. Said to be the bee's Knees, but is now there is a small group of Dr's who dislike it. It draws heat out really well....sometimes too well, as it can cause Hypothermia in some cases. HOWEVER, we still carry Glad Wrap as a back up, for all these reasons mentioned earlier, and make it a great thing to know for us campers who may be some hours from more advanced assistance (in an ambulance or by plane  ) . By covering the burnt area is prevents nerve ending contact with air (because it is normally covered by skin) which in turn reduced pain (it does seem to work in my experience) is sterile (as discussed) and can be cooled through. And as Rastus said I think, go DOWN the limb NEVER around to allow for the inevtiable swelling

GLC Said:"The reason we dont go over the 20 minutes is that we need to ensure that we dont over cool the area, if the burn is so serious that it will need recooling of the area then it is more important that the person is in medical care and not ours:)"

Very relevant point. Especially for those in remote locations. I've been to 1 pt who was having his burns enthusiastically cooled by bystanders with a garden hose!! Great for the burn, not great in the middle of a melbourne winter and the pt is hypothermic!! Cool the area, not the whole patient (unless the whole pt is burnt - which i hope no-one ever has to deal with!!)

From my memory of that incident, the first aider provided what assistance he could and the staff member then refused further treatment or ambulance assistance becasue he felt ok.

The Business owner became liable because he failed to dake due care of his worker - ie, call the ambulance or ensure he received medical treatment.

Yeah, but hang on - if the patient doesnt want an Ambulance, and was in a fit state to refuse said ambulance, how does the business owner get in the poo for that?? Perhaps he was fined for failing to keep a safe workplace (either due to the lack of  forklift movement/pedestrian seperation or failing to have an appropriately trained first aider), but in the end, a person can decline an ambulance, and unless you think the person is unfit to refuse (confused, disoriented, severity of injury, effected by substances etc), all you are doing is wasting the Ambo's time if the person is just going to tell them to bugger off when they arrive!!! If the patient is making it plain they dont want an ambulance, there isn't much the ambos can do when they get there!! NOR can the business owner bundle the worker into their car and force them to go to a doctor or hospital, and force them to seek medical attention. Whilst it's sad the person in question died, but one of the benefits of being a human being is that you have the right to make decisions for yourself, and if someone relieves you of this right, that someone can be charged with assault and/or false imprisionment. Very extreme, but legally factual. You can offer, encourage, persuade and cojole, but you cant force, someone to seek medical attention.

I attended a case where a man had a fall at a shopping centre. He had no injuries, just stummbled and fell, but  was being essentially held down by a security guard at a shopping centre so he didnt leave before we arrived. Security Guard is lucky to have a job and not an assualt conviction instead. Aforementioned Security Guard, when asked used the all too frequent "Its our policy that anyone who is injured is checked out by an ambulance" NO Worries, I'll send your employer the bill then shall I?  Thats funny, I dont remember being their  first aid provider. Ambulances are for sick/injured people, not there for large multinational companies to have a free first aid service to give them someone to try and throw their liability onto. If someone is injured, no worries. (there.... rant over!!)

Clearly common sense (and here is the flaw in my plan) would say that if the person had significant injuries then OF COURSE you should call, and please dont take this as a dont call an ambulance comment. Some people will ask you to call, some people wont be able to call for themselves, some people will need one called on their behalf ( mental health issues as a primary example), and some people wont need you to call or may ask you not to call.  But remember, that if you do call, and the situation changes, and the person says "Nah mate, i'm all good and I'm leaving" then you can call back and cancel!! So many people get us confused with Fire Trucks (who in Victoria ALWAYS keep going once called :/ ), because trust me, there is always another job waiting if YOU dont need us......sad but true.

As a Paramedic Educator and (Civilian) First aid Trainer, if someone has a question, I'd be happy to try and answer as best as possible, if someone has a burning (no pun intended) question.

[MrWilson]

For those who often camp bush hours away from medical care or dont have an extensive 1st aid kit with burn aid etc ... try this.

Most of us campers enjoy eggs so will have some handy.

Initial first aid consists running cold water on the affected area until the heat is reduced and stops burning the layers of skin. 
Then, spread egg whites on the affected area.
Separated 2 egg white from the yolks, beat them slightly & apply to burn area the whites when dried and formed a protective layer.
Egg white is a natural collagen and if continued during at least one hour to apply layer upon layer of beaten egg white. 

Pain can be redused or even in some cases no longer felt and by the next days have limited a trace of the burn. 
The burned area regenerates thanks to the collagen in the egg whites, a placenta full of vitamins.

This information could be helpful to everyone: Please pass it on.