Dr. Rahul Gorka
Deepawali being the most joyous festival is celebrated by Indians worldwide. It’s a gala event marked with lights, colours, sweets,crackers but at the same time, marred by unfortunate accidental burn and cracker-blast injuries. By definition, a firecracker is a small explosive device primarily designed to produce a large amount of noise, especially in the form of a loud bang, any visual effect is incidental to this goal. Firecrackers, along with fireworks are thought to have originated in China. The explosion of a conventional fire cracker also generates a blast wave that spreads out from a point source. The continuous availability of high intensity crudely produced fire crackers throughout the year in the markets is one of the reasons for increased cracker burn injuries. Social customs of bursting crackers during the festivals and marriage functions also lead to accidental burn incidents.
The unsafe practice of bursting crackers in the hand is a major risk factor.
Common causes of BURNS during Deepawali:
* Thermal flame burns due to accidental fire caused by crackers, diya etc.
* Inhalation burns due to smoke or entrapment in closed space during fire
* Blast Injuries due to cracker bomb blasts
* Electrical burns due to short circuiting of decorative lights, wiring etc.
In case someone sustains a burn injury, his management should include two aspects-
Pre-hospital care and Hospital care. Both pre-hospital and hospital care play an important role in the management of burn patients by preventing deaths and disability. Education and sensitization of individuals/communities on pre-hospital care in the form of first aid can further help in early recovery of the burn patients.
Pre-Hospital Care includes:
* STOP, DROP, ROLL AND COOL- Stop the burning process by removing clothing, jewellery. Drop to the ground. Roll over the ground to douse fire. COOL down the body by Irrigating for at least 5 minutes. Use cool, clean running water to reduce the temperature of the burn.
* Extinguish flames from the body by pouring plain water, if water is not available, douse the flames by applying a blanket and remove the blanket as soon as the flames are put off.
* In electrical burns, don’t use water. Firstly put the main switch off as quickly as possible and use an insulated non-metallic object to push the victim away from electricity. (No such manoeuvre should be attempted while a person is connected to a high voltage source, as the current is likely to “arc” to the rescuer as he approaches).
* Cover the burn area with a sterile gauge bandage or clean cloth. Wrap the burned area loosely to avoid putting too much pressure on the burn tissue. and transport patient to the nearest appropriate facility for medical care.
* Hydrate the patient with plenty of oral fluids (electrolyte containing solutions such as ORS/Electral). In case of vomiting, avoid giving anything orally. Better to start intravenous line at a medical facility.
* Take care of fractures and probable injuries during transportation.
* Ensure A-Airway, B-Breathing & C-Circulation before transportation to a higher center.
* Do not start first aid before ensuring your own safety (Douse the fire, move away from source of fire, switch off electrical current, etc.)
* Do not apply ice because it may cause further damage to the injured tissues.
* Avoid prolonged cooling with water because it may cause hypothermia (low temperature).
* Do not apply paste, oil, haldi (turmeric) or raw cotton to the burn wounds.
* Do not try to open or burst the blisters.
* Shift the patient to appropriate medical facility and beware of quacks/ traditional dressings, which are unsterile.
Even a small burn, may have the potential to become infected and cause life threatening sepsis.
Unfortunately, many quacks lure patients by claiming that they can heal the burns wounds faster, without scars and better than a qualified Burns/Plastic Surgeon. These quacks selectively treat only the superficial burn wound to support their claims (the type of wounds that would otherwise heal within a week without leaving a scar). So its always advisable to seek qualified medical attention as soon as possible to prevent life threatening complications.
Hospital Care includes:
Hospitalization in a hospital with a dedicated “Burns Unit” is required. Burn wounds are managed with fluid resuscitation, intensive monitoring, sterlized dressings, skin grafting or flap surgery depending on depth, site and tissue damage of the wounds. Splinting, pain management, nutritional supplementation, physiotherapy, Psychological counselling orthotic & prosthotic support along with vocational training in case of disability are essential components of a holistic burn care centre.
(The author is working as Burns, Plastic & Cosmetic Surgeon, at Government Medical College Jammu.) feedbackexcelsior@gmail.com