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I'd hoped there was an opportunity here to get into the meat of this particular area of clinical care and there still is if comrades are prepared to just discuss the issues and point out key items of interest, problems and so forth such as Tiggers' point about the absence of consensus from...

Sorry Tigger/Rick - seems to be some cross wiring of comments in this conversation.

Precisely why I am lobbying to establish a standard model literally across as many bodies as I can write to, e-mail, phone or otherwise hassle!! And there have been more successes than you might realise. The first was my own service who have now adopted the 20 minute model in full. I also...

I hope comrades don't mind if I interject myself into your conversation at this point. I don't want the key points to be missed. The first is 20 mins of running water cooling is a clinical goal with clinical outcome measures attached. And the "running" bit is actually clinical as well. The...

Thanks for the query Rick. I appreciate the general premise of EMS scene times vs resourcing and preventing delays to definitive care in hospital. I'm sure you would also agree however that with the availability of more research, pre-hospital practices have become increasingly aligned to more...

Hi DrParasite. Exactly - ideally, cooling should be done before EMS arrives. If incomplete, we do the rest of the 20. This applies in all isolated thermal burns. Obviously airway and major trauma e.g. may be priorities, but even in these circumstances a 20 minute cooling block should be...

Back from school. There are lots of concerns about hypothermia in trauma and well there should be. The pathophys is pretty clear. In burns the hypothermia issue is even more pronounced. 1/4 degree and 1/2 degree drops are proportionally more significant in burns than all other forms of trauma...

Well thank you Tigger for asking a pertinent question. First, I will refer readers to the PowerPoint I uploaded in the other thread titled "Towards a standard model of burn first aid - one step forward two steps back" (and the rest of the papers if comrades are so inclined - its all the latest...

OK Agreed. The paper on burns dressings by Wasiak and Cleland from 2014 (A Cochrane systematic review no less) details how little evidence there is to guide choice especially in pre-hospital where there is almost no evidence specifically on dressings. Hydrogels, despite being a "dressing", are...

Hello Rubicon and thanks for the enquiry. I'm not the expert - the evidence is and this is the very point I have made with everyone I have spoken to about this matter. Since you asked about my training and experience. I started with Ambulance Victoria in 1990 and still work for them as an...

What screwed up system would that be? Perhaps you mean our screwed up universal health care system Medicare that we've had since 1975 that provides free medical care for every man, woman and child in the country. Or our PBS - prescription products scheme that means people with chronic illnesses...

How do you know? I'm very interested in US politics as a matter of fact.

I assume by "coming" you meant cooling with tepid water. I think bandages + clingwrap is overkill if that's what you meant as well. Whats become clear from studies is the duration of cooling is significant and an independent factor impacting recovery and complications . It is the clinical sweet...

That's truly harsh. The orange dome idiot monster as a comparison.

Clinically, cooling with running water for 20 minutes is so beneficial that in isolated thermal burns - so no multi trauma, RSI for airway required etc. the time frame to ED is not the primary consideration. And 8 minutes won't change anything anyway and its likely cooling in the ED is...

I hope you all enjoy the documents I uploaded. There's a fair bit of half decent information if you're interested.

Clearly all the things I have said warrant insults, abuse, accusations, put downs, condescension and otherwise deciding there and then I am some kind of second rate smartarse, scumbag idiot that deserves a mob put down. Its obvious from the years of contributions I have made here I was deserving...

You guys shouldn't laugh - I can point you in the direction of YouTube videos stating categorically that such approaches are great for burns. Like toothpaste, turmeric powder, vinegar, potato peels, egg whites and even more heat applied to the burn - a chef reckoned that was the way to go.

After all the put downs and insults I'm going to persevere anyway and stick my nose in here because this issue matters to me and I have many years of work invested in it Tigger so go ahead like the rest and tell me where to go, tell me my delivery sucks again, I should learn to put out fires...

Hi Dr Parasite. No I'm suggesting the exact opposite and seriously can't believe posters here are finding it so easy to feel offended despite the fact I have called no-one a "horrible provider" or that "all medicine in the US sucks" or anything close to such a ridiculous standpoint. And why...