A burning question

[MedicSqrl]

I am taking a first aid class just for giggles and can use it as an elective for my EMS degree... While looking through the book before the class starts I stumbled on a thing about first degree burns. It says to not use any type of OTC burn cream/spray (waterjel, or anything with "caine") on it. Just clean, maybe some ointment, and pain meds. The reason stated is to not get sensitized to those topical burn meds because they only provide short relief so why bother. Plus you can become toxic from over use. So my questions are...

1. What does people think about this?

I've used burn creams/sprays with no adverse affects. I do see the point that you need to reapply, but I never was toxic.


2. If contraindicated, Why is there alot of product out there for it?

Then again there are alot of snake kits with plungers that are now contraindicated. they say for all bites and stings just wash and ice. Except for coral snake which needs a pressure dressing.


3. Is this why burn kits (like waterjel/Celox/etc) are useless now for someone who fell in a fire pit perhaps.. ?


I don't come into contact with alot of burns so this if very interesting. Thanks in advance for the input.

 

[ExpatMedic0]

My service uses burn gels and burn bandages covered in gel. Most of them contain lidocane for numbing that we use. Ive used them on myself for minor kitchen burn and have had no problems.

 

[8jimi8]

I think those creams and gels are only contraindicated in severe burns.

If you get burned, but not bad enough to call 9-11. You should be ok with some burn cream.

 

[ExpatMedic0]

I guess I should add we only use them for minor burns

 

[Veneficus]

Most OTC burn ointments in the US are 0.5% lidocaine, it will act as a local anesthetic on any broken skin. Burns, blisters, etc.

Generally OTC burn ointment for shallow (1st and some 2nd) is dictated just like cooling, based on Body Surface Area. Like sunburns.

With larger BSA it is best not to use them because the suspensions can interact with the more potent ointments like silvadine. Additionally they can be an excellent bacterial culture medium or prevent drainage.

If the burn isn't large or very deep, you will probably be ok. First aid is not really medicine, so it is better to print for people to do too little to avoid the "some is good, more is better" mentality.

Many first aid courses I have seen have little to do with helping and more to do with not making the problem worse.

 

[MrBrown]

We use water or saline preference on water tho

 

[mycrofft]

Good replies above. Add these thoughts.

1. Large burn areas can conceivably absorb lidocaine from OTC preps even faster than through intact skin. Not good.
2. How many first aid kits contain outdated useless topical preps, and how many medicine cabinets hold outdated contaminated or just "the wrong" topical preps for treating burns? Ask always "where is the benefit? Where is the risk? Do they balance?".
3. If the pt needs a hosp., the ER will waste time and cursing cleaning off the topical prep.

a. Remember FAST administration of any clean cooling (running tapwater is great) agent is worth three times that much carefully selected but delayed treatment. Stop the burn.

b. I have directed and used immediate and very judicious direct application of ice for very short periods. Worked great, a couple times a grease burn never blistered. DO NOT let the pt control it without your supevision, and never make an ice bandage.

b. Personally, I use the OTC green gel with aloe and lido in it for very minor stuff. Keep it away from the kids, looks yummy, and it does have an outdate which seems to be superfluous by a couple years if it's stored at controlled room temp.