Written on 14thJanuary, 2013
Beginning from the first day of this year when Ikoku Spare Parts Market in Port Harcourt was razed by fire, hardly has any day gone by without reports of fire incident; the most recent being the fire at Arepo pipeline vandal site in Ogun State. Following the poor or near-absence of ambulance service system, it is pertinent for people to know the first aid to give the victims of fire disasters who sustain burns injury. An urgent transfer to a health facility is the way to go after the first aid is given. I will elucidate some steps relevant actions needed to be taken here.
A burn involves the destruction of skin cells, and sometimes the underlying structures of muscle, fascia and bone. It could be partial thickness when it affects the outermost part of the skin (epidermis) or full thickness when it involves both the entire skin layers plus/minus other structures underlying the skin. Ironically, someone with partial burn would be more restless because it is more painful. The deeper the burn, the less painful it is and the more the likelihood of complications or even death. Another determinant of the severity of burns is the body surface area involved. The more the surface area involved, the more severe the injury. Other causes of burn injury could be electrical or chemical. In either case, the injured person deserves the best possible quality of care.
The safety and first aid tips for fire-related burn injuries are: Stop the burning process if you can, or at least take the injured person(s) out of the harm zone. Expose the body by removing the clothing (cover the private parts if it is not burnt) – clothing may keep in the heat and cause deeper injury. If clothing sticks to the skin, cool the material or cut/tear around the area to preserve good skin tissue. Pour cool water over the burnt area for about 3-5minutes. Never put ice or refrigerated cold water on a burn site. Then remove all jewelries, belts and other wears. Do not apply ointments, squeezed leaves, creams, GV or any substance at all as they may cause infection and worsen the injury. Cover the burn sites with a soft, clean, dry dressing bandage or sheet if available. If not available, leave it exposed rather than using a dirty material that may introduce infections like tetanus. Then cover the victim to keep him or her warm. Don’t give the person food or drink as it may worsen inhalation injury if present. Seek medical care as soon as possible.
From my experience treating people with burns, I observed that relatives of the patients most time underestimate the impact of the injury. Many apply all kinds of substances including egg before coming to the hospital. The most important thing you can do for anyone with open injury is to keep the injured site clean. Most times, it is the infection introduced that delays healing, causes complications, costs more money and may even cost a person’s life. People with deep (full thickness) burn injuries always require lots of intravenous infusion (drip). Some may need blood transfusion or even surgery depending on severity. I must stress that people with burn injury need close monitoring and special care. Many Nigerians believe so much in non-conventional or unorthodox methods of treating their health conditions. They work a few times but in the case of burns, it almost always results in complications some of which may require multiple surgeries or death. In my opinion, I do not think the risk is worth taking.
Treatment of burn injury is usually expensive. I’ve treated someone with burn injury that the cost of materials for initial wound dressing and intravenous infusion was more than N40, 000. Nevertheless, the victims of fire disasters in Nigeria are usually of low socioeconomic class. To save these people from dying, I strongly recommend that government at federal and/or state level create a social insurance scheme to cover all medical emergencies in all health facilities across the county. This would cover not only victims of fire disasters but also road traffic accidents.
Some chronic complications of burns on the skin include de-pigmentation of the skin, abnormal scars including keloids, contractures and chronic ulcers. They are usually prevented by early medical intervention. But rather than treatment, the saying that prevention is better than cure still stands. Prevention of fire disaster or other causes of burn injuries will save the individual, the loved ones and the society at large more troubles. The individual and government have roles to play in this regard and both should endeavor to act accordingly.