Lesson 6: Burns, eyes, and airway
Three specific emergencies that need specific tools - and the common mistakes to avoid.
Burns, eyes, and airway
Three specific emergencies, three specific tools, and the folk remedies to forget.
Three skills, three emergencies.
Treating a thermal burn
Folk remedies and other ways to make it worse
Burns, eyes, and airway recap
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Three specific emergencies in this lesson, chosen because each one has a correct response that is genuinely different from what most people instinctively do, and because folk remedies are unusually persistent in all three. Burns, where almost every household remedy makes the injury worse. Eyes, where the instinct to help by removing something is precisely the wrong move. And airway, where the sign people find reassuring is actually the emergency. What links them is that they are all time-sensitive and all managed badly by default, so knowing the right first move matters more here than owning the right product, though we will cover the products too.
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Three skills, one per emergency. First, treating a thermal burn correctly, which means cooling, dressing, and knowing which burns need a hospital rather than a dressing. Second, managing an eye injury: flushing, covering, and deciding whether this is an urgent care or an emergency department problem. Third, recognising and opening a blocked airway in an unconscious patient, which is the highest-stakes skill of the three because the timescale is a few minutes. Each of these also comes with a short list of things not to do, and in this lesson the do-not list is more valuable than the do list, because the harm here is almost always caused by well-intended action.
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Burn gel dressings are pads pre-soaked in a water-based gel that cool a burn and cover it at the same time, and they are genuinely useful for the burns you will actually meet: partial thickness, the kind that blisters, from a pan or an oven or hot liquid. They come in sizes from a finger to a torso, cost roughly fifteen to forty dollars, and belong in both the home base and vehicle layers, since kitchen burns and roadside burns are both common. Two clarifications. The dressing is convenient, not magic. Cool running water for ten to twenty minutes remains the primary treatment and the gel does not replace it, so cool first with water where water exists and use the gel for what follows. And do not use them on full-thickness burns, the ones that are white, leathery, charred or painless. Those get covered loosely with something clean and dry, and go straight to hospital, and the absence of pain is a sign of severity rather than a reassurance.
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The burn sequence has four steps and the order is the point. Stop the burning: remove the person from the heat, and for a chemical burn begin flushing immediately and keep flushing far longer than feels necessary. Strip: take off jewellery, watches and anything constricting near the burn before swelling starts, and remove clothing unless it is stuck to the burn, in which case leave it. Cool: cool running water for ten to twenty minutes, and it is still worth doing up to a few hours afterwards, so being late is not a reason to skip it. Not ice, which causes further tissue damage. Then cover with a non-stick dressing or clean cling film laid over rather than wrapped tightly, which protects the surface and reduces pain. And avoid the folk remedies entirely. Go to hospital for anything full thickness, larger than the patient's palm, on the face, hands, feet, genitals or over a joint, or any electrical or chemical burn regardless of how it looks.
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Three ways to make things worse. Butter, toothpaste, oil or ice on a burn: the first three trap heat and introduce contamination into tissue that has lost its barrier, and ice causes additional injury through cold. Cool water, nothing else. Digging at a foreign body in the eye: if something is embedded, leave it, cover both eyes and go to hospital, because pressing or probing can convert a surface injury into a penetrating one. Cover both, not just the injured one, because the eyes move together and covering the good one keeps the injured one still. And assuming a snoring, unconscious patient is sleeping comfortably: snoring or gurgling in somebody who is unconscious is the sound of a partly blocked airway, usually the tongue. Tilt the head back and lift the chin, or roll them onto their side into the recovery position, and that repositioning can be the single action that keeps them breathing until help arrives.
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Recap, one line each. Burns: cool running water for ten to twenty minutes, then a non-stick dressing or cling film, nothing from the kitchen cupboard, and hospital for anything deep, large, or on face, hands, feet, genitals or joints. Eyes: flush, do not dig, cover both eyes, and go to hospital for anything embedded or any chemical exposure. Airway: snoring or gurgling breathing in an unconscious person means the airway is obstructed, so reposition, either head tilt and chin lift or the recovery position, and keep checking that they are still breathing. If you take one thing from this lesson, take the airway one, because it costs nothing, needs no equipment, and is the one where a few minutes of doing nothing cannot be recovered from.