QI’ve just given one of my characters first-, second-, and third-degree burns from an automobile accident. The character is treated in a specialized burn center. I want him to survive. Beyond IV fluids and high-flow oxygen, what type of treatment might he receive? I suspect that infection and pneumonia are issues. Is he allowed visitors?
Norm Benson
Freelance writer and writer for the
“Green Chain” environmental column
in the Lake County Record-Bee
AHe would be placed in strict isolation and allowed no visitors. At least not until the healing process was well under way. Each physician, nurse, lab tech, or other medical personnel who entered his room would wear sterile gowns, masks, and gloves.
He would receive broad-spectrum antibiotics by IV, and his burns would be dressed using Silvadene. This is a thick white ointment that looks and feels similar to Crisco. It is applied thickly on the burns, which are then dressed with gauze. This dressing is changed once or twice a day. Morphine, Demerol, or some other powerful analgesic would be liberally used to control pain, particularly with each cleaning and dressing since this process is very painful. Many third-degree burns are less painful than second-degree ones since the deep burn damages the nerves in the skin, blunting sensation. This is not always the case, however. Your character, as you pointed out and as is the case with most burn victims, would have burns of varying degrees.
If the wounds began to heal and no infection was present, skin grafting of the third-degree burns would begin. Wound healing is heralded by the appearance of granulation tissue, which is red, moist, and rich in blood supply. It appears in the burned areas after one to two weeks in most victims. Many third-degree burns will not granulate. Either way, grafting could be done from several days to a couple of weeks after the burn. Sometimes longer. Infection sets everything back and increases eventual scarring.
Infection and pneumonia are the most common causes of death in severe burns.