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Burns/Burn is it 2nd or 3rd? How to care for?

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Expert: Jim B - 11/30/2008


Question
Six days ago I was burned by a pot of fresh hot coffee. The coffee spilled on top of my hand. The burn is approximately 3x2 inches. The liquid appeared to melt away my skin. The area is very swollen, extending to my fingers which are so swollen my rings will not fit and the knuckles are puffy. Bruising is now showing all around the burn, I cannot lower my hand below my waist without pain and pretty intense pressure, I have been putting neosporin, a sterile gauze and a wrap on my hand. I change the dressing 2-3 times per day and each time I change it the gauze is yellow and the last two times it started bleeding when I took the gauze off. I cannot lift heavy items without pain and two of my fingers are now painful when I move them. When I take the gauze off the wound is white then turns bright red and when the air starts to dry it out and it becomes more painful. I hope I have given you enough information to tell me whether this is a second or third degree burn and if you recommend I do anything different than I have been. Oh, I have also been taking amoxicillin. for the last two days. I was worried about infection and hoped this would help. I appreciate a response as soon as possible.


Answer
Hi Debb48,

I would see your doctor for this one, as it soulds like a third degree burn. It should be treated with silvadene cream (prescription) and kept covered with sterile gauze. Each finger should be kept bandaged seperately to insure that the wounds do not end up joining together. But see the doctor promptly for care of this burn.

Jim

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Jim B

Expertise

I can answer a variety of questions concerning the physical care of burns and burn patients which commonly are of interest to both patients and their families. Also I may be helpful in suggesting lifestyle modifications which will help with a more complete recovery from a serious burn. I can also accept questions regarding the physical classifications of burns and the implications regarding the size, depth, and location of burns. What I cannot answer based on my own knowledge and experience I can refer to my current and former collegues in the field including the plastic and trauma surgeons and burn recovery organizations. In many of these cases I will provide a line of communication directly to a specific expert or organization. While I can describe general treatments routines with which I am experienced,I cannot answer questions dealing with specifuc diagnosis of conditions or problems. Additionally, please understand that the area of burn treatments is an experimental one in which there is constant progress and change. Each Burn Center invests a major effort in the development of new materials, treatments, medications, and techniques. In this area of constant change and growth no one can be fully aware of all treatment courses employed.

Experience

I am a licensed Paramedic and have also worked as a wound technician in a large regional Burn Center in a Trauma Level 1 hospital. I have experience in the areas of burn evaluation and care, both long-term and immediate first aid. I have also worked as a volunteer couselor with post-burn patients dealing with issues ranging from life-style changes to re-entering the world as a serious burn survivor.

Education/Credentials
BA Economics and Biology, AA Health Care Management, EMT-P licensed in Missouri, ABLS (Advanced Burn Life Support)qulification, ACLS-EP (Advanced Cardiac Life Support-Experienced Provider), Former National Ski Patrol Winter Emergency Care Instructor and Senior Evaluator, Emergency Medical Technician and Paramedic Instructor.

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