Wednesday, April 22, 2015

Scalded Dog

Hotels want to provide amenities like hot water for their guests.  As a consequence they'll often turn their water heaters up to their highest available temperature to guarantee at least some hot water under even the highest demand.  But sometimes actual safety is overlooked and faucets can release boiling hot water and injure guests.

Burn baby burn
Hot water can cause significant burns very quickly.  In the picture above, my foot was under the bathtub faucet for only an instant and received first and second degree burns in less than a second.  The red oval is the blister from the second degree burn which immediately ruptured and peeled off.  The blushing around it is the first degree burn caused by less direct contact with the water and energy spreading off the second degree burn.  The rest of the foot wasn't as pale as it appears in this photo; it's just poor color management in the camera and no post-production.

Even though this is a second degree burn, this is very small.  First aid training teaches the Rule of Nines to measure the area of a burn.  Human anatomy divides up readily into multiples of nine percent of the skin's surface area.  Your palm is one percent, an entire forearm and hand front and back is nine percent, the anterior torso (the front of the chest) is eighteen percent, etcetera.  First degree burns aren't counted, only second and third degree burns matter for this.  First degree burns are superficial, like a sunburn.  Second degree burns are more damaged, often characterized by blisters and damage in deep layers of skin.  Third degree burns are severely damaged, charring skin and exposing bone.  Of course, because these degrees categorize how much energy the skin was exposed to, higher degree burns will have lower degree burns around their periphery where skin was exposed to less damage.  This particular injury above is a fraction of a percent of burned area.

First aid for a burn like this is immediate immersion into cold water to take away the excess heat energy and stop the burning.  Burns can continue to develop for 72 hours after the initial injury due to the excess heat in the tissues.  Treatment continues by covering the significant burns with a sterile bandage and dressing.  Then the patient would normally be transported to a burn center.  Or be me, trained to treat serious but small non-life-threatening burns like this.  And I had stuff to do that day.