Fireball

Today was my first experience of a serious burns patient. My only previous experience was a child who put his hands on an electric hob. Painful, but not life threatening. 

A young man at work was asked to burn some old wood in a large metal container. This young man decided that using petrol would be a good way to ignite the fire. When the match hit the fumes from the petrol, it created a fireball that engulfed our patient, catching his clothes on fire. 

He was immediately hosed by his colleagues as they called 999. 

We arrived to find him sat on a chair shivering and obviously in pain. We carry a special cooling gel dressing that is fantastic. We also use humble cling-film which stops any air getting to a burn and reduces the pain. We also had to check that he didn’t become hypothermic from the cold water, and wrapped him up in a blanket – counterintuitive, I know. 

A full assessment of his injuries showed about 16-18% burns with 5% partial-full thickness. His face, neck, chest and arms were badly burnt. His hair was singed back to level with his ears and he had also burnt his tongue. This was a problem, as it meant that the fire had potentially entered his airway. The result of this is swelling as fluid rushes to the area. As this happened, it would block his airway and he would asphyxiate. 

We were 25 minutes away from the nearest Emergency Department and 45 minutes from the nearest specialist burns centre as an emergency drive, so I called for the air ambulance to attend. 

They arrived swiftly and agreed that the 6 minute flight would be better for him in case he deteriorated. So off they went. 

A fast paced, potentially life changing/threatening job where we all did what we needed to do.

He’ll recover well as he has age on his side (he was only 20), but he will be left with some life long scarring. I got an update later in the day and he was transferred to a specialist burns unit for ‘plastics’ assessment. 

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