Here's your sign...

It sounded like a dying camel. We could hear it from the front porch. My partner and I looked at each other with quizzical expressions on our faces.

The lady was rolling around on the ground in a t shirt, her underwear, and socks. The animal noises were coming from deep in her throat. Her family members were standing around in tears, looking bewildered.

"What happened?" I asked.

The family told us that the pt had been using a steamer machine to remove wallpaper when it began to leak. She knelt down to open the lid and it flew off, spewing hot water and steam everywhere. She ripped her jeans off and had been screaming in pain and agony ever since then.

"Let me look." I begged her. She continued to scream and hyperventilate. My partner finally grabbed her face with his hands and sternly to her to calm down. He made eye contact with her and told her that he knew she was hurting and in pain but we needed her to calm down a little bit so that we could help her.

Her leg was burned badly. There were several areas that were full thickness, the rest partial thickness burns. That's new terminology for 2nd and 3rd degree burns. The skin was peeling and sloughing off and you could tell that the one leg was already so much more swollen than the other.

"Ma'am, you have to calm down. Take slow deep breaths. Help us to help you", I said.

We helped her to the cot and got her prepared for transport. She couldn't sit still and I was worried about her tipping us off balance and potentially injuring one of the 3 of us.

"Medic xyz to dispatch"

"Go ahead, medic xyz"

"Dispatch, you're going to have to send us some help here"

"10-4 medic xyz, I'll get anytown fire department en route"

They should have been sent anyway, but that is beside the point. Sometimes we have glitches in the mutual aid agreement---that's the subject of another blog entirely.

So, we get the pt loaded in the back of the truck. My partner got her vitals, obtained IV access, and started to provide wound care.

The Anytown firefighters stuck their head in both doors and asked what we needed.

"I think we're ok back here, can you just drive us in?" I asked.

"Sure thing! Whatever you need."

I got her 10 mg of Morphine and told her to let me know if she started to feel sick to her stomach, I'd get her some phenergan too.

We wrapped her leg in a sterile burn sheet and began irrigating it. The relief was instantaneous---the cool sterile water combined with the morphine gave her some measure of distraction from the intense pain.

"You're an angel", she said to me. "And you're not too bad yourself", she said to my partner.

I notified the ED of her status by radio and we rigged up a continuous drip for irrigation with an IV bag and a 16 gauge catheter. Just before we got to the ED, I gave her another 10 mg of Morphine.

We got her inside and I gave report to the RN who would be taking care of her.

I called later to the ED and they said she had been sent home, to follow up in the morning with the local burn clinic.

Folks, please don't open a pressurized cap until it has cooled off. Serious injuries, burns, loss of life, and incredible pain can result. It is pressurized for a reason and the liquid inside is is generally very hot. This includes radiator caps, small household appliances, and other tools.

Happy Holidays.

A wonderful blog I found the other day. Those who are in the medical field will surely appreciate the descriptions about family members.