Yeah, happened to me again. Contrary to popular opinion, in the annals of self inflicted wounds I've only burned myself a few times. Once was a rather impressive petrol fire involving both hands and a carburetor full of fuel, another was yesterday when I inadvertently bumped a pipe under pressure on the Fairlane releasing a large volume of very hot, caustic sodium silicate solution across a hand. Ouch.
Now normal boiling water burns are at STP, meaning generally the temperature of the liquid is around 100C or less (at one atmosphere water boils at 100C).. of course frying oil or sugar syrup burns are at higher temperatures, but thankfully these are rarer than water burns (and much, much nastier)
Sodium silicate is also known as waterglass, a pretty powerful mineral glue that's used to seal and weld shut leaks in the cooling systems of cars and it's also pretty good at sticking to skin.. and really good for turning flesh into a soap like substance.
So I did what I've done before with burns and I was pain free reasonably quickly, although the skin has already started to slough off and it's going to be a bit yucky for a week or so while the new skin grows.
Done this before? I hear you ask - well, many years back I was assisting someone removing the carburetor from the Ford Falcon Utility in a shed in Joondanna when they for some reason the assistant professor turned the key. I had released the carby and was holding it just off the manifold when the spark kicked back up and ignited the fuel in the carby, the fuel on my hands and the fuel all over the engine intake. Under these circumstances the reactions available to a person are to run screaming in ever diminishing circles whilst waving their flaming arms above their heads (amusing, but largely useless), hurl the flaming carby back into the engine bay to burn while running for a tap, or do what I did, an unusual combination of comedic and damaging actions.
First I carried the carby outside the shed while still aflame, avoiding spilling fuel all over myself and elsewhere. I dropped the carb in a safe location, went back inside and used toweling to put out my flaming self, then I attempted to use the said same towel to extinguish the fire in the engine bay. Of course my fuel soaked hand caught ablaze again and this farce was repeated until the flames were extinguished on both the car and myself.
Now to tend to the burns. Cold water did little, but detergent washed away the excess petrol (it's also antimicrobial not that it matters given the amount of liquid I was yet to wash across the hands). Then the Host of this party declared their skill in first aid and they smeared a wonderful greasy oily antiseptic substance over the hot bits which immediately induced a Great Sensation of Burning. Detergent and cold water resolved that mistake and deciding I'd had enough of that place I drove home, picking up a bag of ice on the way.
I had decided at this point to do an experiment, having encountered the popular first aid dogma that ice is bad, running water good I thought I'd put it to the test. Now while this may seem an anecdotal and singular experiment, I choose to view it as I would a twin study (the most ideal of all experiments) - see, comparing little Mary-Jo's scalded pinky to 'Neckless' Arnold D'Masher's arm being immersed in a deep fryer for a minute is a lousy way of studying anything, but two hands on the same body - man, this was an awesome opportunity!
Since both were immersed in cold running water for around 20 minutes or more already and I was still in a large amount of pain, I could neglect Test Subject Hand #1, and thus Hand #2 was immersed in an ice slushy for about 12 hours until the pain ceased altogether. I would sit there with my hand in the ice until it kinda went from a sensation of too hot to too cold, then I would remove it. When I started feeling too hot (burn pain) again, in the ice it went. This worked well.. in 12 hours the hand went from ouchy-burny-hot to feels fine thanks for asking.
By comparison poor Hand #1 was still burning like hell and anaesthetic creams (lignocaine 10%) were slathered on and continued to be slathered on for a good week to dull the hurties. As to how they healed, well the un-iced hand blistered the next day then the skin came away. The iced hand did not blister but the skin nonetheless also came away - and in time they both grew back to look like my normal freakish hands more or less. Conclusion .. Pain bad. Ice good. Ice numbs pain. Petrol burns also rate a little higher than water scalds too given the temperatures involved, but I'm working with my experiences here..
So yes - I plonked recently maimed hand in ice slushy again and it was pain free after about 12 hours as before.
So - mentioning this to folk, I got the usual advice that ice is bad and running water for 20 minutes is all you need (leading me to wonder if these folk have never burned or scalded themselves). Now by all means, if running water of your minor scald alleviates the pain within 20 minutes or less then by all means, go for it - but don't for one minute dismiss the experience of others who feel the need to soak their body parts in ice water for longer. Your burn may have stung you for a moment, or it may be severe enough that something more is needed. You be the judge. Myself, I decided the pain was not worth it and went with ice. I do not do this for fun.. For a start it means I have to carry abound my ice filled container which my good wife refers to as my Bucket of Shame.
So anyhoo, back to the Informed Folk - they tell me it was Scientifically Proven that ice is bad as it can cause worse burns than the fire. So off I went to the interwebs to find out what research has actually been done on this matter.
Lert me begin by saying I find a lot of medical and burn sites, specialists and organizations stating that The Burns Dpeartment of the Western Medicine's Department of Burns declaring Their Researchicles has shown Burns is to must to be kept away from the ices as ices is BADS (dot dot dot) with none of it linking to anything remotely resembling research. Appeals to authority are mere propaganda - I can't view this as anything more than anecdotal rhetoric repeated ad nauseum until it becomes 'Fact'.
So onward and upward I go armed with a couple of thoughts.. if ice is so bad, WHY DO THESE SAME PEOPLE PUT IT ON THEIR SPORTS INJURIES!?? I have said for years it does NOT aid healing and was only ever intended to numb the pain experienced by professional athletes so they could get back on the field, anaesthetized enough that they could carry on and win their little flag or prize smarties or whatever, whilst worsening the original injury, and that heat should be used instead to promote healing by raising the metabolism in the affected area. This I would add is backed up by actual real research.
..yet millions of icicles die each year so these folk can apply unlimited quantities of ice to every toe strain and tentacle they stretch whilst pursuing their idea of 'fitness'. (These folk who tell me ice is bad are the same folk who tell me ice is good for injuries. What am I to make of the world when such folk are free to wander and breed without keepers or guardians?)
So I discover a curious thing - There were actually two or possibly more totally separate things being examined back in the Snow V Water for Burns discussion days and somehow they blended into one.
Let me begin by quoting Part 5: New Guidelines for First Aid from the US - " studies have noted the paucity of scientific evidence to support many interventions in prehospital emergency care. Many first aid practices rest on an equally precarious scientific foundation" they go on to note that burn treatment was 'contentious'. I'm seeing that.
The first lot of research dates from times when ice wasn't actually that common, pre-1960's (yes stupid young people.. they did not have much ice back in the day when they were inventing code hopping wireless algorithms that would make mobile technology work, they had to make do with pinning photostats of Eskimos to their meat to keep it cold), and it looked at old wives remedies for burns which included such things as lemon juice, egg whites, butter, vinegar, bicarb soda poultices and other weird household items and compared the rate of success to simple running water. Obviously it found for MINOR burns, 20 minutes under running water was better than any of the other strange things. i.e. don't let Aunt Myrtle with her witch cures near your burns, run it under cold water instead.
So this research is where we get 'running water good'.
A much more recent retrospective study of kids burns showed water cooling versus no cooling of burns reduced the severity of burn depth.. and so on. Much information available showing water is better than nothing at reducing burn depth, severity and pain.
The next lot of research compared ice V running water for MAJOR burns exceeding 30 or more percent of the body - treatment then was immersion in iced water until the pain ceased, however this carried the very real and often encountered case where hypothermia substantially increased the risk of mortality (that means it makes you dead). No surprise, immersing a whole person in ice for 12 hours turned out to be a bad thing compared to using sporadic cold water baths.
Strike one against Ice. Ice baths killed people. This is where we get 'ice bad'.
Other studies across the years compared the rate of healing between ice bath immersion and cold water immersion (running or still) and it found healing was delayed or slowed by ice baths (duh.. it's as I said above re sports injuries).
Ice V water on the matter of rate-of-healing, Ice not so good, water better.
So you can kinda see how all this blurred over the years to become Ice Bad, Water Good, but then there's more!
This one is from September 2014 and finds reduced mortality in rats when mild hypothermia was induced in rat-patients
The theory: " Early surface cooling of burns reduces pain and depth of injury and improves healing. However, there are concerns that cooling of large burns may result in hypothermia and worsen outcomes" what they found was "survival of the hypothermic rats was significantly greater than that of the nonhypothermic rats" to test this they iced up rats for 2 hours after burning the poor little things. I'd add that the rats were anaesthetized, so pain control was clearly provided.. yet it did not help the poor blighters survive.
article here: http://onlinelibrary.wiley.com/doi/10.1111/j.1553-2712.2011.01016.x/full
This shows that judicious use of ice (and not slamming an iceblock against someone 'till their skin freezes to it, or immersing them in ice 'till they die) gives ice a big thumbs up. Ice = winner
Also waay back in 1960, Dr Alex wrote: "Patients with burns of all degrees involving less than 20 % of the body surface were treated by immersion of the burned areas in baths of ice water or by applying ice-cold compresses as promptly as possible. In each of 150 cases, pain was immediately relieved and the extent of the redness and blistering visibly reduced. Local cooling was continued for several hours, until pain no longer returned when the part was taken out of the bath. No infections occurred in patients treated within one hour after the burn. This form of treatment has advantages in emergency care for lesser burns, since it is easily available, inexpensive, humane, and promptly effective"
Dr Alex clearly thinks ice is a winner, so we're going with Ice as the winner here.
This article : http://www.ncbi.nlm.nih.gov/pubmed/3986639 compared water temperatures, 8C 15C, 20C, 25C, 30C and found only at 8C was blistering significantly reduced. 8C is closer to iced water temperatures than the 20C we get out the water pipes.
but here http://www.ncbi.nlm.nih.gov/pubmed/9115611 > "they found holding an iceblock directly on the burned area "is harmful in some instances". There are literally hundreds of articles looking at burns and first aid treatment, many conflicting conclusions and many either so specific to certain circumstances or couched to specific outcomes that a clear conclusion is difficult if not impossible to determine. And anyway, who holds an iceblock against themself until their skin freezes? How do you even do that without it melting?
So what else is there to consider? Well, we know about hypothermia and I can assure the good reader the risk of hypothermia from immersing a hand or foot in ice water is fairly low unless you are really really tiny.. We also know that frostbite can occur, but again, the good reader will surely be aware that the -C temperatures over many hours it takes to freeze and damage or destroy a toe is unlikely to occur with a hand dipped intermittently in an ice slushy at something between 5C and minus 5C. There's also great confusion revolving around 'ice' and 'iced water' - two totally different things.. heck I have measured water from the cold tap in Perth in summer as high as 27 C - that's hardly 'cold'.
Also we operate at around 37C, on a hot day we can stand 60C air temperature with our air conditioner working (sweating) - however air is not a liquid stuck to us - 60C water will scald and 100C will definitely scald a person in a very short time. We also know that cold can literally 'cook' meat too - So how long does it take to cook with heat and cold? Well, Throw a finger sized prawn in boiling water (100C) and you'll find it can cook in under 30 seconds - heat cooks fast.. My freezer runs at -14C - I can put raw prawns in there and they most certainly will cook.. the process takes about 6 to 12 months. Cold cooks slow.
From this observation alone I can guess that my finger encountering 100C + sodium silicate from a boiling radiator for 2 seconds is going to take a lot more damage than intermittent immersion across 12 hours at something around 0-5C
I also know from experience that with a scald or burn that will blister and remove skin, there is considerable benefit in reducing the level of pain and iced water does the job better than cold running water does. Sure, there is clearly damage done to the hand, but it's evident by the fact the skin around the burn remains normal and healthy.. so the cold clearly did that portion no harm whatsoever. The burned area though, yeah - that's borked.
So, a day after the burn and ice-slushy treatment I'm totally pain free and the hand is alive and functioning.. not so bad for a radiator burn. There are deep purple patches where the underlying tissue has taken a hammering. That meat is cooked and the skin most definitely will be falling away in a day or two.
If you find yourself thinking 'yeah nah, pussy.. that's not even a real burn' .. picture a V8 Ford that had been running for 30 + minutes on a 40 C day at 2000 rpm with the air con on full.. the pipe burst under full pressure dumping hot caustic across a delicate man paw - If you're brave you can google 'radiator burn' and go check out some evil looking scald blisters to compare. I would look the same as those were it not for the ice water.
Whatever you make of all this, you're free to decide next time you burn yourself whether to go with 20 minutes of cold water, or however long you need in iced water for the pain to stop. My guess is you get a REAL burn you'll find yourself with your own bucket of shame and a war story to tell about the benefits of iced water pretty quick!
It seems it is not just me who discovered iced water aids in burn pain, here is another sensible person who unfortunately experienced what others may encounter when they seek medical advice, reluctance by doctors to listen to the patient. Fortunately for him he had the wit to leave and continue his own treatment. Interestingly you'll note many of the comments on the page offer some pretty lame treatments suggesting to me that they've never suffered a serious burn.
8:56 p.m. - 2015-01-30
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