The Dangers.

The dangers inherent in using explosive devices for special effects are fairly evident, and include: direct burns, cuts and wounds, blast damage (usually with 'shrapnel'), deafness, and blindness. Of these only the first two can be immediately treated by First Aid with any real benefit. Since these are the most common injuries, this section will deal mainly with First Aid for burns, and will deal slightly with cuts later.

What Burns Are.

According to professional First Aiders, burns can be one of the most misleading types of injury. It is not easy to tell how serious a burn is, or what complications could be present. Burns can kill! When the body is burnt, it naturally pumps plasma from the blood to the affected area, to cool it. If this continues, the body will enter fluid-loss induced shock, which can result in death!

Burns are usually divided into three types: shallow - the skin is reddened and tender. No deep damage is sustained to tissue; medium - the skin is reddened and tender. Blisters form as the body pumps plasma to the affected area. The patient will probably suffer from shock. This sort of injury is commonly caused by prolonged contact with a hot object, immersion in a hot fluid, etc.; and deep - the damage caused by the bum affects deep tissue layers. The flesh splits and cooks, leaving the skin cratered. The pain is intense as the nerve endings buried in the cooked flesh die. This sort of injury is common with some chemical burns, and most pyrotechnic burns, where burning material is forced onto and into the flesh, while it continues to burn.

How Burns Happen.

The body has a high specific heat capacity which means that it can absorb a lot of heat, and takes a long time to lose it. If you boil an egg, then hold it under cold running water for twenty seconds or so, the surface will feel cool. When the egg is removed from the cold water, it quickly heats up again. This is because the egg stores heat inside. In the same way, the human body stores the heat inside whilst it is in contact with something hot. Even when the source of the burn is removed, the heat absorbed will cause the flesh to continue cooking, destroying the deep tissue layers. It is essential to get this heat out, and keep the injury as cool as possible, as quickly as possible.

Treatmenl of Burns.

Shallow Burns.

The only necessary treatment is to cool the area with (preferably) cold running water. If the skin breaks, or produces blisters, then a dressing should be lightly fastened around the affected area.

Medium and Deep Burns.

The following is the procedure for the treatment of bad burns:

1. Sit the person down and reassure them. Simply talking to them and telling them that they will be all right can prevent shock, heart attacks and similar stress problems. This can save lives!
2. Perform a visual inspection of the wound. You are looking for: i) restricting items to remove, such as rings, bracelets or clothing. The wound will swell with time, and these items could cause serious damage. ii) foreign bodies, such as pieces of wire, glass or twigs. These should not be removed at this time. iii) other complications, such as obvious broken bones, bleeding or loss of circulation.
3. Get the person comfortable. Preferably sit them down, and try to position the injury so that it is higher than the heart. This is to reduce blood pressure to the injury, and so reduce the risk of going into shock. Do not let the person sleep. Keep them talking.
4. Cool the wound. If possible use cold fresh, running water. If this is not available, use anything which is. It is essential to keep the injury as cool as possible for at least 10 minutes. This will ease the pain felt, and should reduce the amount of internal cooking the burn causes.
5. Perform another visual inspection of the wound. Tie a light tourniquet above the injury (if possible) to further constrict the blood flow to the wound. Note that tourniquets are considered to be very dangerous by some First Aiders.
6. If the person complains about continuing pain, go back to Step 4 above for another few minutes.
7. Once the immediate pain subsides, use a light sterile lint bandage to cover the burn. Do not tie this tightly. Leave an uninjured part of the body exposed to check this. This bandage will reduce fluid loss by holding plasma near the wound; it will help prevent infection of the wound. Bind over any foreign bodies present (see later).
8. If the injury covers an area of two square inches or more, you must seek medical advice from a nurse or doctor.

General Considerations.

1. If you are in any doubt at all about treatment, or if it is a serious burn, you must seek medical assistance as soon as is possible.
2. Although it is necessary to cool the wound in any way possible, it is recommended not to use creams or ointments, such as 'BURNEZE', unless there are no alternatives.
3. Foreign bodies should be left in the wound. This is especially important in dealing with clothing, which has burnt and is stuck to the wound. Do not remove this. It will have been sterilised by the burning, and is holding the skin together.
4. If you manipulate a wound and cause damage, even whilst trying to help, you are liable. Get the person to close his own fist on the bandage, etc. (Sounds cruel and heartless but it helps prevent further damage.)
5. Try to avoid bursting blisters, as these hold the plasma on the injury and prevent infection.
6. If the injury is not serious, and there is no likelihood of the person needing hospital treatment, it is all right to allow them to drink. In all other situations "nil by mouth" that is do not let them eat or drink.

Binding over Foreign Bodies.

To bind a bandage over a foreign body requires a 'bandage bridge'. Take a bandage and unroll it about halfway. Roll the unrolled half into a second roll. What you should get is two rolls of bandage joined by a strip, looking similar to a 110 camera film cartridge. This should be used to protect the foreign body without actually touching it. It is essential to seek medical assistance immediately if there is a foreign body in the wound.

Handling Burning Clothes.

If clothes are set alight, lie the person down and smother the fire with cloth, or douse with water. If possible, avoid using plastics (e.g. Nylon) as this makes a mess that the surgeon has to clean up. Do not roll the person around, as this just feeds and spreads the fire.

Damage to the Face.

A prematurely igniting pyrotechnic will occasionally spray burning material over the face, including the eyes. The natural reaction is to rub them, but this must be prevented. Both eyes should be lightly dressed and medical assistance sought immediately.

Treating Cuts.

There are few differences between treating a bad cut and a bad burn. These are as follows:

Do not soak the wound in water. This is unnecessary and will prevent clotting of the wound. Tie the bandage tightly. Direct pressure on the wound will stop blood loss from the cut.

Handy Reference Sheet.

The following is the procedure for the treatment of bad burns:

1. Relax and reassure the patient.
2. Visually inspect the wound for constricting objects, foreign bodies or obvious complications.
3. Raise the injured area to reduce blood pressure at the injury.
4. Cool the wound for at least ten minutes.
5. Give the wound another visual inspection.
6. if the patient is still in pain, repeat (4) again.
7. Loosely bind the injury with a sterile bandage.
8. If the injury covers and area of two square inches (i.e. 5 centimetres) or more, you must seek medical advice from a nurse or doctor. (I feel you should seek medical advice anyway, burns are a nasty kind of wound and are liable to infection.)