Just about one year ago this weekend I had an accident.
I wasn’t feeling well; I had a sore throat and was very congested. Not being one that likes to take medications for such things, I made some herb tea in a teapot on the stove. The teapot whistled, and poured the water that had moments before been at a rolling boil into a large cup. As I was carrying this cup across the room to sit down in front of the television the handle of this cup broke free and I lost control of the cup. The boiling water, just under a quart if it, spilled over unto my left leg.
I’ve been hurt before. Lots of broken bones. Leg, arm, collarbone, shoulder. Dislocated an elbow once. None of those felt anything like this; this was a level above. To make matters worse the cotton pants I was wearing had a knotted drawstring so my leg was literally cooking in the water trapped in the cotton.
I eventually got the pants off and to the emergency room. They took one look at me and said “there’s nothing we can do for you here”. They put me on an ambulance and transferred me to the regional burn center at Santa Clara Valley Medical Center. That’s when my education began.
When I got to the burn center, the first thing that struck me was just how specialized the equipment and procedures are. High-coverage severe wound care isn’t like anything else. Patients are submerged, showered, scraped, scrubbed, and dressed several times daily. It’s profoundly uncomfortable, excruciating at times, and the larger the burn coverage area, the longer the patient has to endure it each day. For a patient with severe burns over 80%+ over his or her body, it’s an exercise in character and resolve that can last several hours a day.
The resolve is required not just from the patient, but from the would care nurse as well. They know what they’re doing is painful, but they know it’s also critical to affect the patient’s recovery. Even in the generally aseptic conditions of the burn unit, it’s common for there to be infections that can quickly become life-threatening. Once again, the larger the burn converage, the larger the risk of infection, the harder it is to fight, the higher the risk of mortality.
Proper and diligent wound care, enduring through the pain of it, and performing it expertly and compassionately, means survival to burn patients.
Some statistics that I didn’t appreciate until I spoke to these nurses (from the National Burn Repository 2007 Annual Report):
- There were 178,ooo burn cases in the US in 2007
- Of those 178,000 cases, 21.4% were children 15 or under. 9.4% were in the 5-15 age group.
- 40.3% of cases were burns from fire, 29.5% of cases were from scalding water.
- There were 2,189 burn cases in 2007 that were more than 40% of body coverage.
- For cases with 40-49% coverage, the mortality rate is 25.4%. For coverage 60-69%, that mortality rate nearly doubles to 47.3%. For 80-89%, it’s up to 71.9%. Over 90% is 81.2%.
Let’s back up on that last statistic. If a patient is burned on 90% or more of her body, there’s an 81.2% change she’ll die. When I was in the Santa Clara Valley burn unit, there was such a girl in the suite adjacent to me. A child, 4 years old. She had been playing with her cousin near the kitchen, when decided to see what was cooking on the stove. She pulled down the oven door, and to help herself up up to see what was up there, she pulled down on the stew pot on the front burner.
She accidentally poured two gallons of boiling water all over her body.
Three months later, she was alive, despite a 90% coverage injury. She was not recognizable as a girl, but she was very much alive. All due to the care and treatment that she received from the nurses in that unit.
What’s amazing to me is that I didn’t learn about the details of this case from the nurses. I learned about it from a firefighter that came to drop off a basket of treats for the nursing staff. In his free time.
There are several ways to determine if someone’s a hero. Firefighters coming to drop off gifts of appreciation to you in their free time, well I have to say that about the very top of the list.