First Aid burn injuries -Simple Do’s and Dont’s

Introduction

Burn injuries are one of the most debilitating and life threatening injuries seen. Most of us (99% of us including health professionals) are not aware of first aid when burn happens. The reason I am writing this blog is because of my patient Ram (name changed). Ram visited my clinic sometime back with burn injury to his hand with hot oil. Ram had deep burns on his hand which led to huge blisters. He tried home treatment for sometime before the blisters increased significantly in size. This is when he decided to visit my clinic. Though his burn injury is deep and he is recovering quite fast, He told me all the strange first aids told by the neighbours for first aid of his hand burns. This prompted me to write about what to do and what not to do in burn injuries.

I am Dr Deepak Rathore. I am a Plastic surgeon trained specially in dealing with burn injuries (both acute and chronic). This blog will give you a broad overview of burn injuries and what to do when you encounter one.

Classifying Burn Injuries

  • Burn injuries can be divided broadly into 5 major types.
    1. Thermal burns: due to flame burns like gas leakages cylinder blasts and bonfires.
    2. Scald burns: due to hot water, liquids, oils etc. (Like our patient Ram)
    3. Electrical burns: due to high voltage transmission electrical lines, lightening etc.
    4. Chemical burns: Acid or alkali burns and various industrial burns.
    5. Radiation burns: after nuclear accidents or nuclear bomb explosions.

Of the above list type 1 and 2 (thermal and scald burns) lead to most of the injuries. Burns may be extensive or minor depending on the areas involved. Irrespective of the amount of area involved we can provide some assistance/first aid for burns at the spot of injury to the patient that might be life saving.

Onsite management (What to do)

  • First rule of First aid is that rescuer should be safe while attempting a rescue.
  • Get yourself and patient away from smoke.
  • If the individual is in flames try to douse it with water/sand or ask patient to stop-drop-roll.
  • Stop-drop-roll is classically taught to douse fires. But unless someone is previously known to the idea it is difficult to do when needed. So do read Stop-drop-roll and learn it.
  • In case of electrical burn switch off the mains, Do not try to remove the patient with your bare hands directly.
  • Cool the burn with running water or bucket of water till burn sensation/pain disappears.
  • Cover the burn area if possible with a clean cloth/dressing to reduce pain.
  • If patient is conscious give ORS solution to drink till patient reaches hospital.
  • Remove acids or chemicals by washing it with large amounts of water to prevent further burn. (Note: Do not wash certain chemicals like dry lime, phenols, concentrated sulfuric acid, sodium metal )
  • Remove clothes and jewellery in case of chemical burns.
  • In case eyes are involved with chemicals wash them thoroughly with water and rush to nearest hospital.

Most important what not to do?

People tend to advice all sorts of Dadi and Nani k nuskhe as First aid for burns. Some of these suggestions can be very harmful to you. Inspite of being the burn capital of the world the general knowledge of first aid for burn injuries is very low in our country. Let me list some very common things which should NEVER be done. I see these very frequently being done in my clinical practice but I always discourage my patients from doing these.

  • Never apply toothpaste or colgate on the wounds. This advice is so common that even some hospitals ask people to do this. This is the worst thing that you can do to the burn injury. Don’t ever apply toothpastes on burn injuries.
  • Do not apply potato juice or other vegetable juices on wounds.
  • Never apply cow dung on wounds.
  • Avoid applying Ratanjot and Kapoor on wounds.
  • Never apply Ink/turmeric on wounds. This hampers depth assessment by plastic surgeons later.
  • Do not use blankets as they trap heat and cause further burns.
  • Avoid use of ice for cooling burn area. This may lead to further injury to skin.
  • Do not try to remove clothes adherent to wounds in case of thermal burns.
  • Blister management: Let a trained doctor break blisters to prevent infections.

When to seek help

Any burn involving more than 10-15% body surface area in adults and more than 5 % in children can cause serious repercussions. Once first aid for burns has been given, patients should be immediately transferred to a centre equipped to handle such injuries. A Plastic surgeons trained in burn surgeries should evaluate these injuries.

We at essence follow very strict guidelines for burns treatments. We use latest available special dressings (like collagen, nano silver dressings and skin substitutes) in large surface area burns. With a dedicated team of four plastic surgeons you will have the best care anyone can offer.

Dr Deepak Rathore (MBBS, MS, Mch Burns, plastic, maxillofacial and microvascular surgeon)

for more info you can leave comments, email us or call us directly.

Skin care Overview: A simple guide to gorgeous face

Face Skin care : the elusive “perfect skin”

Beautiful Skin Needs regular care

I am a Plastic surgeon practicing in Delhi NCR. Often in my Opd, as I begin to wrap up at day’s end young staff girls at the hospital come for quick face skin care queries. They are no different from the patients I have just finished seeing. Women and men alike today are misled by bombardment of advertisements on Television and internet.

Yet after spending so much money on small bottles with big brands , the fair and lovely look of face is still trapped inside the television. To add to it the lucky few who are blessed with good skin have also joined the acne prone or cracked skin group because of hours in the sun, traveling in dust and harsh climate in Delhi NCR, and living on diet sodas.

The skin specially your face skin is an essential part of one’s personality, it’s how the world knows you and relates to you.

Healthy glowing skin adds to your charisma ,improves your confidence , it’s not something limited to the starlit world, it’s the right and need of every human being.

So , what can one do to get it right.

Plastic surgeons or Skin care doctors like me in Delhi NCR will tell you that the correct choice of products depends wholly and solely on your skin type of face.Whether it’s oily, dry , mixed, acne prone, dandruff prone , scaly , itchy, sensitive.

If there are episodes of rashes and allergy after using common products, do not indulge in over the counter creams, get a proper consultation and use specific products only.

It surprised me to see people using steroid based creams for months,just because it’s easily available over the counter and claims are sky high.

Steroids results in thinning and worsening of skin,often observed a little too late by the user. DO NOT USE STEROID CREAMS BLINDLY. Refrain from such lucrative but harmful ideas.

Sunscreen

Sunscreen protects your Skin

The use of sunscreen in this country cannot be overemphasised , SPF 30 is what you should be looking for on the label. Sunscreens are available depending on skin type.

Spf 50 suits Indian climate

In Case you are unable to use screen cause it looks like you are melting , it’s time to change not stop the sunscreen.

Diet and creams among other things

A good Face care regimen that the skin care doctors especially in Delhi NCR will prescribe you involves taking care of yourself throughout the day. Skin Care is not just in terms of putting stuff on your face but also your diet, your stress levels, your hormonal profile .

Staying hydrated, and consuming fruits and natural vegetables will keep the skin healthy. Often people are unable to chalk out a proper diet.

Taking expert help will go a long way and is an easier way rather than struggling with Calorie and protein contents.

We now have products available like never before, they give appreciable results. We have UV cameras that can detect skin damage at an early stage.

Creams like Retinoids in acne, Hydroxy acids and Vitamin C in skin whitening and anti-ageing are available. When used in right manner skin lightening agents can do wonders.

Vitamin C does wonders for your Skin

When to use , how to use and when to stop are the questions whose answers are different for every individual.

The point to understand is that Your face is not an experimental playground. Choosing the right products and following in a proper manner will give you much better cost effective results. It’s time to get that image out of the TV set into real life!

Dr Vaishali Srivastava (MBBS, MS, Mch plastic surgery)

Get in touch with us at essencecosmeticsurgery.com or call us at 9711707831, 9968539463. You can also Email us : essencecosmeticsurgery@gmail.com

Reducing hospital bills: Simple steps to Ease your Pockets

Reducing medical expenses

Reducing hospital bills = Removing Agents in practice

Magnitude of problem

Hospitals bills can ruin your financial planning. Did u know that 20% of your medical bills can be reduced by simply removing the agents who take you to hospitals ?????
We seldom realise the web of agents surrounding us in healthcare sector. People pay lakhs of rupees for their treatments. They never realise that upto 30% of bills are inflated because of agents. Agents charge 20 -30% of total bill costs just for introducing patients to hospitals. This cost is then transferred to patients in their bills.

Possible Reason for the problem

The most important reason of this happening in healthcare sector is because of lack of regulations of quacks. Quacks run clinics everywhere in our country and when they refer patients to hospitals they expect kickbacks which is accepted by hospitals at times. People turn to agents thinking they will reduce their bills end getting inflated hefty bills. Sending patients and earning commissions is so common now that most people don’t find anything wrong in it. In fact to get new patients this is the easiest way.

A World of irony

One one hand central and state governments are trying to reduce burden of health costs on people by bringing schemes like Ayushman Bharat and Delhi arogya kosh. On the other side we have these tours working without any regulations charging such exorbitant commissions. Middle class population is mostly hit by this type of malpractice.

Scary and sad at the same time

Imagine yourself paying 1 lakh rupees hospital bill for treatment or surgery. Now imagine that 20-30 thousand of this bill went to the agent who brought you to the hospital. This could have been avoided if you went directly to the hospital/ doctor probably.

My experience

Very early in my private practice I was regularly approached by such agents with lucarative offers. Agents try to lure you with prospects of getting huge number of patients. Though tempting as a newcomer I have always resisted these offers. As a result I get less number of patients but genuine patients. I am able to reduce their hospital bills because I don’t have to pay any agents. It is my privilege that Max group of hospitals where I am currently employed shuns this practice totally. I don’t allow such agents in my clinic based practice also.

A ray of hope

Thankfully many of the corporate hospitals have stopped giving commissions for domestic patients. Though The practice still runs for international patients in most hospitals. Situation is more deplorable in smaller centres where patients go with a hope of cheaper treatment. They end up paying much much more than what was needed.
I can only hope such kickbacks stop in medical treatments. Have you ever heard of lawyers giving 30% of his professional fees for bringing in clients? Have you heard of chartered accountants or architects giving 30% as commissions??

You can save yourself from agents

1) Try to get in touch with your doctor/ hospital directly most of them are readily approachable.
2) Stay away from unrelated people who tend to talk on your behalf with hospitals saying they will get your bills reduced. Talk to the hospitals directly.
3) It is better to go to your family physician( certified) or hospitals for referrals directly. They tend to give you genuine advice usually.
4) Never go to a hospital where you are being forced by someone to get treated.

International patients should be vary of their interpreters who can sometimes act as agents themselves. This way patients can save 20% on their hospital bills.

Dr Deepak Rathore (MBBS, MS, Mch plastic surgery)

Get in touch with us at essencecosmeticsurgery.com or call us at 9711707831, 9968539463. You can also Email us : essencecosmeticsurgery@gmail.com

Hair Loss treatment: A Simple Start up guide

Hair loss guide

Hi I am Dr Deepak Rathore. I am a certified plastic surgeon practicing in Delhi NCR. We are doing cosmetic surgeries along with other plastic and reconstruction procedures in Delhi NCR Today we are talking about hair loss and role of plastic surgeons in finding solutions to hair fall and hair loss. 

As plastic surgeons we mostly come across patients in various stages of male pattern baldness according to Norwood scale ranging from grade 1 to grade 7 

Hair restoration surgery or hair transplant as commonly called is one of the most common cosmetic procedures done for men in India and worldwide. 

Male pattern baldness affects almost all ageing men ( some more than others) . Androgens levels affect male pattern baldness. Most of the  pharmacological treatment is directed towards androgens only. 

However the spectrum of causes leading to hair fall and hair loss in present day population is so much more.   

We have environment affecting our hair quality. We have stress related issues leading to hair fall. We have nutritional issues ( due to poor intake or bariatric surgery these days) leading to poor quality hair which fall easily. 

All these factors compound hair fall problems demanding a more comprehensive approach to tackle hair fall or hair loss. 

Hair fall is increasingly being reported in females also so much so that 40-50% patients approaching us for hair fall are females

Hair restoration technology is advancing very rapidly. We are now able to see scalp skin and hair roots in much better magnified details than we could see before. It is helping us understand the factors causing hairfall better. Today we can measure thickness of every hair or count number of follicular units in a given area with sophisticated imaging softwares. It helps us in better follow ups and documentation of results after various therapies. 

Markets are filled with various treatment being done by plastic surgeons, dermatologist and also by numerous unqualified persons like Autologous blood treatments, pharmacological treatments, oils and hair restoration surgery. 

Patients often get confused about what to do? 

Patients often call us asking if Autologous blood treatments will help them or they need hair transplant. We always tell them to visit and have a proper examination because it is almost impossible to advice patients which procedure or medication might help them without a proper examination. 

Patients with same Norwood scale baldness may benefit from different strategies ranging from Autologous blood treatments, Nutritional supplements, pharmacological drugs , hair restoration surgery.

With so many factors playing role in hairfall it is important that your plastic surgeon is able to pinpoint the exact cause of hairfall and direct his treatment to mitigate the cause.  

Hairfall is preventable, reversible and curable provided proper evaluation is done for you. 

We usually apply a mutipronged strategy with our patients to evaluate all these parameters. We see hairfall not as an isolated problem. In doing so we are able to improve overall well being of our patients along with hair improvement. 

For example one might be suffering from micronutrient and mineral deficiency leading to poor hair quality and hair loss. If we do not improve upon nutrition and start Autologous blood treatments or minoxidil or hair transplant for the patient it may not give expected good results. 

Similarly patients dealing with stress and having hair fall may have suboptimal results if stress is not dealt with and rest of the treatment is started. 

Markets are flooded with people  offering 100% results ( mostly quacks and unqualified people with no formal training whatsoever) 

Patient should be aware and smart enough to choose best plastic surgeon for his evaluation and treatment. Hair treatment does not always mean Autologous blood treatments and hair transplants. There is so much more to it. An able plastic surgeon can help you choose the best treatment strategies. 

Hope this article helps you understand the basics of hair fall problems and select best suited plan for your hair loss.

Our next article brings to you 5 easy DIY ways at home to keep your hair healthy.

Dr Deepak Rathore (MBBS, MS, Mch plastic surgery)

Get in touch with us at essencecosmeticsurgery.com or call us at 9711707831, 9968539463. You can also Email us : essencecosmeticsurgery@gmail.com

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