The Survival Doctor’s Guide to Burns

What to Do When There Is No Doctor

by James Hubbard, MD, MPH

© 2012 by Hubbard Publishing LLC

www.TheSurvivalDoctor.com

All rights reserved. No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, including photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the publisher, except in the case of brief quotations embodied in critical reviews and certain other noncommercial uses permitted by copyright law.

IMPORTANT CAUTION—PLEASE READ THIS!

Use of the information in this book is AT YOUR OWN RISK, intended solely for self-help, in times of emergency, when medical help is not available, and does not create a doctor–patient relationship. DO NOT USE THIS INFORMATION INSTEAD OF SEEKING QUALIFIED MEDICAL PERSONNEL.

Readers are strongly cautioned to consult with a physician before acting on the information described in this book.

This book is based on information from sources believed to be reliable, and every effort has been made to make the book as complete and as accurate as possible based on information available as of the publication date, but its accuracy and completeness cannot be guaranteed. Despite the best efforts of the author and publisher, the book may contain mistakes, and the reader should use the book only as a general guide and not as the ultimate source of information about the subject of the book.

The book is not intended to reprint all of the information available to the author or publisher on the subject, but rather to simplify, complement, and supplement other available sources. The reader is encouraged to read all available material and to learn as much as possible about the subject.

The author and publisher are not engaged in rendering medical services, and the book is not intended to diagnose or treat medical or physical problems. If medical, professional, or other expert assistance is required by the reader, please seek the services of a competent expert.

This book is sold without warranties of any kind, express or implied, and the publisher and author disclaim any liability, loss, or damage caused by the contents of this book.

>>Back to “How to Use This Book.”

Table of Contents

Important Caution—Please Read This!

About This Book

How to Use This Book

4 Steps to Treating a Burn During a Disaster

Step 1. Limit the Damage.

Step 2. Apply Aloe Vera.

Step 3. Assess the Damage.

Step 4. Seek Medical Advice.

In-Depth About Burn Depths

First-Degree Burn: Red

Second-Degree Burn: Blistered

Third-Degree Burn: Blanched or Speckled

3 Burn Complications to Watch For

Infection

Swelling

Severe Dehydration

Debridement: How to Remove Dead Skin—and When You Should

How to Debride Blisters

How to Debride Eschars

How to Make a Good Burn Dressing

How to Use an Aloe Vera Plant

How to Disinfect Water

Using Honey As an Antibiotic

How to Sterilize Instruments

Burn Supplies

Acknowledgments

About the Author

Other Books by Dr. Hubbard

About This Book

The roads are underwater. All lines are down. Cell phones aren't working. No medical expertise is available. What do you do?

If there’s a disaster and you can’t get help, this information’s for you—survival medicine for hurricanes, earthquakes, tornadoes, floods, social upheaval, or anytime you're isolated.

I’ve been a family doctor for over thirty years. I’ve practiced in small and large towns, worked in emergency rooms and in clinics.

I’ve come to realize that many very smart people don’t know the basics about medicine. Now, I’m not putting that down. Put me near a leaky faucet, and my wife hides the tools. But if I have a flooded basement and can’t get a plumber, I know how to turn off the water supply.

Would you know what to do first for a bad burn? What to do next?

I think about this every time there’s a disaster like a hurricane or earthquake. I thought of it after the Japan nuclear disaster and after the London riots. What if those people can’t get out of their house and medical personnel can’t get to them—for hours, days? Worse, what if their phone lines are down? What if the ERs are packed, or damaged themselves?

Please, please, I beg, don’t ever use this information instead of seeing qualified medical personnel. This book is for times when that is not possible—improvisational, last-ditch medical treatment to keep you alive until help is on the way.

James Hubbard, MD, MPH

How to Use This Book

The Survival Doctor's guides are among the first books to be written around interactive links. As best as is possible with computers, I use the links to mimic my decision-making process.

Instead of writing, “If this burn needs debriding, flip to page such and such; when you’re through, flip back to the original page,” I can write, “If it needs debriding, click here.” You click the link, and like magic, you read about debriding. Then you click back. No frantic page turning.

I've also created a video to go with the book. It demonstrates how to extract the most gel from an aloe-vera leaf—a soothing home remedy for burns. You can click straight to it in the section about aloe vera.

Download this book to your smartphone, laptop, and tablet. Make sure it’s on the one you’ll have with you on the hike or the camping trip—and on the one with the most battery life for when the electricity goes off. Because that’s when you’ll need it.

Of course, you can print the pages out, laminate them, and use them the old-fashioned way for backup just in case. Just do it before you need the information.

However you decide to store the book, be sure to read it before an emergency strikes. That way, if you're in an urgent situation, this information won’t be completely new to you.

Warning: I can share my general knowledge, but I can’t download my experience. Not all injuries go by the guidelines. There are in-betweens. Complications occur. No information in this book should ever take the place of seeing your health-care provider. If you can get expert care, by all means, do so. If you can’t, do so as soon as possible. The information contained here hopefully can help until you can get to that expert medical advice and treatment, or it can get to you. Please read the full disclaimer at the beginning of the book.

4 Steps to Treating a Burn During a Disaster

It seems like burn treatment should be complicated. After all, all sorts of things cause burns. There are heat sources like fire, stoves, and boiling water. Hot oil and tar are bad because they stick to your skin and hold the heat in. (Incidentally, that's why the butter-on-a-fresh-burn home remedy is a bad idea.) There are electrical burns. And did you know sunburns aren't caused by direct heat? They're from radiation—thus the sunburn–skin cancer link.

But despite their differences, all burns require the same immediate first steps: Wash off the substance, and cool down the skin. All burns can also do one thing that affects your ability to treat yourself: make your whole body go into shock so you can't think straight.

The remedy for that shock is to memorize the first step's details, as laid out in this chapter. Have them down in your mind so well they're a reflex. If you or someone else gets burned, do step 1 immediately. Then you can open the book to this chapter, which is a quick overview of what to do. The rest of the book goes into more detail.

Step 1. The first thing to do is to try to limit the damage.

- DO remove any hot or restrictive clothing (anywhere on the body, not just at the burn site) and run cold water over the affected area. That will wash off the causative substance, ease the pain, and cool the skin down.

- DON'T use ice because it may constrict needed blood flow to the area.

- NEVER use grease, butter or ointments that may hold the heat in. Caveat: Hot tar is different. It’s not going to wash off, so petroleum jelly, such as Vaseline, can help remove it. You can rub it on and wipe it off repeatedly or apply petroleum jelly-soaked gauze to remove and replace every 2 hours.

Step 2. After the washing apply aloe vera if you have it.

See "How to Use an Aloe Vera Plant," or just use the bottled gel form.

Step 3. Assess the damage.

This is where you figure out how much risk you want to take during a disaster to get professional medical care. Burns are not immediately life-threatening unless they (a) pose a risk to your airway due to damage or swelling of your face or neck, or (b) involve 10 percent or more of your skin surface. Also, chronic disease and age extremes (young and old) place you at increased danger.

To estimate the burn's severity, assess the following:

a. The burn's location. Is it on the face or neck? If so, there’s a greater possibility of respiratory-tract damage. Also, swelling could block the airways. Unless it’s a very small burn, get medical help ASAP.

b. How deep the burn goes (its degree). Are there blisters (second-degree), or was the skin initially blanched or speckled white (third-degree)? Keep whatever you decide in mind when you go to step 4.

c. How much skin surface is involved. Is it 10 percent or more of your whole body? If so, this could be a life-threatening emergency. (Even if you find that it's over 5 percent, that could be significant as you go to step 4.)

You can estimate skin surface by using the rule of nines. Each arm accounts for 9 percent of your total body surface. Your head and neck are 9 percent together. Each leg is 18 percent. The front part of your trunk is 18 percent, as is the back part. The last 1 percent goes to the genital area.

Another way to estimate skin surface is to measure with your palm, which is close to 1 percent.

Caveat: With kids under four years old, the head-to-body proportion is different. The head and neck account for 18 percent instead of 9. The littler legs account for 13.5 percent each.

>> Back to “Severe Dehydration.”

Step 4. Seek medical advice for most burns other than minor ones.

That becomes increasingly urgent if a second-degree burn covers more than 5 percent of your body or you suspect a third-degree burn. They're going to be harder for the body to heal and more likely to get infected. And burns over 10 percent can become life-threatening in a hurry.

The next chapter explains burn degrees and what to do for bad burns if step 4 is impossible and you have to take over treatment yourself.

In-Depth About Burn Depths

What to Do When You Have to Treat a Bad Burn Yourself

When someone has a bad burn, less pain is not necessarily a good sign. One odd thing about burns is some of the worst ones don’t hurt initially.

Nerve endings sit close to the skin surface. They don’t like to be irritated, but if the damage goes deeper—beyond the endings—they get killed off. No nerve endings, no pain. At least, not at first.

Pain-free? Sounds good. But the problem is, a deep burn also kills all the tissue around the nerve endings, including the skin layer that grows new cells. So your painless burn is in fact a third-degree pain in the neck.

Therefore, when you're figuring out a burn's severity, use your eyes, not the burn victim's pain experience. You need to determine both the amount of surface area that's been charred and the depth of the damage—called the degree.

First-Degree Burn: Red

Typically, first-degree burns are the mild sunburns that make your skin red and painful. Try cool compresses or aloe vera, along with an anti-inflammatory, like ibuprofen, for pain. The burn should heal in a few days with resultant sloughing of the damaged top layer of skin.

Second-Degree Burn: Blistered

Blistering is the second-degree burn's calling card. The blisters may pop up immediately or after several hours. Infection is the worry.

These burns usually heal in two or three weeks with minimal scarring, but you need to keep them clean and protected.

Don’t yield to temptation and start popping all the blisters. As long as they’re intact, they act as sterile bandages. Okay, maybe puncture the ones greater than an inch in diameter since they’re probably going to leak anyway.

But, remember, once you puncture a blister or it starts leaking on its own, it becomes an open wound prone to infections, so then you need to do the following:

1. Debride the blister.

2. Wash the wound with soap and water. Towel dry around it.

3. Apply antibiotic ointment or honey (not for babies).

4. Apply a gauze-and-tape dressing.

5. Change the dressing daily or if it gets wet or dirty: Clean off any dirt or crust buildup, then reapply the ointment and bandage.

If the redness starts moving into the healthy skin, you need an oral antibiotic.

Third-Degree Burn: Blanched or Speckled

A third-degree burn damages all the skin layers—down to the fat or muscle. If it goes into those non-skin layers some people call that a fourth-degree. For our purposes you’ll treat them the same.

The skin is initially blanched or speckled white, or gone altogether. Since nerve fibers have been killed, a third-degree burn may not hurt as bad as other burns. Your skin may even be numb.

If you can’t get to a doctor, initial treatment is the same as for a second-degree burn: Deal with blisters and open sores, and debride the loose, dead skin.

Long-Term Treatment for Third-Degree Burns

Depending on the amount of surface area, third-degree burns will take months to heal. Some that don’t go quite as deep can take less time. Scarring is inevitable. It’s important to keep affected joints as mobile as possible to prevent restrictive scars.

Unless you’re going to get help within a day or two, the only chance for new healing is to  debride the black, leathery, dead tissue that will form, called an eschar. A third-degree burn destroys the layer of skin that produces new skin cells—the layer that allows your skin to grow back. The only skin that’s going to grow now will be from the undamaged outer edges, so you need to remove the eschar to allow the edges to grow inward and eventually meet.

Most full-thickness third-degree burns over an inch or two in diameter are going to require skin grafts to heal. Until then, keep a burn like that clean and covered because infection is the biggest danger.

3 Burn Complications to Watch For

Burns may cause serious problems besides pain. Here's what to keep an eye out for.

1. Infection.

If the top skin layer is interrupted, even a crack, there’s a risk of infection. The deeper the burn and the more skin area involved, the higher the risk.

To prevent infection, you must keep the area clean by gently washing it with soap and water. This is essential, but fair warning: It’s going to hurt.

Then keep the burn area moist with an antibiotic ointment or honey and an absorbent dressing. It heals quicker that way. Repeat once or twice a day.

Many times a yellowish film forms over a healing burn. A little of this is okay, but sometimes it’s hard to tell this film from infection. An infected area usually oozes, and the skin around the wound becomes warm and red. If you have a doubt, or if the film seems to be getting thicker, it’s time to vigorously clean the wound—or even debride it by picking and cutting the yellow film with sterile tweezers and scissors.

Start antibiotics if you:

- See pus in the burn or redness spreading around it.

- See red streaks.

- Run a fever.

If you don’t have any antibiotics, apply mupirocin ointment or honey to the burn.

2. Swelling.

One of the functions of the skin is to retain, or store, tissue fluids. Damaged, burned flesh causes the smallest blood vessels (capillaries) to ooze lots of fluid (usually not blood cells, which are bigger than the leaks). This can cause dramatic swelling in the surrounding tissue. It's a major reason face and neck burns can be so serious. In the arm or leg, swelling can cut off the blood supply to the hand or foot.

To minimize or avoid the swelling, keep the affected area elevated at heart level or above. Avoid any restrictive clothing or jewelry.

3. Severe dehydration, even shock.

With large burns you can lose a tremendous amount of fluids, including electrolytes. Most of this happens when the fluid from your tissues accumulates in spaces between the tissue. At that point the fluid is no good for anything other than to make you swell.

If the burn involves 10 percent or more of your body surface, you’re at high risk for severe dehydration. ("Assess the Damage" tells how to estimate skin surface.)

The best replacement fluid is Pedialyte or a sports drink like Gatorade. An alternative is a half-teaspoon of salt and a half-teaspoon of baking soda in a quart of water. (If you don't have clean water, see "How to Disinfect Water.") Whatever you choose, if 10 percent or so of your body surface is burned, drink four quarts (one gallon) a day minimum. Add a quart to that four for every percent of burned surface over 10 percent.

If the burn area is 20 percent or more, you’re going to require special IV fluids.

Debridement

How to Remove Dead Skin—and When You Should

A bad burn kills your skin. But as you've seen every time you've gotten a scrape, skin grows back … usually. The problem with bad burns is the dead or dying tissue can get in the way of new tissue growth. It also makes it more difficult to keep the living tissue clean. So you may need to remove the dead stuff through a process called debriding.

While debriding, take it slowly and the pain will be less. The tissue you cut away shouldn’t have any feeling, but tugging on it or touching the tender living skin will cause pain.

How to Debride Blisters

Leave blisters intact as the body-made bandages they are. But when one pops, or if you pop a big one because you know it's headed that way, try to remove most of the loose, dead skin. Do this daily by washing and picking with sterile tweezers. Scissors may or may not be necessary. You’re going too far if you cut into skin that bleeds.

>> Back to “Second-Degree Burn.”

>> Back to “Third-Degree Burn.”

>> Back to “Complications: Infection.”

How to Debride Eschars

An eschar is the dry, leathery remains of dead skin in a third-degree burn. The burn has no chance of healing while the eschar is in place. Debridement should be done in a medical setting, in part because it can leave you especially prone to infection. If that’s not going to be possible for days, be very careful as you attempt the following:

1. Use a sterile scalpel, or sterilize a clean knife. (See "How to Sterilize Instruments.")

2. Clean the eschar and the area around it with soap and water. (If you don't have clean water, see "How to Disinfect Water.")

3. Whittle away.You may have to make a longways cut down the middle if the eschar is thick. Notes: It’s better to make a cut too shallow than too deep. Don’t cut into the living tissue. You can probably judge the depth of the eschar by observation. Cutting away the eschar should not hurt or bleed. The tissue is dead. Living tissue is going to be pink and bleed. In order to get all the eschar, there may be some light oozing of blood from the living tissue.

4. Apply an antibiotic- or honey-soaked dressing when you're finished.

5. Elevate the extremity to cut down on the bleeding and swelling if the burn is to an arm or leg.

6. Change the dressing twice a day.

>> Back to "Long-Term Treatment for Third-Degree Burns."

How to Making a Good Burn Dressing

When dressing a burn, keep in mind two basic guidelines:

- The dressing should be light, not bulky. (Bulk, when taped down, puts pressure on the wound.)

- The dressing should keep the burn moist. (It heals better this way.) But the area around the burn should be kept dry. Otherwise the normal skin gets soft and more prone to infection.

Step-by-Step Guide

1. Get some clean gauze. If you don't have any, use the cleanest absorbent material you have.

2. To keep the burn moist and prevent infection, apply any antibiotic ointment to the gauze—triple antibiotic (Neosporin), bacitracin, gentamicin, silver sulfadiazine (Silvadene)—take your pick. If you don't have that, use honey, except in babies. No honey? A+D ointment or petroleum jelly (Vaseline) is fine.

3. Put the gauze on the burn so that the ointment and pad cover the entire burn. Keep the ointment off unburned areas since the moisture it holds in will soften the normal skin and make it prone to infection.

4. Apply a light wrapping or taping to keep the bandage in place. Warning: Don’t wrap it tightly since any swelling could cut off the circulation. If there’s a question on an extremity, check the fingers or toes every ten minutes or so. If they get dark, cold, or numb, loosen the wrapping.

5. Keep the dressing clean and dry. If it gets wet, replace it.

6. Once or twice a day, clean the burn with soap and water and apply a new dressing.

>> Back to "Second-Degree Burn."

>> Back to “How to Debride Eschars.”

How to Use an Aloe Vera Plant

The clear gel from the aloe vera plant has been used to soothe skin ailments for thousands of years. The outside waxy leaf makes a good laxative also, but only use a little since it's pretty powerful.

To use the gel, cut off a leaf near the bottom of the plant. Split it down the middle with a sharp knife, then cut multiple horizontal and vertical slits to loosen the gel. Apply it directly to the affected area several times a day.

To watch a video demonstration of aloe vera being used, exclusively for readers of this book, click here (TheSurvivalDoctor.com/aloe).

Aloe vera gel is good for:

- Burns

- Rashes

- Insect bites

- Dry skin

- Hemorrhoids

>> Back to "Step 2. Apply Aloe Vera."

>> Back to “First Degree Burn.”

How to Disinfect Water

No matter how pristine-looking, mountain streams are full of parasites. Animals don't have outhouses, after all. Their stuff goes right down the river. Pond water is also loaded with bacteria just waiting to make you deathly ill. Even rainwater isn't safe. But what if that’s all there is?

It’s relatively simple to disinfect water manually so it becomes drinkable and fine for cleaning burns.

Step 1. Filter the water.

If the water is cloudy, strain it through a clean piece of cotton fabric, coffee filter, or clean gauze. This removes debris and bacteria. Then let the water sit for a couple of hours to let residual sediment settle. Pour all but the sediment into another container.

Step 2. Use one of the following options to disinfect your water.

A. Boil the water.

Just bringing the water to a boil will disinfect it. Some would say, just to be safe, boil the water for one minute. If you have a lid, keep the lid on for a few extra minutes after you turn off the heat source.

OR

B. Add chlorine.

Add two to four drops of unscented, 5 percent chlorine bleach to each quart (four cups) or liter of water. That’s eight to 16 drops per gallon. Mix it well. Wait thirty minutes or so before drinking it.

OR

C. Add iodine.

Add one iodine tablet, five to ten drops of 2 percent iodine solution, or eight to 16 drops of 10-percent iodine-povidine (Betadine) solution to each quart of water. Mix. Wait at least thirty minutes.

OR

D. Use the sun’s UV rays.

If none of the other options are available, and if the sun is shining, set a clear, glass container of water (such as a mason jar) in the sun for eight hours. Be sure the top is covered. Place the container on a black surface. It needs a minimum of four hours sunlight. The more the better.

These are but a few ways to disinfect water. None of these methods removes toxins, poisons, or any chemicals from the water. I don’t know of any improvisational method that does.

Even Better, Be Prepared.

Buy some gallon or 5-gallon clear water containers to use for drinking. Keep them full. Even unopened bottled or chlorinated water should renewed every six months or so. Check for an expiration date.

You need to drink at least two quarts of water per person per day. There are four quarts in a gallon. So one gallon would last you two days. Fourteen gallons would last a week for a family of four. You may want few gallons extra for bathing and cleaning wounds. In fact, I would suggest a minimum of two gallons per person per day since you'll need more with heavy activity or in hot weather.

If you have any warning your tap water is going to be off, fill all the bathtubs as reservoirs.

Alternative to Water

If water is scarce, use peroxide to clean burns.

>> Back to “Severe Dehydration.”

>> Back to "How to Debride Eschars.”

>> Back to "Supplies."

Sweet Treatment: Using Honey As an Antibiotic

If you don’t have antibiotic ointment, honey’s a great antibacterial for wounds. It kills bacteria and helps cuts, scrapes, burns, bedsores—even ulcerated leg wounds in people with diabetes—heal, and there have been plenty of studies to prove it.

In my mind you can’t have enough honey. It’s tasty and good for coughs too. The fact that it kills bacteria is why it stores forever. Just keep it sealed. If it turns to sugar, gently heat it. Or use it in its granular form. It’s all the same.

Warning

Babies have died from eating honey because of botulism spores. Honey can contain a few of them, though not nearly enough to hurt an adult. They've also never been known to cause harm in wounds. Still, to be safe, don’t use honey on children under two years old unless it’s the kind you buy sterilized. Sterilized honeys such as Medihoney have been zapped clean of bacteria and can be found at pharmacies.

How to Use Honey as an Antibiotic Ointment

Option 1: Apply liberally. If the wound is deep, pour it in. For scrapes and abrasions, paste it on. Then cover the wound and seal it with tape.

Option 2: Apply the runny honey to gauze or clean cloth first, pop the material on the wound, and seal it with tape.

If the bandage remains clean and dry, only change it every day or two. You may have to change it sooner if the wound is oozing a lot of fluid on its own.

How Honey Works As an Antibiotic

Honey's high sugar concentration dehydrates bacteria. Plus, it’s acidic, and most bacteria hate that.

Honey also produces a small amount of hydrogen peroxide when it's mixed with a little fluid—say, from the burn. Unlike the commercial kind, this peroxide is dilute enough to not irritate or inflame the skin.

Researchers are finding other ways honey works as an antibiotic. For example, it may stimulate the body’s natural bacteria-fighting white blood cells to get to work.

Some honeys are more antibacterial than others. The New Zealand manuka honey is particularly popular in medical circles.

>> Back to “Second-Degree Burn.”

>> Back to “Complications: Infection.”

>> Back to “How to Make a Good Burn Dressing.”

>> Back to “Supplies.”

Salve Treatment: Mupirocin—the Killer Ointment

Mupirocin is an expensive prescription antibiotic ointment, but it's very handy.

Unlike the over-the-counter antibacterial ointments, which reduce your risk of getting an infection, mupirocin actively treats the infection like an oral antibiotic does.

Because of widespread use, some bacteria are becoming resistant to mupirocin, so use it only if you have an active infection and not just for preventive purposes.

>> Back to “Complications: Infection.”

>> Back to “Antibiotics.”

How to Sterilize instruments

Unless you have a commercial autoclave and a power source, or some prepackaged sterile products, you’re going to have to make do. First, always clean any obvious debris off your instruments. Clean with soap and water or alcohol. Use a cloth or brush if needed.

A couple of quick methods for sterilization are:

1. Heating the instrument.

Hold the part that’s going to touch the injury under an open flame. If the handle is also metal, find something to hold the instrument with so you don’t burn your fingers. When the part under the flame is red, that’s enough. Let it cool and you’re ready. If I have alcohol, I also like to dip it in that just for good measure.

2. Using a disinfectant.

If you don’t have fire and you're in a hurry, you can wipe the instrument off with a clean cloth soaked in iodine, povidine, or alcohol. No clean cloth? Dip the instrument in the solution and stir it around for ten seconds.

If you have more time you can:

1. Boil.

This is good method for larger instruments or those that might melt under the flame. Let the instrument soak in boiling water for twenty minutes.

2. Use a disinfectant longer.

Soaking the instrument for twenty minutes is better than just the wiping/dipping method.

What to Do Before and After the Procedure

Always wash your hands. Wear clean gloves, if available, to protect yourself and the patient.

Immediately after the procedure is finished, any object that came in contact with infectious bodily fluids should be washed down with disinfectants.

>> Back to “How to Debride Eschars.”

>> Back to “Supplies.”

Burn Supplies

Emergency-Kit Must-Haves

General

Latex gloves (vinyl, if there’s a chance of allergies). Use dishwasher gloves if you don’t have a pack of disposable. It’s good to have a few pairs of sterile gloves also.

Small scissors and tweezers—preferably sterile and at least a couple of each.

Matches and candles in a waterproof container (to sterilize instruments).

Rubbing alcohol for sterilization.

Iodine-povidine (Betadine).

Aloe vera—the plant or a bottle of gel.

Acetaminophen (Tylenol) and ibuprofen (Advil, Motrin)—liquid also if you have small children.

For Burn Dressings

Gauze pads, three inches by three inches—several packs. At least a pack or two should be sterile.

Duct tape or surgical tape.

Paper or nonallergenic tape, in case of a reaction to the regular kind.

Adhesive bandages (Band-Aids) of various sizes.

Antibiotic ointment or cream.

Honey. The best for antibiotic use is Manuka or Medihoney.

Other Resources

Potable water. You’re going to need at least two quarts per person per day to drink. Then there’s boiling, irrigating wounds, and washing. That’s, say, two gallons per person per day. Depending or your perspective, I’d say have fourteen gallons per person minimum stored on hand. Have some chlorine or iodine on hand also for disinfecting. If you have preparation time just prior to a disaster, fill all your bathtubs up before the plumbing goes out.

Antibiotics. Some good oral antibiotics for burns are cephalexin, erythromycin, and ciprofloxacin. Mupirocin ointment is an alternative. Always consult medical personnel before taking, if available. Be aware of side effects and allergies. If you start use, continue for seven to ten days unless your doctor says otherwise.

Tetanus shot boosters every seven to ten years. This prevents the rare but almost always fatal disease tetanus, which burns are particularly prone to.

Training. Local courses on first-aid, CPR, and injury care are musts.

Acknowledgments

This book has been a collaboration with my daughter, Leigh Ann Otte, who not only edited it but helped me put it in language a nonmedical person can understand. Her website is LAwordsmith.com.

I also thank my daughter, paramedic Beth Nelson, for her valuable input, and Pam, my wife, who knows more about nutrition, natural medicine, and nonmedical disaster-preparation than I ever will.

About the Author

James Hubbard, MD, MPH, grew up in Pontotoc, Mississippi, and now lives in Colorado Springs, Colorado. He's practiced family and occupational medicine in rural towns and large cities.

Dr. Hubbard's mission is to spread medical knowledge as far and wide as he can so people are empowered to live healthier, safer lives. To that end, he teaches down-to-earth survival medicine at his blog TheSurvivalDoctor.com so everyone can be prepared. He also publishes the health-information website MyFamilyDoctorMag.com.

Dr. Hubbard is a member of the American Medical Association, American Academy of Family Physicians, and American College of Occupational Medicine, and a prior member of the American College of Preventive Medicine and Wilderness Medicine Society. He has a master of public health and a medical degree.

Other Books by Dr. Hubbard

Dr. Hubbard is also the author of The Survival Doctor's Guide to Wounds, available from TheSurvivalDoctor.com. Learn the best tips for makeshift wound treatment that anyone can do—even when there is no doctor.

More The Survival Doctor's Guide books are coming soon! To be the first to hear about them—and to get more lifesaving medical tips—subscribe to Dr. Hubbard's blog at TheSurvivalDoctor.com.

Table of Contents

Copyright

IMPORTANT CAUTION—PLEASE READ THIS!

About This Book

How to Use This Book

4 Steps to Treating a Burn During a Disaster

In-Depth About Burn Depths

3 Burn Complications to Watch For

Debridement How to Remove Dead Skin—and When You Should

How to Making a Good Burn Dressing

How to Use an Aloe Vera Plant

How to Disinfect Water

Sweet Treatment: Using Honey As an Antibiotic

How to Sterilize instruments

Burn Supplies

Acknowledgments

About the Author

Other Books the Author