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FMF Doc,
That is pretty darn near perfect. We soaked the shirt off of him but moved him to the rec center where it was air-conditioned to get out of the ambient heat that was een killing us under a tent. We poured water on the shirt and it peeled away to show a 4.5 percent second degree. Once the water hitthe shirt it "wanted" to fall off under its own weight with him sitting up. We had RL for IVF's and started two IV's. We "spritzed" him with water from a spray bottle and had two fans we brought in from outside blowing on him. His temp was 104 degrees F. His HR was 125. After 4 liters his heart rate started to come down. His pulse ox was 99% to 100% on 2 liters. Still had not urinated with us before he left.
For his burns, we did not have silvadene but we had a ton of sunblock. So, after his temp hit 100 degrees we covered him in sunblock and wrapped only the second degree burns in kerlix since the skin was open and defenseless at those points. The first degree burns were just covered in sunblock without the bandages. We called fro air transport because of concerns for the holiday traffic. By the time he left he looked like a burn patient in our center.
By the way, I really like the kiddy pool idea and agree with oral resuscitation as long as there is no nausea or vomiting. His GCS never wavered but we worried about it so we had him on O2 by NC. Slipped him some Ibuprofen PO. When you are out of your comfort zone, everything beomes a tool to be used.
Oh, we gave him a telephone to call his parents so they could come and get his car.
Dutch Matthews
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