ETHOS

I burned my hand with chemicals, and it caused a blister.

Patient

Hi, thank you for taking my call. I'm looking for some advice regarding an injury I've sustained. Can you help me, please?

Triage Assistant

Sure, where does it hurt?

Patient

It's my hand that's injured.

Triage Assistant

When did the injury happen?

Patient

It happened earlier today, just a few hours ago.

Triage Assistant

Have you applied cold water to the burn?

Patient

No, I haven't done that yet.

Triage Assistant

Please run cool water over the burn for 20 minutes immediately, or apply a cold, wet washcloth if cool running water is not available. This helps to prevent the burn from getting worse and reduces the pain. Where is the burn located on your hand?

Patient

The burn is mainly on the palm of my hand.

Triage Assistant

How large is the burn? You can use the size of your palm to estimate; the palm represents roughly 1% of the total body surface area.

Patient

The burn area is a bit smaller than my palm, but it's significant enough to be concerning.

Triage Assistant

Are there any blisters on the burn?

Patient

Yes, there's a blister that's formed on the burn.

Triage Assistant

How large is the blister? If you can, please estimate the size in inches or centimeters.

Patient

The blister is about the size of a nickel, so roughly 2 centimeters in diameter.

Triage Assistant

On a scale of 1 to 10, how bad is the pain? Here, we define pain levels as: - MILD (1-3): doesn't interfere with normal activities - MODERATE (4-7): interferes with normal activities or awakens from sleep - SEVERE (8-10): excruciating pain, unable to do any normal activities

Patient

I would say the pain is around a 6. It definitely interferes with my activities but isn’t completely unbearable.

Triage Assistant

It's important to keep the burn clean and try to reduce the pain. Here’s what you need to do: 1. **First Aid:** - Continue cooling the burn with cool running water for 20 minutes. - Avoid using ice directly on the burn. 2. **Pain Management:** - You can take over-the-counter pain relief like acetaminophen (Tylenol) or ibuprofen (Advil) to help manage the pain. 3. **Blister Care:** - Do not pop the blister. The skin over the blister protects the underlying tissue. 4. **Cleaning and Dressing:** - Wash the area gently with warm water once a day. Avoid soap unless absolutely necessary. - You can apply a mild antibiotic ointment (like Bacitracin) directly on the blister and cover it with a clean bandage. Given that the burn is on your hand and there is a blister larger than 1 inch (2.5 cm), you should seek immediate medical attention to avoid complications. Please go to the emergency department or urgent care now for proper assessment and treatment. Thank you for calling, goodbye.

Dispositions

  • Call EMS 911 Now

  • See More Appropriate Protocol

  • Go to ED Now

  • Go to ED/UCC Now (or to Office With PCP Approval)

  • Go to Office Now

  • See in Office Today

  • See in Office Today or Tomorrow

  • See in Office Within 3 Days

  • Home Care

  • Triage result should be Go to Office Now.

  • First aid advice was given.

  • Some assessment questions asked.