TPR Lifeline: Cuts, Burns and Fevers

13 hours ago

When it’s a broken bone or a heart attack, you know to seek emergency medical help. But what about those minor household medical problems like cuts, burns and fevers? In today’s TPR Lifeline, Bioscience-Medicine reporter Wendy Rigby asks internal medicine specialist Fred Campbell, MD, of UT Health San Antonio for some practical advice. Here's a transcript of the interview.

  

Rigby: Dr. Campbell, let’s start with cuts. Bleeding cuts. When is it okay to use Neosporin and a BAND-AID, and when to we need urgent or emergency care and stitches?

Campbell: Sometimes old wives tales are actually true when it comes to injuries. Cuts, for instance, can be treated with just cold running water. And not only does that provide some relief from pain, but also can reduce the duration of bleeding and can clean out the wound.

Rigby: So cold water first over the cut, and then?

Campbell: It depends on how large the cut is. Usually cuts that are smaller than about two inches or five centimeters that aren’t under tension might be treated by something like a Steri-Strip. That’s an adhesive strip that can actually bring the edges of the wound together. Bringing the edges of a cut as close together as possible is going to cause quicker healing and a decrease in the chance of a serious scar.

Rigby: So how do you know when it’s bad enough to need stitches?

Campbell: Normally a cut under two inches in length or about five centimeters can be treated with something like a butterfly. Anything larger than that will probably require stitches or staples to close adequately.

Rigby: Now that it’s summer, people tend to use the outdoor grill more and they set off fireworks. So burns are a common household injury, one of the most common childhood injuries. So you hear put ice on it or put butter on it or run cold water over it. What’s the best approach?

Campbell: Again, an old wives tale like running cold water over a burn is another excellent way to provide immediate relief of pain which can be pretty significant and quite frequently we need to use other medications that are available without prescription like aspirin, ibuprofen or Tylenol to treat the pain from a burn.  The biggest problem is in young people, particularly children. When they are burned they can get into trouble much quicker and smaller burns are proportionately more dangerous.

Rigby: So when would it be necessary for professional help with burns?

Campbell: Typically a burn that’s larger than about ten to fifteen percent of the body surface. That would be the bigger part of an arm or half of a leg or a burn that goes all the way around an extremity or involves the face and neck. Or a burn that looks like it’s going to heal poorly and that usually is not detectable for a week or ten days. Those are the kinds of burns that need to be seen by a professional or even require admission to a hospital.

Rigby: Another condition we often encounter at home that can be confusing is fevers. It’s especially concerning for parent of young children who can’t communicate how they feel. So what’s the rule of thumb when it comes to the level of fever and how long it lasts?

Campbell: For children and very, very elderly people, high fevers are the most concern. For a child, usually temperatures of up to 105 degrees are tolerated well whereas in an older person that would be much too high. Heat stroke is defined as 106 degrees but it can be a much lower temperature depending on how sick the individual is or how young they are.

Rigby:  And so if a child has a fever that lasts more than two or three days, what should you do?

Campbell: I think that it’s very important the child be hydrated as best possible but even in the circumstances where someone’s hydrating regularly, two to three days would require an emergency visit.

Rigby: If you’re in doubt when it comes to any of these – cuts, burns, fevers – are there good hotlines that exist where you can call and consult with someone, say a nurse or something, before you go to urgent or emergency care?

Campbell: Most hospital systems have a nurse line. And San Antonio’s one of those. If you have insurance, there are also nurse lines that are associated with your insurance plan. If in doubt, I would say call something like Poison Control or the emergency center closest to you.

Rigby: I think you’ve empowered us to take care of a lot of these situations at home. Dr. Fred Campbell, thanks.

Campbell: Thank you.