some more information about what treatment and (hopefully) recovery will look like..
The first 24 to 48 hours are referred to as the acute phase. During this phase, oxygen, fluids, electrolytes, and proteins must be administered. The wounds and organs are monitored, and sometimes surgery is already performed. During the acute phase, patients are sometimes placed in an artificial coma.
Oxygen is one of the first aspects of treatment to be administered. “If the mucous membrane of the windpipe swells after damage caused by hot air, a tube must be inserted as quickly as possible.”
Victims who have inhaled toxic gases must also be given extra oxygen. “We sometimes increase the pressure of that oxygen so that toxic gases such as carbon monoxide in the lungs and bloodstream can be flushed out.”
Many of the seriously injured victims have external burns. “The larger the burned area, the greater the risk,” explains burn specialist Keli Jansen of the Rotterdam Burn Center. Some of the injured have burns covering 60 percent of their bodies, i.e., 60 percent of their total skin surface. “Your fingers and palm together account for one percent,” says Jansen.
Jansen explains that the skin is the first barrier against everything from the outside, such as bacteria and viruses. “With a large-area burn, a large part of that barrier is gone. Infections can enter more easily, your immune system is working at full speed, and you lose many important substances, including moisture. This can make the body very ill.”
A third-degree burn does not heal on its own. It must be covered with the patient's own skin tissue. Van Zuijlen: "If someone has 60 percent third-degree burns, that means we still have 40 percent skin to harvest, as we call it. The wounds are covered with skin grafts. We have all kinds of techniques for stretching skin cleverly and using it effectively."
Donor tissue can only be used to temporarily cover a wound when someone is very ill. Donor skin cannot adhere; ultimately, the patient's own skin must be used again.
In some situations, patients are placed in an artificial coma. Jansen: “This happens when people are in incredible pain. Pain can cause people to become stressed, which makes the body work even harder. In such cases, it is sometimes better to keep someone asleep, not only to bypass the pain, but also to keep vital parameters such as temperature, heart rate, and blood pressure under control.”
Recovery from such severe burns takes a long time. “Victims spend months in a burn center, the first few weeks of which are spent in intensive care. This is followed by months in a rehabilitation center. Once home, you have to continue outpatient rehabilitation, which can easily take two years, if not longer,” says Jansen.
The healing process for burns varies from person to person. Some patients experience pain. Others describe stinging, burning, or tingling sensations. Some patients feel no pain, sometimes because the burns are so deep that nerve endings have also been burned. In addition to pain, many patients experience intense itching, according to both doctors. This often keeps patients awake at night.
Van Zuijlen refers to the café fire in Volendam 25 years ago. “The people with the least pain actually needed the most urgent care. It was a bizarre situation, because some people gave up their place in the ambulance to injured people with superficial burns, because they were in much more pain.”
After wounds heal, following surgery or skin grafts, scars remain. Movement becomes more difficult because the healed skin and scars are tight around the joints. According to both doctors, the psychological consequences of burns are also significant. You often have to deal with trauma and learn to live with a different appearance. Sometimes shame is involved.
Nevertheless, there is hope, even for victims in Switzerland, according to Van Zuijlen and Jansen. They believe that many people with severe burns who get through the initial acute phase will survive, provided that no infections occur. Young people also have a greater chance of survival.
And even though it takes a long time, people with a history of burns often regain their independence, say both experts. “Over time, scars become more supple and there are options such as skin therapy and plastic surgery,” says Jansen. “Fortunately, reintegration into society is usually successful,” says Van Zuijlen.
Herstel van grote brandwonden kost tijd. Gewonden moeten vaak maanden in een brandwondencentrum liggen, en daarna naar een revalidatiecentrum.
nos.nl
en.wikipedia.org
) that showed people trampling over each other trying to get to the exit... at the time I felt like it was irresponsible of him to show something so graphic with no warning (and tbh I still think that a little bit), but I can't deny that it was extremely effective
