By Jeff Daniels EBS Medical Columnist
Work-related injuries come in many varieties and luckily, burns are a small percentage of those injuries, mostly seen in chefs and kitchen workers. That was true for the Medical Clinic of Big Sky until this summer, when we treated a couple of serious burns within a few days of each other.
During the first half of July, two workmen came in with significant burns to an entire hand. One young man was cleaning the inside of a tar-coated container with a propane torch. Propane must have built up in the container when a spark set it off. He remembers pulling his hand away and noted that it was on fire. The flash of burning flame didn’t coat his hand with any flammable material; the heat of the propane flame was enough to cause second-degree burns on his fingers and hand, and blistering was apparent early on.
He was in a lot of pain. The hand has lots more nerve endings than other parts of the body, and a burn to the entire hand could be excruciating. The only treatment we could offer was pain control and a tetanus shot. The hand was bandaged to protect the blisters, and he promised to wear protective gloves the next time he used the propane torch.
A few days later, another workman rushed into the clinic with one hand coated in a black substance, plunged into a tub of cold water. He said he was carrying a pail of molten rubber, when he tripped and dropped the pail, splashing a coating of a 375 degrees Fahrenheit liquid onto his hand, which quickly hardened and adhered like a tight rubber glove.
Blisters were already forming as we examined the hand, which was hard to do since he wanted to keep it soaking in cold water to ease his pain. It took injections of an anesthetic into the hand to allow us to try to peel away the coating of rubber.
I sent one of my students to the Ace Hardware store to pick up a tub of GOJO hand cleaner and a tube of GOJO with pumice. We also got a tube of lanolin from the pharmacy. All of these items were recommended by the manufacturer of the rubber product to help remove it from the skin. Our problem was not only the pain of rubbing the rubber off the skin, but also the fact the big blisters had already formed underneath the rubber coating on almost the entire hand.
My students Ty Tantisook from the University of Tennessee and Greigh Hampson-Tindale from Griffith University in Australia scrubbed and scrubbed and cleared most of the rubber off the hand, without breaking one of the blisters. They carefully wrapped the hand and fingers with gauze, and we sent him home with medicine for pain when the anesthetic wore off.
We’ll have to keep a close eye on both hands to make sure that infection doesn’t set in, and to make sure that scars or contractures (tightening of the skin) don’t form and diminish the function of the hand.
Both of these injuries could have been avoided, or at least been less severe, if protective gloves were worn. This is the case with many of the work-related injuries we see.
The Medical Clinic of Big Sky is open every weekday from 9 a.m. to 5 p.m. this summer, to take care of all your medical needs.
Dr. Jeff Daniels was the recipient of the 2015 Chamber of Commerce Chet Huntley Lifetime Achievement Award and has been practicing medicine in Big Sky since 1994, when he and his family moved here from New York City. A unique program he implements has attracted more than 800 medical students and young doctors to train with the Medical Clinic of Big Sky.