Shake and bake meth accidents filling burn units

dirtyhippiegirl, BSN, RN · Jan 24, 2012

Honestly, at least on my unit, very few patients ever fess up to making meth as being the cause of their burns and it's often hard in explosion cases for the police to tell exactly what was going on to begin with.

I will say that we get a LOT of patients who are positive for meth with combination severe inhalation and skin burns who, after the fact, ALWAYS say that they were "in the garage, working on a car." Always the same story.

I mean...it's like freakin' pulling teeth half the time to get them to admit that they do use drugs, even when you confront them with positive tox screens AND the fact that we cannot adequately control pain or sedation without knowing how much they use.

LydiaNN · Jan 25, 2012

That's interesting. I know nothing at all about burn nursing, because it is probably the specialty that scared me the most to even consider pursuing. I had never given any thought to how the meth epidemic might impact the field, or to how the victim's refusal to be forthright about how the got their injuries would further complicate your job, either. Isn't it amazing to think that they've come up with a way to make meth manufacturing even more dangerous? Thank you for your response.

dirtyhippiegirl, BSN, RN · Jan 26, 2012

I don't know how interested you are on the subject but there's a quick read called Methland which gives some interesting insight into the meth issue. It's a little bit dated these days but the author goes into some history of how meth became such an issue, home cooks vs. cartels shipping it in, etc.

LydiaNN · Jan 26, 2012

Thanks... I have a 19 year old son. He's never given us any reason to suspect drug use, but of course, so very many parents say that and discover the hard way what's been going on. I've been trying to keep abreast of what's new with that scene since he became a teenager. I was at a health fair once when he was still a preteen and there was a guy from the San Diego Police Force with samples of all the ways kids camoflauge drugs to look like something else. I hadn't seen or heard of any of them, so that kind woke me up to my naivete. Thanks for the recommended read... I'll check it out!

rph3664 · May 17, 2012

I live in the Midwest (meth capital, as you probably all know) and my local newspaper recently did a big story about the burn unit in that city. The story said that some hospitals have had to close their burn units because the entire hospital was in danger of financial collapse just from all the uninsured people who blew themselves up in meth lab explosions. And this unit assumes that all patients are from a meth lab unless they can prove otherwise (paramedics brought them in from a job site, that kind of thing). Among other things, they always get an eye wash because they've seen a few cases of people who weren't that badly burned but ended up blind, and didn't have to be that way.

NatGeo has a show about meth that airs periodically, and they interviewed the director of the burn unit at Vanderbilt University Hospital in Tennessee. He said that this hospital provides $300 million in charity care every year just to their meth lab explosion patients.

There was an implication between the lines of both stories that if it was up to them, meth lab explosion people would get comfort care and nothing else, and whether people like this should even get aggressive treatment, whether they are insured or not, is a medical ethicist's nightmare.

I've read "Methland", and I recognized enough factual errors in the book to make the entire thing suspect.

dirtyhippiegirl, BSN, RN · May 17, 2012

Our unit alone spent 15 million on the care of a single patient who was burnt under very suspicious circumstances.

All of our facial burns get a stat optho consult but I haven't heard of anyone suddenly going blind? There has been a push to draw orificenic levels on all fires that happen in enclosed areas. But we have to send out the levels and by the time they come back, it's apparently useless to treat. And I guess the treatment is extremely expensive, so treating everyone prophylactively isn't going to work.

Just anecdotally, our meth lab cases have actually gone down. Most of the nurses that I've been talking to think it's because the economy in the area is getting better.

tothepointeLVN, LVN · May 19, 2012

Isn't there a lot of meth being moved across the border now.

phil1968, ADN, BSN, LPN · May 19, 2012

Our unit alone spent 15 million on the care of a single patient who was burnt under very suspicious circumstances.
All of our facial burns get a stat optho consult but I haven't heard of anyone suddenly going blind? There has been a push to draw orificenic levels on all fires that happen in enclosed areas. But we have to send out the levels and by the time they come back, it's apparently useless to treat. And I guess the treatment is extremely expensive, so treating everyone prophylactively isn't going to work.
Just anecdotally, our meth lab cases have actually gone down. Most of the nurses that I've been talking to think it's because the economy in the area is getting better.

If that is true, I would think it is due in part from the availablity of cheap meth made across the boarder. I can't imagine it would be that usage is less, but that you don't have to make it and risk blowing yourself up.

tothepointeLVN, LVN · May 19, 2012

Damn those cheap foreign imports taking away good hard working American Meth Lab workers jobs. They should form a union and protest. Oh and get a health plan too.

elprup, BSN, RN · May 21, 2012

Wow, I never thought of this. But, I can totally understand it.

dirtyhippiegirl, BSN, RN · May 22, 2012

If that is true, I would think it is due in part from the availablity of cheap meth made across the boarder. I can't imagine it would be that usage is less, but that you don't have to make it and risk blowing yourself up.

Yes, this is the general reasoning behind that line of thought.