Neosporin and EMLA for 2nd degree burn?

prmenrs, RN · Jan 2, 2005

I would think that a 2nd degree burn on a child would require admission, if only for Child Protective Services check on home situation? EMLA is not going to last forever, child will need pain control, and ? fluids if s/he won't eat or drink.

JMHO

suzanne4, RN · Jan 2, 2005

How did child acquire the burn?

PA-C in Texas · Jan 2, 2005

The treatment sounds appropriate, even if I would have chosen something different. Certainly no reason to admit for what sounds like a borderline partial thickness from your description. I probably would have gone with some Tylenol w. Codeine syrup instead of the EMLA and some silvadene (just because I think it is cool stuff). My philosophy is that I have more medicine than you have pain.

I used to write exclusively for Tylenol #2 because I was so terrified of writing for narcotics. This was back when my doc had to co-sign all of my controlled substances prescriptions because PA's and APN's couldn't write for them alone. But when I got my first job in a rural ER, there was this LVN named Sheila with 30+ years of experience (who ended up being like my second mom), and every time I would call the pharmacy for Tylenol #2, she would just give me "that look". She eventually broke me of that and made me realize that narcotics are my gift to all of the people in pain in this world. LOL

Trauma Columnist · Jan 2, 2005

I agree with Silvadene and narcotic po meds for pain. This works for us.

shanneff · Jan 2, 2005

Thanks for your responses.

Baby in question was my son... I don't think a social services consult was necessary. He apparently taught himself how to climb out of his crib, and as his luck would have it, on the first time doing so after climbing out of it went over to the vaporizer in his room (he had had a cold) and pulled out the steamer part onto his leg. He was discharged with tylenol with codeine for pain, and that has helped a lot. EMLA was just used in the ED for immediate pain on the site.

I just wasn't sure if putting neosporin on it to keep it moist was a good idea.

Thanks for all your inputs. :)

PA-C in Texas · Jan 3, 2005

Poor kid! These things will inevitably happen. Don't be afraid to use the Neosporin. It certainly won't do him any harm.

MaryPush · Jan 3, 2005

Sounds like it's time for a "big boy bed"

Mary

live4today, RN · Jan 3, 2005

Sounds like it's time for a "big boy bed"
Mary

And a cool mist humidifier, too. :)

Nursinist · Jan 3, 2005

I recently finished a course for health-care professionals on aromatheraphy and would not hesitate to apply essential oil of lavender on burns--has miraculous healing powers.:balloons:

Pediatric Critical Care Columnist · Jan 3, 2005

I'm not sure I would put EMLA on a burn. One of the ways it blocks pain sensation is by creating local edema. There would already be local edema with a second degree burn; more would only make the pain more intense once the EMLA wears off. As for the Neosporin, go for the gusto. Several years ago, my son poured a cup of almost-boiling tea over his good hand. (The aide with him didn't realize that he has Go-Go-Gadget arms and can grab things that should be 'way out of his reach.) Anyway, they called me at work and told me about the burn, describing it as minor. I asked that they loosely dress it with gauze and I'd deal with it at home. To my utter dismay, the burn was actually a second degree one that spread between his fingers, onto his palm and down to his wrist on the dorsum of his hand. Neosporin isn't available in Canada OTC, but I did have some Bactroban. I anointed his burn with it three times a day and in a week it was well on the way to healed. He took Tylenol #1 before each dressing change and was able to continue using his hand while it healed.

BTW, letting a burn dry out is very old school; scarring and pain are minimized by keeping the skin lubricated. We use Flamazine for skin we can cover with a dressing, Polysporin or Bactroban for facial burns and Sulfamylon for ears and noses.

BittyBabyGrower, MSN, RN · Jan 3, 2005

When I had 2nd degree burns to my hand, thanks to a corningware bowl melting my fingers to it, they applied bacitracin and wrapped it with telfa. The told me to change the dressing BID and leave the blisters that were there, then I went in to the burn unit 2x a week for a check until it was healed. Luckily we have a burn unit in my hospital :) My hand healed with no scarring, so keep it lubed up! I had Tylenol with codeine for a few days, then it didn't hurt quite as much.