http://tw.news.yahoo.com/article/url/d/ ... 1msv2.html
更新日期:2009/07/10 04:09
文／吳玉蘭
80歲的王老先生自行用熱水泡腳，但因曾中風過，末梢神經較不敏感，已經燙傷了還不知道，一直到隔天，家人發現後送醫，才診斷出雙足已3度燙傷，需做植皮手術。
王老先生難過地問：「又不是沸水，為什麼也會3度燙傷？」
其實並不只有攝氏100度的沸水才會造成3度燙傷，不論任何物質或溶液，在攝氏50度至65度時，只要皮膚持續接觸3至5分鐘即可造成3度燒燙傷，當溫度到達攝氏100度時，造成3度燙傷的時間便縮短為三秒；若是老人、嬰幼兒或糖尿病患等皮膚較薄、耐受度較低者，所需時間又會再縮短。
所以，一旦燙傷，最重要的就是立刻降溫，避免高溫一直留在皮膚上，繼續傷害皮膚，但要避免立刻冰敷，因為已燙傷的皮膚很容易被凍傷；也需避免立刻在受傷的皮膚上塗抹牙膏、藥膏及乳液等任何物質，因為這些東西都會將「熱」包覆住，減緩降溫的速度，而且，如果需要送醫治療，這些東西也會增加傷口處理的困難。
◎燙傷的正確的作法是「沖、脫、泡、蓋、送」
●首先，要先在緩和流動的冷水下，沖30分鐘，並在水中除去衣物。
●接著再泡在乾淨的冷水中30分鐘，如需就醫，則在傷口蓋上乾淨的紗布或衣物。
●傷口上，若有水泡，不要弄破，儘量保持皮膚的完整，減少在送醫途中感染的機會。
有的人會在情急之下，不先沖水，或只沖水一下子就直接到醫，這其實是很大的錯誤，因為這樣就錯失了馬上幫皮膚降溫的機會，而讓熱能可以進一步傷害皮膚，讓原本可能只是一度燙傷的傷口，變成2度，甚至是3度燙傷。
其實，不論燙傷的傷口如何，總會讓人不舒服好一陣子，所以最好的方法就是避免燙傷。
●泡溫泉、洗澡及泡腳的水溫應在攝氏38至42度之間較安全，對溫度感覺較不敏感的人可買沐浴用的溫度計測量。
●熱茶及熱湯等需放在幼童不易碰到的地方。
●速食店的熱飲通常都會放在隔熱的保麗龍杯中，不易感受到真正的溫度，因此最好由大人先確認過溫度再給老人及小孩食用。以上這些都是日常生活中可能造成中高溫燙傷的物品，不可不慎。 （作者為中華民國燒傷學會資深護理師）
燙傷要降溫 不宜冰敷
版主: 版主021
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throne
- V3
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Re: 燙傷要降溫 不宜冰敷
不適合冰敷是有道理
但是應該是冰敷通常會有機械性摩擦以及接觸面不均勻的問題
可是如果在水中加些冰塊降溫，對燙傷部位熱能的移除效率會不會更快?
至於凍傷與否牽涉到時間問題，應該不是重點吧
但是應該是冰敷通常會有機械性摩擦以及接觸面不均勻的問題
可是如果在水中加些冰塊降溫，對燙傷部位熱能的移除效率會不會更快?
至於凍傷與否牽涉到時間問題，應該不是重點吧
-
chichang
- 科主任級
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Re: 燙傷要降溫 不宜冰敷
我以前被熱湯燙到
趕快冰敷
咦，沒有起水泡，傷口也很快就好了
所以我一直認為冰敷很好
今天看到這個主題，對於「不宜冰敷」的結論，有點 fighting
結果 search 了一下，發現：
Cooling of the burn wound: the ideal temperature of the coolant.
Venter TH, Karpelowsky JS, Rode H.
Department of Paediatric Surgery, Red Cross Children's Hospital, University of Cape Town, Rondebosch 7700, Cape Town, South Africa.
BACKGROUND: The beneficial effects of cooling a fresh burn wound were well demonstrated. However, there are still conflicting reports as to the optimum temperature of coolant, duration of application and effects in limiting tissue damage. A study was undertaken to investigate this, the importance of the temperature of, and the time period of application of the coolant. MATERIALS AND METHODS: Four identical deep dermal wounds were created on the back of 10 anaesthetised pigs. Each animal served as an independent experimental model. The effectiveness of cooling was monitored by measuring intradermal temperatures. The animals were divided into two groups; using ice water and tap water as the coolants. In each pig one wound was not cooled (wound 1). Three were cooled; one immediately for 30 min in group 1 and for 4 h in group 2 (wound 2). The other two wounds were cooled after 30 min for 30 min and 3 h (wounds 3 and 4, respectively). RESULTS: It was found that the temperature of the coolant was crucial. When ice water of 1-8 degrees C (group 1) was used more necrosis than in the wounds that were not cooled was seen. When tap water was used at 12-18 degrees C (group 2) it was demonstrated clinically and histologically that the cooled wounds had less necrosis than the uncooled wounds and thus healed faster. In group 2 the beneficial effects of cooling were still present when delayed for half an hour. CONCLUSION: First aid cooling of a burn wound with tap water is an effective method of minimising the damage sustained during a burn, and is universally and immediately available. Ice water cooling is associated with an increase in tissue damage.
趕快冰敷
咦，沒有起水泡，傷口也很快就好了
所以我一直認為冰敷很好
今天看到這個主題，對於「不宜冰敷」的結論，有點 fighting
結果 search 了一下，發現：
Cooling of the burn wound: the ideal temperature of the coolant.
Venter TH, Karpelowsky JS, Rode H.
Department of Paediatric Surgery, Red Cross Children's Hospital, University of Cape Town, Rondebosch 7700, Cape Town, South Africa.
BACKGROUND: The beneficial effects of cooling a fresh burn wound were well demonstrated. However, there are still conflicting reports as to the optimum temperature of coolant, duration of application and effects in limiting tissue damage. A study was undertaken to investigate this, the importance of the temperature of, and the time period of application of the coolant. MATERIALS AND METHODS: Four identical deep dermal wounds were created on the back of 10 anaesthetised pigs. Each animal served as an independent experimental model. The effectiveness of cooling was monitored by measuring intradermal temperatures. The animals were divided into two groups; using ice water and tap water as the coolants. In each pig one wound was not cooled (wound 1). Three were cooled; one immediately for 30 min in group 1 and for 4 h in group 2 (wound 2). The other two wounds were cooled after 30 min for 30 min and 3 h (wounds 3 and 4, respectively). RESULTS: It was found that the temperature of the coolant was crucial. When ice water of 1-8 degrees C (group 1) was used more necrosis than in the wounds that were not cooled was seen. When tap water was used at 12-18 degrees C (group 2) it was demonstrated clinically and histologically that the cooled wounds had less necrosis than the uncooled wounds and thus healed faster. In group 2 the beneficial effects of cooling were still present when delayed for half an hour. CONCLUSION: First aid cooling of a burn wound with tap water is an effective method of minimising the damage sustained during a burn, and is universally and immediately available. Ice water cooling is associated with an increase in tissue damage.
Re: 燙傷要降溫 不宜冰敷
另外一篇
The optimal temperature of first aid treatment for partial thickness burn injuries.
Cuttle L. Kempf M. Kravchuk O. Phillips GE. Mill J. Wang XQ. Kimble RM.
Wound Repair & Regeneration. 16(5):626-34, 2008 Sep-Oct.
[Journal Article. Research Support, Non-U.S. Gov't]
AB Using our porcine model of deep dermal partial thickness burn injury, various cooling techniques (15 degrees C running water, 2 degrees C running water, ice) of first aid were applied for 20 minutes compared with a control (ambient temperature). The subdermal temperatures were monitored during the treatment and wounds observed and photographed weekly for 6 weeks, observing reepithelialization, wound surface area and cosmetic appearance. Tissue histology and scar tensile strength were examined 6 weeks after burn. The 2 degrees C and ice treatments decreased the subdermal temperature the fastest and lowest, however, generally the 15 and 2 degrees C treated wounds had better outcomes in terms of reepithelialization, scar histology, and scar appearance. These findings provide evidence to support the current first aid guidelines of cold tap water (approximately 15 degrees C) for 20 minutes as being beneficial in helping to heal the burn wound. Colder water at 2 degrees C is also beneficial. Ice should not be used.
The optimal temperature of first aid treatment for partial thickness burn injuries.
Cuttle L. Kempf M. Kravchuk O. Phillips GE. Mill J. Wang XQ. Kimble RM.
Wound Repair & Regeneration. 16(5):626-34, 2008 Sep-Oct.
[Journal Article. Research Support, Non-U.S. Gov't]
AB Using our porcine model of deep dermal partial thickness burn injury, various cooling techniques (15 degrees C running water, 2 degrees C running water, ice) of first aid were applied for 20 minutes compared with a control (ambient temperature). The subdermal temperatures were monitored during the treatment and wounds observed and photographed weekly for 6 weeks, observing reepithelialization, wound surface area and cosmetic appearance. Tissue histology and scar tensile strength were examined 6 weeks after burn. The 2 degrees C and ice treatments decreased the subdermal temperature the fastest and lowest, however, generally the 15 and 2 degrees C treated wounds had better outcomes in terms of reepithelialization, scar histology, and scar appearance. These findings provide evidence to support the current first aid guidelines of cold tap water (approximately 15 degrees C) for 20 minutes as being beneficial in helping to heal the burn wound. Colder water at 2 degrees C is also beneficial. Ice should not be used.
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herotopone
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chichang
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Re: 燙傷要降溫 不宜冰敷
補充：pedi 寫:我以前被熱湯燙到
趕快冰敷
咦，沒有起水泡，傷口也很快就好了
所以我一直認為冰敷很好
今天看到這個主題，對於「不宜冰敷」的結論，有點 fighting
小範圍的燙傷和大面積的燙傷有很大的不同點，特別是大面積的燙傷，降溫太快可能導致失溫的情況發生
以前還看過一篇患者的心聲，在急診室被冷水沖的打寒顫，直呼醫院沒人性。
冷水和冰水是不一樣的。但是光是冷水，就可能讓人受不了。
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lingokon
- V1
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- 註冊時間: 週五 8月 25, 2006 4:56 pm
- 來自: 台中
Re: 燙傷要降溫 不宜冰敷
網路上流傳的方法 , 真的 ?假的 ? 用鹽巴 .
一度的燙傷應該都有效吧
燙傷處理新法 !
2009/07/19 10:57:50 瀏覽10｜回應0｜推薦2
★ 未破皮處之燙傷處理 (熱水、熱湯、熱油、摩托車煙管、蒸氣燙傷) ---
燒傷如果沒有馬上降溫與止痛，未來的辛路歷程是可想而知。當燙傷時
第一時間不是很痛，是因為身體有百分之 0.9 的鹽繼續吸皮膚發炎的熱
而變成越來越灼熱痛，我們用鹽把熱吸過去就不痛了，因為鹽有吸熱和
滲透的特性，民俗廟會過火撒鹽就是這個原理。
我向一位年長的婦女說燙傷須馬上泡冰鹽水：有一次她跌倒整隻手掌插入
熱油鍋裡，她整隻手掌藏入鹽堆裡，結果手心手背都好了，指縫起水泡是
因為沒有把手指頭張開，還高興的向我說謝謝。
像一般家庭小燙傷：沖水後用很厚的鹽再用濕的面紙敷蓋，偶爾加水！！
只要離開鹽不痛約三小時就好了，不需敷藥也沒有留下疤痕。
(註：皮膚未破皮用大量的鹽沒有關係)
一度的燙傷應該都有效吧
燙傷處理新法 !
2009/07/19 10:57:50 瀏覽10｜回應0｜推薦2
★ 未破皮處之燙傷處理 (熱水、熱湯、熱油、摩托車煙管、蒸氣燙傷) ---
燒傷如果沒有馬上降溫與止痛，未來的辛路歷程是可想而知。當燙傷時
第一時間不是很痛，是因為身體有百分之 0.9 的鹽繼續吸皮膚發炎的熱
而變成越來越灼熱痛，我們用鹽把熱吸過去就不痛了，因為鹽有吸熱和
滲透的特性，民俗廟會過火撒鹽就是這個原理。
我向一位年長的婦女說燙傷須馬上泡冰鹽水：有一次她跌倒整隻手掌插入
熱油鍋裡，她整隻手掌藏入鹽堆裡，結果手心手背都好了，指縫起水泡是
因為沒有把手指頭張開，還高興的向我說謝謝。
像一般家庭小燙傷：沖水後用很厚的鹽再用濕的面紙敷蓋，偶爾加水！！
只要離開鹽不痛約三小時就好了，不需敷藥也沒有留下疤痕。
(註：皮膚未破皮用大量的鹽沒有關係)