| Outside magazine, April 1996|
When your hair-trigger camp stove has just seared your backcountry buddy, forget what you think you know. "Your campsite isn't the place to 'stop, drop, and roll,'" says Dr. William Forgey, editor of Wilderness Medical Society's Practice Guidelines for Wilderness Emergency Care (ICS Books, $12.95). "Burns start out sterile, but they won't stay that way if you start writhing around in the dirt."
The first thing to do, says Forgey, is douse the flame completely with cool water. Then it's time to assess the damage: If the feet, hands, face, or genitals are burned, get the victim directly to a hospital. For slightly less sensitive parts, examine the wound closely to gauge the degree of the burn and the surface area affected (a palm-size region is about 1 percent of the body).
First-degree burns, indicated by dry, red skin, don't necessarily require an early return to civilization--as long as you can stand the pain. The same applies to second-degree burns, usually distinguishable by moist and blistered skin, that cover less than 10 percent of the body. (But watch for sub-blister redness and swelling, which could mean an infection.) Third-degree burns, indicated by chalky white or charred skin, and second-degree burns over 10 percent or more of the body mean an immediate end to your trip. Walking out is an option if the victim feels up to it; if not, send for an evacuation team. While waiting, have the victim lie down and elevate the limbs.
As for treatment, Forgey recommends that you gently clean all burns with soap and water and apply a water-based gel dressing, such as Spenco 2nd Skin, either directly or in a light gauze wrap. Reexamine, reclean, and redress the burn daily, carefully removing dead skin from ruptured blisters. Finally, keep folk remedies such as butter and mayonnaise on your food: Like the oil-based ointments they emulate, they prevent healing, trap heat, and create the perfect airless breeding ground for bacteria.