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The rule of 9s


Lotus

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In the posterior neck a cric is what you get when you sleep with your head at an odd angle.

In anatomy a cric is the cricothyroid membrane.

When speaking of emergency airway management a cric is a cricothyrotomy.

In Louisiana a cric is a ditch that water runs through. :)

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We were lucky with my brother in law, the Dr. in my brother in laws case had a scanner and heard that we had a burn patient and were on our way to the hospital. We had no other option at that time but to transport by ground to nearest facility. The Dr. headed to the ER. called the burn unit 60 miles away and talked to the Dr. there, by the time we got there he was all set up ready to administer meds and so forth as per instructions from the burn unit, then transported him to the burn hospital. He did not breathe in when the explosion happened, so his airway was not burned. The first thing he said to my husband when he was able to see him was "What a way to barbecue!" He has a wicked sense of humor. My brother in law had a 20 some the skin graphs, and the bandages they used left a waffle pattern on his skin graphs, looks weird, but he survived and walked out of the hospital about four weeks to the day he was burned. .

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You should print it out, and keep it handy. Like in a clip board. I keep a little card in the actual burn kit. I seen the rule of 9's on a first aid slide when I was younger; then in the EMT class, then never again. Until about a year or so ago, I was aware of how to treat them from a BLS stand point, and I was aware of the rule of 9's. But I'd never treated a burn patient. I'd been on scenes at house fires where we lost several people in one shot; women and children. The smell, bitter sweet, sickening. It's like a GI bleed, you never forget it. It wasn't until about the last 15 months, that either b/c of bad luck or industry; or sheer stupidity, I've seen at least 7 burn cases, and that's out of only maybe 150 or 200 calls. After the first one, I looked into and took Advanced Burn Life Support (as an EMT).

One thing I've learned, is that if a sick person is severely burned, it's likely a death sentence. If they can feel the pain, it's not a bad thing. If they can't, it's definetly a really bad thing. Deep burns tend to cause nerve damage. The nearest burn center is like 200mi from here, so I'm also big on flying these patients. I've been a strong supporter of increasing the supplies on an ambo ever since the 1st burn patient. We had the basic crap, what was required. But there are so many helpful resources you can add, that make care better for the patient. The first is education, there are some really good burn classes for both BLS and ALS. I'd recommend one, even if you just sat in on it; the same as I do a first aid class, or BTLS (PHTLS now a' days). Not con-ed, but bolstering your knowledge with more tricks to add to your bag of ideas.

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I carry a notebook with tidbits of things I tend to forget. The rule of 9's sketch is one of them.

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Yes, 9 is the number of ampoules of opioid-like drugs my DNR/living will says to give me if I end up in ICU with severe burns in order to overdose me on pain medication so I die and suffer less than I would if I lived.

... what, you think I'm joking?

It's a rule to calculate burn area

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