It has happened to all of us at one time or another. The restaurant is jamming, the line is out the door, and the staff is running wild. The server impatiently waits for you to put the final touches on the duck a l'orange. As you cut into the orange, the knife slips and suddenly blood is gushing everywhere. What do you do now?Cuts--as well as burns and falls--are the most common mishaps in the kitchen and must be treated urgently to ensure proper healing without complications. The following are some tips for dealing with cuts, burns and falls.
Cuts
If you cut a finger, the most important action is to control the bleeding by immediately applying direct pressure to the wound. If the blood is squirting, wrap a clean kitchen towel around the wound and continue to apply pressure. Elevate the arm above the heart to slow the flow of blood. If the bleeding does not stop or the wound is deep and can’t be closed, a trip to the emergency room is necessary. A tetanus shot is recommended if you have not had one within the past 10 years.
When the wound stops bleeding, it must be cleaned with water. Dry the wound and apply a thin layer of antimicrobial ointment or cream, such as bacitracin, to prevent infection. The wound should then be covered with a secure bandage (such as a 3M Tegaderm) to keep it clean and to keep blood out of the food.
If a section of finger is accidentally cut off, place the cut section of finger on top of ice--not in ice or water--and bring it with you to the emergency room immediately. Wrap the bleeding finger in a clean moist towel to prevent the towel from sticking to the finger. Continue measures to control bleeding.
Burns
Two common types of kitchen burns are scalding and contact burns. Scalding burns occur from exposure to hot liquid and account for 32 percent of burns treated in emergency rooms. Contact burns occur from skin contact with a hot object and account for 8 percent of emergency room burns.
Knowing what to do when hot oil splashes can save your skin. When a burn occurs, it is most important to wash the burn with room-temperature water. Ice and ice water should be avoided because it may cause further damage. Assessing the burn wound depth will determine the severity of the injury and the course of action. First-degree burns damage only the outer layer (epidermis) of the skin. The skin is pink or red, dry, has no blisters, and is painful to the touch, similar to a sunburn. The skin should heal within three to five days. A trip to the emergency room is not required unless it involves a large body surface area.
Second-degree burns are slightly deeper and involve the epidermis and the upper layers of the dermis. The burn wound will show blistering. It is recommended to keep a blister intact if it has not ruptured. Second-degree burns should be cleansed with mild soap and water twice a day, and an antimicrobial ointment, such as bacitracin or polymyxin B, should be applied. A sterile gauze covering may be needed. The skin should heal within 20 days. Emergency room care may be necessary for second-degree burns with large body surface area.
Third-degree burns destroy the epidermis and most of the dermis layer of the skin, and fourth-degree burns destroy the skin, down to the muscle and bone. The skin may blister, look white, tan, or charred, and is not painful. This condition requires an immediate trip to the emergency room. Skin grafting may be needed.
Infection is one of the biggest complications with cuts and burns. Symptoms that require immediate medical attention are fever and chills, redness, swelling, foul smell, pus or drainage, and increased pain to the wound. It is important to watch the wound closely to make sure it is healing.
Falls
Slippery and wet floors caused by spills, grease or an aggressive dishwasher can cause serious accidents in the kitchen. If a fall occurs affecting the head and neck, observe for symptoms of a head injury. These symptoms require immediate attention and include inability to arouse the person, confusion, vomiting, dizziness, loss of consciousness and short-term memory loss. If the fall affects a person’s neck, support the head in the position it was found and seek medical care. If a person falls, experiencing severe pain in the back or hip, call 911 immediately. Head, back, and hip injuries are a critical matter and should be taken seriously.
Being prepared
First-aid items should be stocked in a cabinet in the kitchen for quick access when an emergency occurs. These items should include: clean kitchen towels, antimicrobial ointment, gauze, medical silk tape, Band-Aids, and 3M Tegaderm bandages. Written instructions on how to proceed if a cut, burn or fall occurs will also be helpful.
Cuts, burns, and falls in the kitchen happen to the best of us. Knowing how to properly treat medical emergencies is important to avoid infection, ensure good healing and allow us to complete that duck a l'orange.
Mobilio is a registered nurse currently working as a clinical instructor at Waterbury Hospital in Waterbury, Conn. She is also an alumnus of the Culinary Institute of America in Hyde Park, N.Y., class of 1979. She pursued a career in pastry for 20 years prior to becoming a nurse.
References
- Henry, C. & Stapleton, E. R. (2004). EMT Prehospital Care: 3rd Ed. J.J. Keller & Associates.
- Taira, B. & Singer, A. (2008). Assessing the severity of a burn injury. Emergency Medicine, 26-35.
- Wiebelhaus, P. & Hansen, S. (2001). Burn emergencies. Nursing 2001, 31 (1), 36-41.
- Kelly, R. (2006). Head injuries: what to watch for afterwards. American Academy of Family Physicians. Retrieved February 23, 2009 from: http://familydoctor.org/online/famdocen/home/common/brain/head/084.html
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