The primary difficulty that sets handling dragons apart from other dangerous magical creatures is the very high potential for severe burn injuries. Dragon burns are caused by exposure to a dragon’s breath, and may be classified according to the chemical basis of the dragon’s ‘fire’. Along with the usual flames, dragon burns may also be caused by corrosive substances from the digestive tract or scale friction. Dragon scalds are caused by wet heat - hot liquids and vapours such as saliva or steam. When burns have been treated, the casualty should also be thoroughly examined for claw and bite damage as well.
Assessing a Burn
There are a number of factors to consider when assessing the severity of a burn and the method of treatment, including the species of dragon, whether the airway is involved, the depth of the burn, and its extent.
The extent of the burn will indicate whether shock is likely to develop, as tissue fluid (serum) leaks from the burned area and is replenished by fluids from the circulatory system. The greater the extent of the burn, the more severe the shock will be. The cause of the burn may also signal any other possible complications. Burns also carry a serious risk of infection, which increases according to the size and depth of the burn. The body’s natural barrier, the skin, is destroyed by burning, leaving it exposed to germs. This is particularly important as dragons’ lairs are often breeding grounds for microbiotic contagions.
Depth of Burns
Burns can be categorised as follows:
Superficial burns (Rare)
These involve only the outer layer of the skin, and are characterised by redness, swelling and tenderness. Typical examples are mild singeing, or a scald produced by nostril vapours. Superficial burns usually heal well if prompt first aid is given, and do not require medical treatment unless extensive.
Partial-thickness Burns (Medium)
These damage a ‘partial thickness’ of the skin, and require medical treatment. The skin looks raw, and blisters form. These burns usually heal well, but can be serious, if extensive. In adults, partial-thickness burns affecting more than 50% of the body’s surface can be fatal. This percentage is less in children and the elderly.
Full-thickness Burns (Well Done)
These damage all layers of the skin. Damage may extend beyond the skin to affect nerves, muscle and fat. The skin may look pale, waxy, and sometimes charred. Full-thickness burns of any size always require immediate medical attention, and usually require specialist treatment.
Extent of Burns
The area of a burn gives an approximate indication of the degree of shock that will develop and, in conjunction with depth, can be used as a guide to the required level of treatment.
The ‘rules of nine’ is a guide used to calculate the extent of a burn as a percentage of the body’s total surface area, and to assess what level of medical attention is required. Due to the relative size of dragons to their likely casualties, full thickness burns of great extent are not uncommon.
In an otherwise healthy adult:
Any partial-thickness burn of 1% or more (an area approximating to that of the casualty’s hand) must be seen by a medical practitioner.
A partial-thickness burn of 9% or more will cause shock to develop, and the casualty will require hospital treatment.
A full-thickness burn of any size requires hospital treatment.
Severe Burns and Scalds
In EVERY case, first make sure the dragon is no longer in close proximity! Its is difficult if not impossible to supply adequate first aid while a dragon is still attacking. The next priority is to cool the injury; the longer the burning goes unchecked, the more severely the casualty will be injured. Resuscitate the casualty only when cooling is underway. All severe burns carry the danger of shock.
Treatment of Severe Burns and Scalds
DO NOT overcool the casualty; this may dangerously lower the body temperature.
DO NOT remove anything sticking to the burn; this may cause further damage and cause infection.
DO NOT touch or interfere with the injured area.
DO NOT burst blisters.
DO NOT apply lotions, ointment, or potions to the injury.
Lay the casualty down, protecting the burned area from contact with the ground, if possible. When cooling spells are unavailable, douse the burn with copious amounts of cold liquid. Thorough cooling may take 10 minutes or more, but this must not delay the casualty’s transmission to hospital. While cooling the burns, check airway, breathing, and pulse, and be prepared to resuscitate.
Gently remove any rings, amulets, belts, shoes, or smouldering clothing from the injured area, before it starts to swell. Carefully remove burned robes unless they are sticking to the burn.
Cover the injury with a sterile burns sheet or other suitable non-fluffy material, to protect from infection. Sterile films are preferred but even plastic kitchen wrap will work in an emergency. Burns to the face should be cooled with water, not covered, unless other arrangements for breathing have been made.
Contact the emergency medical team from St. Mungo’s immediately. While waiting, treat the casualty for shock. Monitor and record breathing and pulse, and resuscitate, if necessary.
Burns to the Mouth and Throat
Burns to the face, and burns in the mouth or throat are very dangerous, as they cause rapid swelling and inflammation of the air passages. The swelling will rapidly block the airway, giving rise to a serious risk of suffocation. Immediate and highly specialised medical assistance is required.
Treatment of Burns to the Mouth and Throat
Contact St. Mungo’s emergency service. Report suspected burns to the airway. Take any steps to improve the casualty’s air supply, e.g., loosening clothing around the neck, bubblehead charms, etc. Give the casualty oxygen if you are trained to do so.
If the casualty becomes unconscious, place in the recovery position, and be prepared to resuscitate.
Minor Burns and Scalds
Minor burns and scalds are usually the result of accidental contact with dragons. Prompt first aid will generally enable them to heal naturally and well, but the advice of a medical practitioner should be sought if there is doubt as to the severity of the injury.
Treatment of Minor Burns and Scalds
DO NOT use adhesive dressings.
DO NOT break blisters, or interfere with the injured area.
DO NOT apply lotions, ointments, creams, or potions to the injured area.
Cool the injured part with cooling charms for about 10 minutes to stop the burning and relieve the pain. If charms are unavailable, any cold, harmless liquid such as water, milk or canned drinks will suffice.
Gently remove any jewelery or constricting clothing from the injured area before it starts to swell.
Cover the injury with a sterile dressing, or any clean, non-fluffy material to protect from infection.