smoke inhalation induced brain damage and burns in general

rosehips · May 30, 2013

Hi all,
I've got a scene where the mc drags a minor character (Gram) out of a burning building.

I need for Gram to sustain no worse than second degree burns, but suffer brain damage from the smoke inhalation that will result in physical effects limiting his movement. I have the gist of how this works from what I've already read about it, but I was wondering if there's typical brain damage and how it manifests. How would he be impaired?

Also, in treating second degree burns, what home remedies would someone who knows what they are doing use? My setting is a fantasy/post apocalyptic style setting, so no doctors or hospitals available. They go see someone who is essentially a wise woman. She doesn't have a ton of herbs or anything on hand (no aloe), but would know the right way to treat burns and such. What might she do?

Thank you all in advance for your help!!!

ETA: Would the brain damage be permanent?
Also, I have Gram knocked out in the building by those that set the fire. Because he was lying down, would he have been inhaling enough smoke to get oxygen deprived enough for brain damage?

Captcha · May 30, 2013

I'm writing a similar situation, so I'll be watching this thread!

One piece of information that might be needed is Gram's age - my research says that kids' brains often compensate much better for damage than adults' brains - so while the damage might be permanent, the effects could be mitigated, especially in a child.

amschilling · May 30, 2013

Cool compresses should be used. Keeping damaged skin moist and cool will help for both pain and damage. They won't want to pop the blisters because of risk of infection. Keeping popped or oozing blisters covered with clean bandages will be important in a world with no antibiotics.

One thing to remember is that if 2nd degree burns are larger than 3" in diameter, or over the face, groin, butt, or major joints, you treat them as if they're major burns. That means being extra careful, and raising the burned area over the heart if possible. There's a risk of shock with them, and can be life-threatening if over a large enough area or on someone who's less than healthy to start.

Don't forget that if there's a willow tree nearby, they can have Gram chew on some bark to help ease the pain. Not as good as the aspirin we buy today, but it's the equivalent herbally.

rosehips · May 31, 2013

Thanks to both of you!

Gram is an adult male, somewhere in his late 30s, maybe early 40s.

Thanks for the willow tree suggestion, I'll be using it and it provides a whole minor side adventure for the mc to run in order to get access to a tree! Yay!

asroc · May 31, 2013

Burns: Cool (not cold), clean running water for at least ten minutes; lacking that, cool moist and clean compresses, cover with clean non-fuzzy cloth and keep as clean as possible. Clean is the keyword here; burns are very prone to infections. Keep the patient hydrated. In a low-tech world, that's pretty much it. Such a situation would also call for supplemental oxygen, antibiotics and IV fluids, but you probably don't have those around in a fantasy setting.
No herbs, no aloe, no ointments etc. on any open burns. They only facilitate infections. (There are ointments that work, but you only get those in a hospital.) No ice. No butter, no milk, no eggs, no bread dissolved in water or other "home remedies." (Seriously, over the years the stuff my patients have put on their burns before they called EMS would cover an entire pantry.) Pain relievers if you have them, but second-degree burns are excruciating and often call for narcotics.

I'm not sure what you mean by "typical" brain damage. Brain damage can affect all kinds of functions; motor, sensory, neurocognitive and so forth. How long was Gram lying there?

rosehips · May 31, 2013

asroc said:
I'm not sure what you mean by "typical" brain damage. Brain damage can affect all kinds of functions; motor, sensory, neurocognitive and so forth. How long was Gram lying there?

Thanks for the information!

What I meant was, from what I read, brain damage can occur due to smoke inhalation for a couple of reasons. One is simple oxygen deprivation and the other is the inhalation of toxic substances in the smoke. If it was a matter of oxygen deprivation, from what I read, it's the outer parts of the brain that suffer first? So in that case, it seems like certain areas will be damaged more than others, and should produce symptoms related to those areas. Everything I've read has been pretty vague on that level, saying "visual, auditory, or motor problems." I realize that the vagueness may be due to how varied the effects can be. But I wondered if it's typical for one side of the body to be affected, like with a stroke, for instance. Or if you're really not going to see a lot of people with motor problems that interfere with walking or something, because that part of the brain isn't as susceptible (I'm making this up--I have no idea). I just don't want to describe Gram's problems only to find out later that what I've written doesn't hold water.

By the time the mc (Ginna) gets to Gram's home, it's fully engulfed in flames. She manages to drag him out (this is very dangerous, I am aware, but she has some supernatural help) but he's totally unconscious. Bad guys knocked him out and set fire to his place. That's the premise at the moment, anyway. I do need bad guys involved as the whole point is to give her reason to go after them. But again, I wonder if the fact that Gram was knocked out would actually have protected him from smoke inhalation.

As for a specific amount of time that he was unconscious, I don't have anything in mind. Whatever works with the results I'm going for.

Other question:
Does willow bark bring down a fever?

GeorgeK · May 31, 2013

rosehips said:
Thanks for the information!

What I meant was, from what I read, brain damage can occur due to smoke inhalation for a couple of reasons. One is simple oxygen deprivation and the other is the inhalation of toxic substances in the smoke. If it was a matter of oxygen deprivation, from what I read, it's the outer parts of the brain that suffer first? So in that case, it seems like certain areas will be damaged more than others, and should produce symptoms related to those areas. Everything I've read has been pretty vague on that level, saying "visual, auditory, or motor problems." I realize that the vagueness may be due to how varied the effects can be. But I wondered if it's typical for one side of the body to be affected, like with a stroke, for instance. Or if you're really not going to see a lot of people with motor problems that interfere with walking or something, because that part of the brain isn't as susceptible (I'm making this up--I have no idea). I just don't want to describe Gram's problems only to find out later that what I've written doesn't hold water.

By the time the mc (Ginna) gets to Gram's home, it's fully engulfed in flames. She manages to drag him out (this is very dangerous, I am aware, but she has some supernatural help) but he's totally unconscious. Bad guys knocked him out and set fire to his place. That's the premise at the moment, anyway. I do need bad guys involved as the whole point is to give her reason to go after them. But again, I wonder if the fact that Gram was knocked out would actually have protected him from smoke inhalation.

As for a specific amount of time that he was unconscious, I don't have anything in mind. Whatever works with the results I'm going for.

Other question:
Does willow bark bring down a fever?

focal defects are the result of embolic or thrombotic effects in which case you see things like hemiplegia. You are describing a generalized hypoxia which could lead to embolic and thrombotic effects if you want it to and those are permanent in adults. Some kids can eventually compensate, the younger the better. The general hypoxic state will have more confusion and combativeness that will resolve (assuming no actual stroke) over 1-3 days. That of course is complicated by things like burns and smoke inhalation. Since you don't have modern medicine you can do much of what you want since your medicine people aren't actual physicians and won't understand neuroanatomy.

Willow bark contains a mild form of aspirin. It might help, probably couldn't hurt but your patient will in no way be able to chew it in that kind of state. Brew it into a tea

smoke inhalation induced brain damage and burns in general

rosehips

Mr. Boo is watching you.

Captcha

amschilling

rosehips

Mr. Boo is watching you.

asroc

Alex

rosehips

Mr. Boo is watching you.

GeorgeK

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