For quite some time now NAFAA it has been trying to stop fire performers sharing Silvadene as a first aid treatment for burns. We still did not endorse this behavior however we feel that it is time to bring the entire subject to a head.
Let’s begin with how it’s supposed to be used. Silver sulfadiazine (sold as Silvadene and Thermazene) is intended to treat open burns of 2nd or 3rd degree (not 1st), after the initial damage is done, and when the wound is in danger of sepsis (bacterial infection). It is a Sulfa Drug and may trigger severe reactions on contact. So it it provided only by prescription and a doctor should be consulted before use.
Okay, so lets start with the big one: Sulfa Allergies. About 1 in 1000 people have allergies to sulfa drugs. Sometimes these are stable allergies with known, constant symptoms, others change. Common allergic reactions are rash, itching, breathing problems, swelling, and more rare headache, trouble sleeping, cloudy urine (crystalluria), and low blood counts. Severe reactions can include anaphylaxis through simple contact. So it’s probably best if you keep your supply in a ziplog bag to help prevent unwanted contact.
Next, first aid. At no point was Silvadene intended for use as immediate treatment of burns. A large study found that it was less effective than placebo for first aid treatment of burns. Here’s why: first, the carrier paste in silvadene is about the consistency of peanut butter and does not dissolve into the body. When applied to a fresh burn, it can trap he heat inside and cause the burn level to increase. Also, because it doesn’t dissolve, there’s the problem of trapping an holding dirt and debris in the wound, sticking to bandages, and concealing complications. Second, though it is an anti-bacterial antibiotic, it does not treat viral infections, and does nothing if the skin is uncompromised. So, first degree burns and second degree blisters get no benefit at all. Further, overuse of this drug is contributing to the overuse of antibiotics in general, leading to resistant strains of disease.
So, to sum up. Sharing prescription Silvadene is helping to develop antibiotic resistant strains of disease, could be putting your friends in danger of allergic reaction that could lead to death, and the first aid use of it could be damaging them further in numerous ways even if they’re not allergic. No first aid kit should EVER have silvadene in it. It should not be shared with people who have not been prescribed. It should be stored inside other containers to prevent accidental contact. Similarly, when used properly, wounds with Silvadene present should be covered to prevent accidental contact.