Search This Blog

7.04.2010

In Case of Fireworks....Burn Care Basics



General Information about Burns

One of the most painful injuries that one can ever experience is a burn injury. When a burn occurs to the skin, nerve endings are damaged causing intense feelings of pain. Every year, millions of people in the United States are burned in one way or another. Of those, thousands die as a result of their burns. Many require long-term hospitalization. Burns are a leading cause of unintentional death in the United States, exceeded in numbers only by automobile crashes and falls.

Serious burns are complex injuries. In addition to the burn injury itself, a number of other functions may be affected. Burn injuries can affect muscles, bones, nerves, and blood vessels. The respiratory system can be damaged, with possible airway obstruction, respiratory failure and respiratory arrest. Since burns injure the skin, they impair the body's normal fluid/electrolyte balance, body temperature, body thermal regulation, joint function, manual dexterity, and physical appearance. In addition to the physical damage caused by burns, patients also may suffer emotional and psychological problems that begin at the emergency scene and could last a long time.

Airway Management

In the realm of EMS, from basic First Responder or EMT classes, we are taught about the "ABCs" (airway, breathing and circulation). When confronted with a burn patient, the priorities are no different. Why is "A" such a big issue? If you don't have "A," don't worry about assessing "B and C" because the patient probably won't be alive very long! This is doubly true for the burn patient -- a nasty looking burn can distract us from a potentially worsening airway compromise that could kill the the patient.

When assessing a burn patient, we need to be especially mindful of how the burn occurred, i.e., the mechanism of injury. In many cases, such as explosions or "enclosed space" fires, if the patient is burned on the outside (especially if there are burns to the face), it is likely he may be burned on the inside (upper airway) as well. More important, if the patient is swollen on the "outside," he may also be swollen on the "inside."

Think of how a victim of a house fire must be breathing. Anxiety, fear and hypoxia all lead to rapid breathing of inhaled smoke, with carbon monoxide and various other toxic gases that accompany the superheated temperatures. Airway tissue edema from the heat injury or from chemical burns can quickly lead to a life-threatening airway emergency. This is a crucial consideration, especially in children, who have proportionately smaller airways, as a little edema goes a long way.

Not all burn patients present with airway emergencies that require intubation, especially in the prehospital environment. An alert and oriented patient with no respiratory distress and no visible airway injury is highly unlikely to need urgent intubation. But when there are concerns about airway edema, patients, especially children, should be intubated quickly, before the airway becomes compromised. For us at GRFD #3 -- that means quick consideration of calling ALS.

"How long does it take an airway to swell, and how much will it swell?" The answer to these two questions is essentially, "We don't know." It might help to think about what happens when a finger is slammed in a car door. The finger swells immediately, but more important, it continues to swell for hours after the initial injury. The same idea applies to a burned airway. Burn center clinical educators teach the following: "We can always take the tube out. We can't always put the tube in!"

If the opportunity for endotracheal intubation is missed, much more difficult and dangerous invasive proceedures (such as chricoidotomy) are necessary.

If the patient is in arrest or unconscious without a gag reflex, EMS providers should immediately provide bag-valve-mask ventilation and strongly consider intubation when ALS is available. If the patient is unconscious (but still has a gag reflex), or remains conscious with severe facial burns, intubation in the EMS environment using rapid sequence intubation (RSI) techniques should be considered. If RSI is not an option, then 100% oxygen via face mask should be administered until the airway is definitively secured in the Emergency Department.


Assessment - How Bad is the Burn?
Burns are commonly categorized as First, Second or Third Degree -- or Superficial, Partial Thickness and Full Thickness.
*

As you can see in the diagram above (1) First-degree burn reddens the epidermis; (2) second-degree burn penetrates the epidermis and causes blistering; (3) third-degree burn penetrates the dermis and requires careful attention to heal successfully. (Illustration by Jason M. McAlexander, MFA. Copyright © 2007 Wild Iris Medical Education.)
Superficial burns are painful burns that are characterized by inflamed red skin. Though field treatment of superficial and partial-thickness burns is directed at controlling pain, the first priority for all burns is ensuring that the burning process has stopped.
After observing Universal Precautions, any jewelry or clothing that may be retaining heat should be removed, followed by a water or saline flush for most burns. Burns caused by dry lime, soda ash, phenol, lithium, and sodium metal should not be flushed with water or saline. Local poison control or CHEMTREC should be contacted for direction on appropriate management of these patients (PHTLS, 2003).

Once the burning has been controlled, the area should be covered to avoid further contamination. Burns should only be covered by dry sterile dressings. Moist burn sheets, ointments, lotions, or antiseptics should never be used prehospital. Use of moist dressings for large burns can result in hypothermia. Avoid breaking open blisters, as this increases the risk of infection. 

Burn patients should be continually reevaluated for airway compromise. Painful burns may distract a patient from recognizing symptoms of advancing airway edema. Stridor, coughing, singed facial hair, and soot around the mouth or nares may indicate potential airway involvement. All patients who have experienced thermal burns should receive supplemental oxygen to treat possible hypoxia related to inhalation and compromised circulation. We’ll talk about this more when we get to treatment.

Assessment -- Classifying Burns

Burns are classified in two ways: Method and Degree of burn. In other words -- how did the burn occur, and how much was burned.

Methods of Burns
Thermal - including flame, radiation, or excessive heat from fire, steam, and hot liquids and hot objects.
Chemical - including various acids, bases, and caustics.
Electrical - including electrical current and lightning.
Light - burns caused by intense light sources or ultraviolet light, which includes sunlight.
Radiation - such as from nuclear sources. Ultraviolet light is also a source of radiation burns.

Never assume the source of a burn. Gather information and be sure.

Degrees of Burns
First degree burns are superficial injuries that involve only the epidermis or outer layer of skin. They are the most common and the most minor of all burns. The skin is reddened and extremely painful. The burn will heal on its own without scarring within two to five days. There may be peeling 
Second degree burns occur when the first layer of skin is burned through and the second layer, the dermal layer, is damaged but the burn does not pass through to underlying tissues. The skin appears moist and there will be deep intense pain, reddening, blisters and a mottled appearance to the skin. Second degree burns are considered minor if they involve less than 15 percent of the body surface in adults and less than 10 percent in children. When treated with reasonable care, second degree burns will heal themselves and produce very little scarring. Healing is usually complete within three weeks.
Third degree burns involve all the layers of the skin. They are referred to as full thickness burns and are the most serious of all burns. These are usually charred black and include areas that are dry and white. While a third-degree burn may be very painful, some patients feel little or no pain because the nerve endings have been destroyed. This type of burn may require skin grafting. As third degree burns heal, dense scars form.

Determining the Severity of Burns
How badly is someone burned? To determine this we take several things into account.
Source of the burn -Mechanism of Injury (flame, clothes or patient caught fire, flash burn, scald, electrical, chemical). a minor burn caused by nuclear radiation is more severe than a burn caused by thermal sources. Chemical burns are dangerous because the chemical may still be on the skin. Burns occuring within confined space make us suspect possible respiratory inhalation injury.
Body regions burned - burns to the face are more severe because they could affect airway management or the eyes. Burns to hands and feet are also of special concern because they could impede movement of fingers and toes. 
Degree of the burn - the degree of the burn is important because it could cause infection of exposed tissues and permit invasion of the circulatory system. 
Extent of burned surface areas - It is important to know the percentage of the amount of the skin surface involved in the burn. The adult body is divided into regions, each of which represents nine percent of the total body surface. (see the picture below)
*  
These regions are the head and neck, each upper limb, the chest, the abdomen, the upper back, the lower back and buttocks, the front of each lower limb, and the back of each lower limb. This makes up 99 percent of the human body. The remaining one percent is the genital area. With an infant or small child, more emphasis is placed on the head and trunk. This is called the Wallace Rule of Nines. Another option for prehospital care is called serial halving (“half burnt/half not”) approach. You look at the patient and ask yourself, is the burn greater than half the total body surface area? If not, is it 1/4? Is it less than one-quarter?  This is a simple and yet, pretty effective way to estimate burn size for those of us in EMS. 
Age of the patient - This is important because small children and senior citizens usually have more severe reactions to burns and different healing processes. In children and elderly, always be mindful of potential Non Accidental Injury.
Pre-existing physical or mental conditions - Patients with respiratory illnesses, heart disorders, diabetes or kidney disease are in greater jeopardy than normally healthy people.




Fluid Resuscitation

Intravenous fluids are administered to replenish circulating fluid volume that is lost as a result of not only the burn, but also the massive fluid shifts and edema that accompany most significant burns. As challenging as it is to establish and secure an intravenous (IV) line on a healthy person in the back of an ambulance, imagine how it is with a burn patient.

Once ALS is available, there are formulas for fluid ressusitation which is vital to combat the fluid shifts and shock associated with major buns. Note the time of the burn as accurately as possible as some formulas are based on time from the burn. 

Dressings

Burned clothing can initially be moistened to extinguish heat and then removed. This can be done within the privacy of an ambulance while en route to the hospital. If clothing adheres to the burned body parts, do not attempt to pull it off. Simply leave it in place; any remaining clothing will be removed with the burned tissue during debridement.

While not specifically related to hypothermia issues, it is a good idea to remove jewelry with any significant burn injury. If the patient offers resistance to removing jewelry, explain that the earlier it is removed, the less chance it will have to be cut off later. There is the distinct possibility of the jewelry becoming a tourniquet of sorts as the surrounding tissues become edematous. Another important reason for early removal is that jewelry can retain heat and continue to burn. Even in non-burned areas, patients may later exhibit significant generalized swelling.

Burn victims can easily and quickly become hypothermic. This is due not only to the physical loss of skin (and its thermoregulatory properties), but also from environmental factors such as wet clothing and the ambulance's or ED's cool ambient temperatures. In addition to maintaining a warm environment, remember that wet skin cools many times faster than dry skin. Hypothermia may result in prolonged blood clotting times, hemodynamic instability and even apnea in infants and children.

Infants and small children lose significant amounts of heat from their large heads, so a hat or towel can be applied to the head in an attempt to minimize heat loss. Other interventions, such as turning up the heat in the ambulance or warming blankets, can also help to prevent heat loss in these patients.


Dressings: Dry vs. Wet vs. ...

School-age children are taught that "Stop, drop, & roll" is the first thing to do if they catch fire. Why? Because one has to "stop the burning process." 

Not only is it important to extinguish the flame, but one should "cool the burn, not the patient."  

Is it OK to briefly run a burned hand under cool water? Absolutely. Small burns (e.g., a burn to the hand) can be covered initially with gauze and saline. Wet, cool dressings feel better, and there is very little likelihood of developing hypothermia from a burn to an isolated area. 

However, for transport purposes, the general rule is that once the burning process is stopped, serious or "bad burns" should be covered loosely with dry dressings. This can be accomplished by simply putting clean, dry sheets (sterile if available, but not mandatory) under and over the patient, with a blanket on top to prevent heat loss (even in summer). The rationale for "dry dressings" is that they cover the burn but do not add to potentially life-threatening hypothermia. As a rule, burn centers teach "dry dressings for everyone."

The exception to the loose, dry dressing rule is availability of a product like WaterJel from WaterJel Technologies in Carlstadt, NJ. 

Especially applicable for EMS, this product makes the patient feel better (like a wet dressing would) but doesn't cause hypothermia. Industrial EMS providers have been using this product for several years, and more recently, the U.S. military and the countries of England, Ireland and Germany have begun to use this product almost exclusively for prehospital burn dressings.

WaterJel gelatinous dressings are composed of sterile water and tea-tree oil. The dressing pulls heat from the burn into the dressing (helping to prevent further burn injury) without adding to the potential for hypothermia, as with wet saline dressings. Once the patient is in the burn center, the prehospital dressings are easily removed (they don't stick to the burn) and debridements begun after rinsing away any residual WaterJel with saline.  
As with other issues in EMS burn care, the type of burn dressing used should be guided by local protocols and burn center guidelines.

An additional benefit of this type of dressing, especially for us BLS providers who cannot administer IV morphine, is the pain relief that is frequently associated with its use. In a prehospital burn patient study, more than 70% of patients indicated a significant reduction in pain, while 7% verbalized "total pain relief" solely with application of the burn dressing.20 For ALS providers who may administer morphine or similar analgesics, studies have shown that after Water-Jel dressing placement, less intravenous medication needs to be administered. In addition to the analgesic effects of the dressing, the other active ingredient is tea-tree oil, which is a naturally occurring antibacterial from Australia that can help prevent further infection.

Silver sulfadiazine (Silvadene), or "burn goop," though commonly used for burns in the outpatient and inpatient hospital settings, should not be placed on the burn by EMS or transferring hospitals, as the receiving staff will have to remove the dressings and the Silvadene to assess the burn.

What about blisters? From the EMS perspective, their care is simple: Cover them with a sterile dressing. 

Pain Management

At home or in the ED, pain associated with minor, superficial burns can be treated with topical anesthetics (Solarcaine, aloe vera) and/or oral medications such as acetaminophen, with or without codeine, or ibuprofen. Caution is advised when using topical anesthetics on children, because absorption of large quantities of the anesthetic may cause seizures. Pain associated with significant partial-thickness or second-degree burns is unlike any other pain and can require what most medical professionals would consider "unbelievable and unsafe" amounts of analgesia.

Major burns require a unique approach to pain management. EMS and ED personnel should serve as patient advocates in assuring adequate pain relief. If the patient is in shock, as many are in the subsequent hours post-burn, blood is preferentially shunted to the heart, lungs and brain, and away from the "butt and the gut." Administration of intramuscular or oral medications is not advisable in these patients. IV is the way to go and that means ALS. Along with airway management and fluid ressusitation, pain management is another reason to get ALS activated and on the patient quickly.

With partial-thickness burns, plenty of intravenous analgesia is certainly appropriate. Though true that the actual tissue involved in full-thickness or third-degree burns doesn't hurt, extensive burns that are only third-degree are not the norm. More commonly, third-degree burns are surrounded by second-degree burns, which are exquisitely painful.

With any burn, regardless of severity, the importance of parental or family support and adequate analgesia (from dressings and/or intravenous medications) cannot be underestimated.



What Not to Put On Burns

If possible, avoid icy cold water and ice cubes. Such measures could cause further damage to burned skin. Never apply ointment, grease or butter to the burned area. Applying such products, actually confine the heat of the burn to the skin and do not allow the damaged area to cool. In essence, the skin continues to "simmer." After the initial trauma of the burn and after it has had sufficient time to cool, it would then be appropriate to put an ointment on the burn. Ointments help prevent infection.

The one exception to the "Cool a Burn" method is when the burn is caused by lime powder. In that case, carefully brush the lime off the skin completely and then flush the area with water. 

ALS -- Why call ALS on a burn injury? Larger partial thickness burns are some of the most painful injuries one can experience. We need ALS to give pain relief. Also, fluid loss and shock are huge issues with burns. Fluid ressusitation must begin enroute.

227 comments:

«Oldest   ‹Older   201 – 227 of 227
Tara Asin said...

Hello, here is a brief information about your health issues. Dr whats-app and Call number: +2348100368288
i was having HERPES for over some year now,and it was not easy for me, because i trow lots of money for tablets and other stuff and yet no result until i came across Dr ALLEN AZIBA a herbal Doctor whom i explained my condition to and to the glory of God he cured me with his herbal medicine which he sent to me directly to my address,words are not enough to thank this God-sent man for me , so decide to share among those who will also need this helpful man to put a smile on your face again and give you a healthy life again, he is also specialize in curing any kind of infection or disease such as DIABETICS,INFERTILITY CASES,FIBROID,HEPATITIS ,HIV,HYPERTENSION,WEAK ERECTION, ARTHRITIS,STAPH INFECTION,ALS,HSV,RELATIONSHIP ISSUES CANCER etc..just make your complain to him and he will surely help you.Remember a problem shared is a problem solved.
Email:[ Priestazibasolutioncenter@gmail.com ]
website: [ https://drallenhealingcureworldwide.webs.com ]
Priest Allen Aziba WhatsApp contact [ +2348100368288 ]

Tara Asin said...

Hello, here is a brief information about your health issues. Dr whats-app and Call number: +2348100368288
i was having HERPES for over some year now,and it was not easy for me, because i trow lots of money for tablets and other stuff and yet no result until i came across Dr ALLEN AZIBA a herbal Doctor whom i explained my condition to and to the glory of God he cured me with his herbal medicine which he sent to me directly to my address,words are not enough to thank this God-sent man for me , so decide to share among those who will also need this helpful man to put a smile on your face again and give you a healthy life again, he is also specialize in curing any kind of infection or disease such as DIABETICS,INFERTILITY CASES,FIBROID,HEPATITIS ,HIV,HYPERTENSION,WEAK ERECTION, ARTHRITIS,STAPH INFECTION,ALS,HSV,RELATIONSHIP ISSUES CANCER etc..just make your complain to him and he will surely help you.Remember a problem shared is a problem solved.
Email:[ Priestazibasolutioncenter@gmail.com ]
website: [ https://drallenhealingcureworldwide.webs.com ]
Priest Allen Aziba WhatsApp contact [ +2348100368288 ]

Elizabeth Matheus said...

HELLO EVERYONE.. FEW MUNINETS TO REDY THIS INFOR ON HERPES CURE 2018..
2017 MY MOTHER WAS DIAGNOSED OF HERPES/ KNOWN AS GENITAL WARTS ,I SPENT A LOT OF MONEY ON HER MEDICATION TILL A POINT I EVEN LOST HOPE,BECAUSE MY MOTHER WAS GRADUALLY DYING AND LOST HER MEMORY TOO, I WAS SO DESPERATE TO GET MY MOTHER BACK TO NORMAL, ONE DAY MY UNCLE WHO LIVES IN LONDON UNITED KINGDOM TOLD ME ABOUT DR OLIHA ,WHO HELPED HIM GET RID OF HERPES /GENITAL WART WITH HERBAL MEDICINE AND HIS HERBAL SOAP ,I WAS SO SHOCKED WHEN HE TOLD ME ABOUT THIS ,ALTHOUGH I NEVER BELIEVE IN HERB BUT, I KEEP TO BELIEVE BECAUSE MY UNCLE CAN'T TELL ME LIES WHEN IT COMES TO HEALTH CONDITION I CONTACTED DR OLIHA VIA HIS EMAIL; OLIHA.MIRACLEMEDICINE@GMAIL.COM , YOU CAN TALK TO HIM VIA CALL OR WHATSAPP MESSENGER ON +2349038382931 , HE REPLIED AND ASK ME TO SEND MY HOME ADDRESS AND MY MOTHER'S DETAIL AND THEN I PURCHASED THE HERBAL MEDICINE,SENT ME THE HERBAL MEDICINE THROUGH COURIER SERVICE, WHEN I RECEIVED THIS HERBAL MEDICINE USED IT FOR 2 WEEKS, AND 4 DAYS OF USAGE THE WARTS FELL OFF, MY MOTHER I NOW TOTALLY CURED AND MY MOTHER IS LIVING FREE AND HAPPY AGAIN. YOU CAN TALK TO DR VIA HIS MOBILE NUMBER OR WHATS APP HIM ON +2349038382931.ALL THANKS TO DOCTOR DR OLIHA

Unknown said...

Hello everyone out there. Dr.Ariba Herbal Medicine is a good remedy for Herpes Virus , I was a carrier of Herpes and I saw a testimony on how Dr.Ariba cure Herpes Virus, I decided to contact him, I contacted him and he guided me. I asked him for solutions and he started the remedies for my health. After he finish he sent me the herbs which i took for 2 weeks before asking me to go for a check up and getting there i could not believe that i was confirm Herpes Negative after the test,Today i am so happy because i'm free from herpes disease with the help of Dr.Ariba Thank God now everything is fine, I'm cured by Dr.Ariba herbal medicine, I'm very thankful to God for making it possible. you can reach him on his email, i strongly recommend him to any one out here looking for a cure . draribahomecure555@gmail.com for more information email me raymondtaylor748@gmail.com

Unknown said...

DR.ARIBA has really made me so much believes in herbs i never believed in natural remedy on thing i try up DR.ARIBA product so surprise i was cure out of herpes after being diagnose over since 3years, now i am free i am cure i am well healthy i have be out of this virus over since 2015 after taking DR.ARIBA herbal treatment. DR.ARIBA is real DR.ARIBA has the herbal remedy for herpes virus please i will kindly advice you to get DR.ARIBA contacted if actually you are passing true this herpes symptom, email draribahomecure555@gmail.com cell phone contact whatsapp contact is +2348138140874 get him contacted today and get his product them come out also to testify. am grateful DR.

victoria janniffer said...

Hello all online viewer ,,,, HERPES AND HIV to heal
Does anyone still doubt natural herbal medicine? I have seen the great importance of natural herbs and the wonderful work they have done in people's lives. I wonder why people are still spending their money on surgery, injections and medications that can not cure you completely. Natural herbs can cure all kinds of diseases, including herpes, diabetics, asthma, HIV, hepatitis, ALS, etc. I saw it with my own eyes. I was cured of HIV and my aunt and her husband were cured of the herpes virus and tested negative after using herbal medicine. I ' have also been healed from HIV and tested negative to HIV after using herbal medicine by Dr. HAZIM who uses natural herbs to heal different types of diseases. Even Dr. Sebi proves to the world that natural herbs can cure all diseases and has cured countless people using natural herbs. I know is hard to believe but am a living testimony. There is no harm in trying herbal medicine. Contact or write Dr.Hazim on: usmandrhazim@gmail.com (phone / whatsap no): +2349058026857,

rosesharon said...

Having herpes is not the end of life there many treatment to cure herpes infection with the help of Dr Edidia herbal product.
I was positive to the deadly virus called HERPES and i lost hope because i
was out casted and rejected even by my closet friends.
i searched on-line to know and enquirer about cure for HERPES and i read
someone testimony on how he was cured from HSV-2 so i decided to contact
the same herbalist Call Dr Edidia because i know that nature has the power
to heal everything.
i contacted him to know how he can help me and he told me never to worry
that he will help me with the natural herbs from God!
after 2 days of contacting him, he told me that the cure has been ready and
he sent it to me via UPS SPEED POST and it got to me after 3 days!
i used the medicine as he instructed me (MORNING and EVENING) and i was
cured!
its really like a dream but i am so happy!
thats the reason i decided to also add more comment of Him so that more can
be saved just like me!
and if you need his help, you can email him on dredidiaherbalhome@gmail.com
or whatsapp +2349074505296
here is the Dr website http://dredidiaherbalhome.weebly.com/
https://dr-edidia-herbal-home.business.site/

I,m rosesharon and you can get intouch with me via rosesharon915@gmail.com also view website to know him

Gloria Evans said...


I'm here to testify about what DR. AFRID did for me. I have been suffering from (HERPES) disease for the past 5 years and had constant pain, especially in my knees. During the first year,I had faith in God that i would be healed someday.This disease started circulating all over my body and i have been taking treatment from my doctor, few weeks ago i came across a testimony of one lady on the internet testifying about a Man called DR.AFRID on how he cured her from herpes disease. And she also gave the email address of this man and advise anybody to contact him for help for any kind of sickness that he would be of help, so I emailed him telling him about my (HERPES) he told me not to worry that i was going to be cured!! Well i never believed it,, well after all the procedures and remedy given to me by this man few weeks later i started experiencing changes all over me as DR. AFRID assured me that i will be cured,after some time i went to my doctor to confirmed if i have be finally healed behold it was TRUE, the test came out negative. So friends my advise is if you have such sickness or any other at all you can contact DR. AFRIA for help via email}
drafridhaberhome@gmail.com CALL/WHATAPPS +17734535649

Jan Gunter said...

I'm here to testify about the great work Dr Osifo did for me. I have been suffering from (HERPES) disease for the past 5 years and had constant pain, especially in my knees. During the first year,I had faith in God that i would be healed someday.This disease started circulating all over my body and i have been taking treatment from my doctor, few weeks ago i came across a testimony of one lady on the internet testifying about a Man called Dr Osifo on how he cured her from Herpes Simplex Virus. And she also gave the email address of this man and advise anybody to contact him for help for any kind of sickness that he would be of help, so I emailed him telling him about my (HERPES Virus) he told me not to worry that i was going to be cured!! Well i never believed it,, well after all the procedures and remedy given to me by this man few weeks later i started experiencing changes all over me as Dr Osifo assured me that i will be cured,after some time i went to my doctor to confirmed if i have be finally healed behold it was TRUE, So friends my advise is if you have such sickness or any other at all you can contact Dr Osifo via email drosifoherbalcenter@gmail.com. You can also call or whatsApp his telephone number +2348072437074.. Thanks once again Dr Osifo

Anna Miguel said...


Am Deg Ceejhay by name from USA Portland I feel so blessed again in my marriage after Doctor Ogun brought back my husband that separated with me for good 6 months. Even though i have mouths all over my body, it won't be enough to thank Doctor Ogun for his help upon my life. My husband separated with me for 6 months and have been in pains and agony without him. So, i searched for help everywhere but nothing worked out not until i meant Doctor Ogun who i contacted online. I explained my situation to him and he promised that my husband will get back to me within 24 to 48 hours as far that my heart still beats for him. I believed in him and he prepared a spell for me and my husband called me exactly when Doctor Ogun said. He pleaded and said he needs me back and now we are living happily again for the past 9 months. Everyone out there reading my article that needs help should contact him... Email. Doctor Ogun via solutiontemple01@gmail.com for more information

If you are out there passing through any of this
problems listed below he is also perfect
(1) Do you want your ex back?
(2) Do you always have bad dreams?
(3) You want to be promoted in your office?
(4) You want women/men to run after you?
(5) Do you want a child?
(6) You want to be rich?
(7) Do you want to tie your husband/wife to be
yours forever?
(8) Do you need financial assistance?
(9) Have you been scammed and you want to
recover your lost money?
(10)Healing of cancer, Hiv/Aids, Herpes and all kinds of sickness
(11)You want to stop marriage problems and Divorced
(12) Child Bearing
(13) Breaking Of Generation Course
(14) Getting Of Job
(15) Spiritual protection
(16) Herbal Care
(17) Divorce Spell
(18) Marriage spell
(19) Breakup spell
(20) money spell
(21) love spell
(22) get pregnant
(23) Business protection
(24) Spell for family problems
(25) Court Case Problems
If you need or want any information on love or
money spells you can get that problem solved
today at Spell Of Solution Temple...

mary care said...

I was depressed when doctor told me that I have been diagnosed with Herpes disease… I thought about my Family, I know my Family will face a serious problem when I'm gone, I lost hope and I wept all day, but one day I was searching the internet I found Dr.ezomo contact number. +2349069171173 I called him and he guided me. I asked him for solutions and he started the remedies for my health. Thank God, now everything is fine, I'm cured by Dr.ezomo herbal medicine, I'm very thankful to Dr.ezomo and very happy with my hubby and family. email him on dr.ezomorootandherbals@gmail.com or you can also reach him through WhatsApp number+2349069171173 He can also cure so many sickness {1}HIV And AIDS {2}Diabetes {3}Epilepsy {4}Blood Cancer {5}HPV {7}ALS {8}Hepatitis

gjhmh said...

AM SANDRA FROM CANADA, THANKS TO DR ONIHA WHO HELP ME BRING MY HUSBAND BACK, MY HUSBAND LEFT ME WITH THREE KIDS, FOR ANOTHER YOUNG GIRL, FOR OVER TWO YEARS, I TRIED ALL I COULD TO SETTLED OUR DIFFRENCES, BUT IT YIELDED NO RESULT, I WAS THE ONE TAKING CARE OF THE CHILDREN ALONE, UNTIL ONE DAY, I CAME IN CONTACT WITH SOME ARTICLES ONLINE, CONTAINING HOW DR ONIHA HAS HELP SO MANY LOVERS AND FAMILY REUNION AND REUNIT AGAIN, AND I DECIDED TO CONTACT HIM, AND HE CAST HIS SPELL ON MY HUSBAND, WITHIN FIVE DAYS, MY HUSBAND RAN BACK HOME, AND WAS BEGGING ME AND THE KIDS FOR FORGIVENESS, IN CASE YOU ARE PASSING THROUGH SIMILAR PROBLEMS, AND YOU WANTS TO CONTACT DR ONIHA, YOU CAN REACH HIM VIA HIS CONTACT NUMBER, ON CALL OR WHATSAP +2347089275769 OR EMAIL DRONIHASPELL@YAHOO.COM

Unknown said...

Hello everyone, Now this is to everyone out there with different health challenges, as I know there are still a lot of people suffering from different health issues and are therefore looking for solution. I bring you Good news. There is a man called Dr. timothy a herbal practitioner who helped cure me from Genital herpes, this i had suffered from for the past 2 years and have spent so much money trying to survive from it. I got my healing by taking the herbal medicine he sent to me to drink for about 14 days . 2 days after completion of the dosage, I went for a medical checkup and I was tested Genital Herpes NEGATIVE. I'm sharing this so that other people can know of this great healer called Dr timothy because I got to know him through a friend he cured from HIV. I was made to understand that he can cure several other deadly diseases and infections. Don't die in ignorance and don't let that illness take your life. Contact Dr. timothy through: Olunkunspelltemple@outlook.com or whats app +2349063230051 Be kind enough to share as you received.

Annie Maxwell said...

Good day friends, i am here to tell you all how the great doc okosun helped me to bring my ex back within two days. I was searching for solution online when i came across his contact, i contacted him and he told me what to do, i did and got my result two days latter. here are his contact just in case you need help from him email: okosunhomeofsolution@gmail.com or whatsapp via +2348026905065

Meyer Becker said...

Health wise, I feel like a child dancing in the rain ever since I got cured of hepatitis. I was diagnosed of HEPATITIS B and I was told it has no cure at the hospital, but I was given several antiviral medications to slow the virus’s ability to damage liver. But after sometime the medicine wasn't working and I became very sick with different symptoms like: vomiting, fatigue, dark urine, swollen stomach and so on. I went back to the hospital and I was told it has become chronic with liver problem, and out of frustration I went online to search for something new to try, and I came across Dr. IYABIYE's recommendation, I gave it a try hence it's a herbal medicine. And behold, I was cured after the treatment. I have to wait for months then went back to the hospital and still I was tested negative. You too will be cured. Contact: (Whatsapp: +2348072229413 or +2348158577300) iyabiyehealinghome@gmail.com

Natasha lanos said...

FINALLY FREE FROM HERPES VIRUS.
what a miracle i never believe there is cure because my doctor tested me herpes positive and she told me there is no cure, i’m very happy today that i’m having a free life without this herpes virus, i can remember some months ago when i was crying all through the night and day that i can’t get cured from this herpes, i found this herbal man called Dr sunny on internet when i was doing research on cure for shingle i contacted him to found out if i can get help from this herpes virus, i was so surprise when he told me that he have the herbs cure to it and he sent me the herbal in less down 5 days i was so happy when i get someone giving me hope that he can cured me i took the herbal for just 2 weeks, when i went for test after taking the herbal i found out that i am cured i was so happy and surprise, i want to use this opportunity to inform you that there is cured to herpes virus you can also contact him for his help as soon as possible so that you can get rid of this herpes once and for all you can reach him through this email: drsunnyna@gmail.com or whatsApp him on +2348077875210 You can also contact him on any disease and virus in this he all have the herbal cure to it.
1 HIV/AIDS
2 HERPES
3 CANCER
4 ALS
5 HEPATITIS
6 DIABETES
7 LOVE SPELL
8 INFECTIONS
9 HIGN BLOOD PRESSURE,.....
THANKS TO DR SUNNY FOE THE GOOD WORK IN LIFE YOU BLESS.....

Sallow Villin said...

Hello viewers in the world am here to share my experience on how I got cured from Herpes through the help of Dr Adigba who use his roots and herbs to cure my Herpes today am healthy and strong once again all thanks to you Dr. may you live long to continue the good work you started, as many of you out there looking for solution to your problems I will like you to give dradigba@gmail.com A try today add him on whatsapp +2348077875210....

neme amber said...

Hello, everyone! I,m here to explore blogs and forum about wonderful and most safe cure for (Herpes Virus).I was positive to the deadly virus called herpes and i lost hope because i was out casted and rejected even by my closet friends.i searched on-line to know and enquirer about cure for Herpes and i read someone testimony on how he was cured from Herpes so i decided to contact the same herbalist because i know that nature has the power to heal everything.i contacted him to know how he can help me and he told me never to worry that he will heal me with the natural herbs from God!after 2 days of contacting him, he told me that the cure has been ready and he sent it to me via DHL and it got to me after 3 days!i used the med as he instructed me (MORNING and EVENING) and i was cured!its really like a dream but i am so happy!thats the reason i decided to also add more comment of Him so that more can be saved just like me!and if you need his help, you can email him on nativehealthclinic@gmail.com, or whatsapp +2348140073965 I,m neme amber and you can get in touch with me via nemeamber@gmail.com..Contact him for help at Herpes virus HIV/AIDS CANCER COPD BRAIN TUMOR All kind of virus and disease

Unknown said...

NEED A LOAN?
Ask Me.

Here comes an Affordable and Legit Loan that will change your life for ever, I am Dave Logan a certified loan lender, I offer loan to individual and public sector that are in need of financial Assistance in a low interest rate of 2%. Bad credit acceptable,The Terms and Conditions are very simple and considerate.You will never regret anything in this loan transaction because i will make you smile. Email: (daveloganloanfirm@gmail.com) have you been looking for a quick and legit loan online why don't you try Dr. Dave Logan loan company and be free from debts note getting a loan from this company is 100% assured and guaranteed. for the bible says””Luke 11:10 Everyone who asks receives; he who seeks finds; and to him who knocks, the door will be opened”.so do not let these opportunity pass you by because Jesus is the same yesterday, today and forever more.


We have provided over $50 Billion in business loans to over 25,000 business owners just like you. We use our own designated risk technology to provide you with the right business loan so you can grow your business. Our services are fast and reliable, loans are approved within 48 hours of successful application. We offer loans from a minimum range of $10,000 to a maximum of $800 million.

Do you find yourself in a bit of trouble with unpaid bills and don't know which way to go or where to turn? What about finding a reputable Debt Consolidation firm that can assist you in reducing monthly installment so that you will have affordable repayment options as well as room to breathe when it comes to the end of the month and bills need to get paid? Dr. Dave Logan Loan Home is the answer. Reduce your payments to ease the strain on your monthly expenses. contact us via Call/Text: +1(501)800-0690 Email: daveloganloanfirm@gmail.com

Our services include the following;
Truck Loan
Personal Loan
Debt consolidation loan
Car Loans
Business Loan
Student Loan
Mortgage Loan
Refinancing Loan
Home Loan
Improvement loan
Construction Loan

Please if you are interested in our financial offer and delighted, do not hesitate to contact us if urgently in need of our service as they will be required to complete the following information to begin with the process of your loan therefore ultimately.

Yours Sincerely,
Dr. Dave Logan
Call/Text: +1(501)800-0690

Joy visa said...

I'm so exited to share my testimonies about the Good Work of Dr Adigba who get me cured from herpes simplex virus (HSV2) with his herbs, I never thought that I will live on earth before the year runs out. I have been suffering from herpes, I had spent a lot of money going from one Hospital to another looking for way to get rid of this disease, the hospital have been my home everyday residence. Constant checks up have been my hobby not until this faithful day, I was searching through the internet, I saw a testimony on how Dr Adigba helped someone in curing his herpes disease using his healing Herbs, quickly I copied his email just to give him a test I spoke to him, he told me that he is going to provide the herbal cure to me, which he did, after i receive his herbs and i take it as instructed i was cure permanently from herpes my herpes disease was gone. so I decided to share my testimony, that nothing is impossible with God, God use a man to healed me. No matter what you are passing through, no matter how deadly the sickness is and no matter what the situation is God that did mine is still going to do yours, people suffering from herpes, brain tumor, kidney disease, pcos, AIDS, ALS,copd, asthma, athritis,herpes, Cancer,Hpv, any kind of disease, you can rich him now via ? Gmail address: dradigba@gmail.com or whatsapp +2348077875210.......

Albert said...

I have been suffering from (HERPES SIMPLEX VIRUS) disease for the past four years and had constant pain, especially in my knees. During the first year, I had faith in God that i would be healed someday. This disease started circulating all over my body and I have been taking treatment from my doctor, few weeks ago I came on search on the internet if I could get any information concerning the prevention of this disease, on my search I saw a testimony of someone who has been healed from (Hepatitis B and Cancer) by this Man Dr VOKE and she gave the email address of this man and advise we should contact him for any sickness that he would be of help, so I wrote to Dr. VOKE telling him about my (HERPES Virus) he told me not to worry that I was going to be cured!! hmm I never believed it,, well after all the procedures and remedy given to me by this man few weeks later I started experiencing changes all over me as the Dr assured me that I have cured, after some time I went to my doctor to confirmed if I have be finally healed behold it was TRUE, So friends my advice is if you have such sickness or any other at all you can email Dr voke on doctorvoke@gmail.com
contact Dr VOKE today for your problem to be solve for you just as my problem have been solved for me also, via Email doctorvoke@gmail.com


E-mail: doctorvoke@gmail.com

Tom Grant said...

Is any one here suffering from any kind of STD or STI ? , Now this is to everyone out there with different health challenges, as I know there are still a lot of people suffering from different health issues and are therefore looking for solution. I bring you Good news. There is a man called Dr. Tokubo a herbal practitioner who helped cure me from Genital herpes, this i had suffered from for the past 2years and have spent so much money trying to survive from it. I got my healing by taking the herbal medicine he sent to me to drink for about 9days . 3days after completion of the dosage, I went for a medical checkup and I was tested Genital Herpes NEGATIVE. I'm sharing this so that other people can know of this great healer called Dr Tokubo because I got to know him through a friend he cured from HIV. I was made to understand that he can cure several other deadly diseases and infections. Don't die in ignorance and don't let that illness take your life. Contact Dr. Tokubo through: drtokubotemple@gmail.com You can also call/whatsapp him on:+2349037990322 Thank you dr tokubo. Be kind enough to share your testimonies as you received your cure.he is good too to cure all type of disease and virus.1 HIV cure
2 cancer
3 diabetes
4 hepatitis
5 herpes
6 HIV.
You can contact him if you are having any disease or infection problem...

Larry Borris said...

I'm here to testify about the great work Dr Iyoha did for me. I have been suffering from (HERPES) disease for the past 3 years and had constant pain, especially in my knees. During the first year,I had faith in God that i would be healed someday.This disease started circulating all over my body and i have been taking treatment from my doctor, few weeks ago i came across a testimony of someone on the internet testifying about a Man called Dr Iyoha on how he cured her from Herpes Simplex Virus. And she also gave the email address of this man and advise anybody to contact him for help for any kind of sickness that he would be of help, so I emailed him telling him about my (HERPES Virus) he told me not to worry that i was going to be cured!! Well i never believed it, well after all the procedures and remedy given to me by this man which i take for 3 week,few months later i started experiencing changes all over me as Dr Iyoha assured me that i will be cured,after some time i went to my doctor to confirmed if i have be finally healed behold it was TRUE, So friends my advise is if you have such sickness or any other at all you can contact Dr Iyoha via email driyohasolutiontemple@yahoo.com. You can also call his telephone number on +1 407 337 9869. Thanks once again Dr Iyoha ...

Tamara Barrow said...

The doctors said Herpes virus do not have medical cure because the virus is capable of hiding within the human cells, it remains protected from your immune system. Herpes isn’t a special virus – your immune system has the tools to fight it back. But because it is able to lay dormant in protected cells, your immune system is unable to remove it from your body,But with strong reactive herbal medication is capable of getting rid of the virus gradually and totally from your body without damaging any of your cells,natural herbs kills the virus totally not just reducing the out break. Get natural herbs cure Email DR. VOODOO at voodoospelltemple66@gmail.com Add Dr voodoo on whatsApp +2348140120719

DAVE said...

This is really a nice information on how to Buy Bulk CBC Isolate | Powder Online. Must necessary to share this blog, This comment will help to get full knowledge on other 420 Extracts Buy Bulk Delta 9 THC Distillate Jars, and will also help for the coming future THANKS.

For more infor please contact the following.....

CALL/TEXT/WHATSAPP >>>>>>>>>
+1(424) 235 3914

EMAIL >>>>>>>>> support@420labextracts.COM

john kelvin said...

i already gave up on ever getting cured of HSV2 because i have try many treatment none of them work out for me i have go to different hospital they always tell me same thing there is no cure for herpes when i came across a post about Dr Iyoha in the internet i contacted him and he reassured me with his herbal medicine which i took according to the way he instructed, that how i was cured. I doubted at first because i have been to a whole lot of reputable doctors, tried a lot of medicines but none was able to cure me. so i decided to listen to him and he commenced treatment, and under two weeks i was totally free from herpes. i want to say a very big thank you to Dr Iyoha for what he has done in my life.you can email him on dr.iyohasolutiontemple@yahoo.com or WhatsApp him now +1(857) 228-8347 or call : +1 407 337 9869 ..

Unknown said...

I'm 61 years old. I contracted HPV in 2011' I has be taking lot treatment for it and embarrassed some months ago the wart stated coming out seriously, I used lot recommendation because there was lot warts around my anus and was so . but today I'm totally happy I got the virus eliminated by using natural treatment from Dr voodoo herbal center after his treatment I got cured. all the warts went away' seriously believed Dr. voodoo he have the cure for human papillomavirus because he has eliminated hpv been in my body since 2011, Dr. voodoo make it possible for me. Here is Dr. voodoo email: voodoospelltemple66@gmail.com or WhatsApp him via +2348140120719 he is welled capable of curing terrible diseases.

«Oldest ‹Older   201 – 227 of 227   Newer› Newest»

If You Want to Make God Laugh...

 Early on in the pandemic one of my daughters exclaimed "Covid ruins everything!"  It became a running joke in our house, a bitter...