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BURN MANAGEMENT  BURN MANAGEMENT BURNS

The skin not only gives us our appearance and shape, 

it also serves other important functions such as protection from:

  • thermic impact (i.e. heat, cold)

  • chemical impact (i.e. acids)

  • microorganisms (bacteria, viruses, fungi)

  • UV-radiation

  • water loss

  • mechanical impact (i.e. pressure, stroke)

A burn is damage to the skin and other body tissues caused by contact with either dry heat or wet heat

 

         Dry Burns may be caused by:

Wet Burns may be caused by:

  • Fire  

  • Flames 

  • Hot metal

  • Electricity  

  • Chemicals  

  • Friction/radiation

  • Boiling water

  • Steam

  • Hot oil

To distinguish a minor burn from a serious burn, the first step is to determine the degree and the extent of damage to body tissues. The three classifications of first-degree burn, second-degree burn and third-degree burn will help you determine emergency care:

Types of burns

DRY

FLAME, HOT OBJECT, FRICTION

SCALDS 

STEAM, HOT LIQUIDS

COLD 

SUB-ZERO SUBSTANCES

CHEMICAL

ACIDS & ALKALIS

ELECTRICAL

ELECTRICAL CURRENT & LIGHTNING

RADIATION 

SUN’S RAYS & REFLECTED LIGHT

First-degree burn - superficial burn

The least serious burns are those in which only the outer layer of skin (epidermis) is burned. The skin is usually red, with swelling and pain sometimes present. The outer layer of skin hasn't been burned through. Treat a first-degree burn as a minor burn unless it involves substantial portions of the hands, feet, face, groin or buttocks, or a major joint.

Second-degree burn - partial thickness

When the first layer of skin has been burned through and the second layer of skin (dermis) also is burned,
the injury is termed a second-degree burn. Blisters develop and the skin takes on an intensely reddened, splotchy appearance. Second-degree burns produce severe pain and swelling.

If the second-degree burn is no larger than 8 cms in diameter, treat it as a minor burn. If the burned area is larger or if the burn is on the hands, feet, face, groin or buttocks, or over a major joint, get medical help immediately.

Management

For minor burns, including second-degree burns limited to an area no larger than 8 cms in diameter, take the following action:

Cool the burn. Hold the burned area under cold running water for up to 20 minutes, or until the pain subsides. If this is impractical, immerse the burn in cold water or cool it with cold compresses. Cooling the burn reduces swelling by conducting heat away from the skin. Don't put ice on the burn.

Cover the burn with a sterile gauze bandage. Don't use fluffy cotton, which may irritate the skin. Wrap the gauze loosely to avoid putting pressure on burned skin. Bandaging keeps air off the burned skin, reduces pain and protects blistered skin. Plastic food wrap is an ideal film to cover the injury.

Remove clothing if cool water is not available. Do not remove clothes that are stuck to the skin.

Minor burns usually heal without further treatment. They may heal with pigment changes, meaning the healed area may be a different color from the surrounding skin. Watch for signs of infection, such as increased pain, redness, fever, swelling or oozing. If infection develops, seek medical help. Avoid re-injuring or tanning if the burns are less than a year old — doing so may cause more extensive pigmentation changes. Use sunscreen on the area for at least a year.

Caution

  • Don't use ice. Putting ice directly on a burn can cause frostbite, further damaging your skin.

  • Don't break blisters. Broken blisters are vulnerable to infection.

  • Do not apply ointments or creams.

  • Do not peel off adhered clothing

Third-degree burn - full thickness burn

The most serious burns are painless and involve all layers of the skin. Fat, muscle and even bone may be affected. Areas may be charred black or appear dry and white. Difficulty inhaling and exhaling, carbon monoxide poisoning or other toxic effects may occur if smoke inhalation accompanies the burn.

For major burns, dial 0-0-0 or call for emergency medical assistance. Until an emergency unit arrives, follow these steps:

  1. Don't remove burnt clothing. However, do make sure the victim is no longer in contact with smoldering materials or exposed to smoke or heat.

  2. Don't immerse severe large burns in cold water. Doing so could cause shock.

  3. Check for signs of circulation (breathing, coughing or movement). If there is no breathing or other sign of circulation, begin cardiopulmonary resuscitation (CPR).

  4. Cover the area of the burn. Use a cool, moist, sterile bandage; clean, moist cloth, moist towels or plastic food wrap.

Electrical burns

An electrical burn may appear minor or not show on the skin at all, but the damage can extend deep into the tissues beneath your skin. If a strong electrical current passes through your body, internal damage, such as a heart rhythm disturbance or cardiac arrest, can occur. Sometimes the jolt associated with the electrical burn can cause you to be thrown or to fall, resulting in fractures or other associated injuries.

Dial 0-0-0 or call for emergency medical assistance if the person who has been burned is in pain, is confused, or is experiencing changes in his or her breathing, heartbeat or consciousness.

While helping someone with an electrical burn and waiting for medical help, follow these steps:

  1. Look first. Don't touch. The person may still be in contact with the electrical source. Touching the person may pass the current through you.

  2. Turn off the source of electricity if possible. If not, move the source away from both you and the injured person using a nonconducting object made of cardboard, plastic or wood.

  3. Check for signs of circulation (breathing, coughing or movement). If absent, begin cardiopulmonary resuscitation (CPR) immediately.

  4. Prevent shock. Lay the person down with the head slightly lower than the trunk and the legs elevated.

  5. Cover the affected areas. If the person is breathing, cover any burned areas with a sterile gauze bandage, if available, or a clean cloth. Don't use a blanket or towel. Loose fibres can stick to the burns.

Chemical burns

If a chemical burns the skin, follow these steps:

  1. Remove the cause of the burn by flushing the chemicals off the skin surface with cool, running water for 15 minutes or more. If the burning chemical is a powder-like substance such as lime, brush it off the skin before flushing.

  2. Remove clothing or jewellery that has been contaminated by the chemical.

  3. Wrap the burned area loosely with a dry, sterile dressing or a clean cloth.

Minor chemical burns usually heal without further treatment.

Seek emergency medical assistance if:

  • The victim has signs of shock, such as fainting, pale complexion or breathing in a notably shallow manner.

  • The chemical burn penetrated through the first layer of skin, and the resulting second-degree burn covers an area more than 2 to 3 inches in diameter.

  • The chemical burn occurred on the eye, hands, feet, face, groin or buttocks, or over a major joint.

If you're unsure whether a substance is toxic, call the poison control centre at 131126. If you seek emergency assistance, bring the chemical container or a complete description of the substance with you for identification.