Burns and Scalds

Burns and scalds, a type of burn caused by wet heat, are potentially fatal injuries. They can cause life-threatening shock through serious fluid loss and, if around the face and neck, can restrict breathing.

WHAT ARE THE RISK FROM BURNS? In burns, fluid is lost in three main ways:

• Blistering
• Swelling around the injury
• Directly from the injury

While the fluid loss may not be visible as liquid lying around the victim it is nevertheless lost from the blood as a straw-colored substance known as plasma. Severe burns therefore can and often do prove to be fatal.

     The second risk from burns is infection. The damaged tissue provides little or no resistance to infection and serious problems may arise some time after the initial injury. The risk of infection increases with the size and depth of the burn, and the victim will probably suffer from shock as well.

CAUSES OF BURNS

Dry heat. This is the most common type of burn and include burns caused by hot objects such as exhaust or by cigarettes or lighters.

Wet heat. Also know as a scald, wet heat usually refers to hot water or steam but it can also include other hot liquids such as oil or fat.

Friction.  When two objects rub together very quickly friction generates heat, causing another kind of dry burn.

Chemical burns. Industrial and household chemicals can cause serious burns.

Electrical burns. These can be caused by the everyday low-voltage currents found in switches, wires, and appliances around the home or from the high-voltage cables scattered around the countryside in the form of power lines, subway tracks, and so forth. In rarer cases electrical burns can be caused by lightning strikes.

Radiation burns. While this may sound dramatic, most of us have suffered some degree of radiation burn at some point in our lives-- more commonly known as sunburn.

DEPTH OF THE BURN

First degree burns involve only the outer layer of skin and, although often extremely painful, are generally not life-threatening unless a very large surface area of the body is covered. The burned area is very sore and is usually red and possibly a little swollen. If good first aid treatment is applied and the area burned is not extensive, then further medical treatment is unlikely to be needed.

Second degree burns include the top layers of skin and involve blistering. They are characterized by red, raw-looking skin, blisters that weep clear fluid, and pain. The risk of shock is high with second degree burns and any burn of this type needs medical attention. Second degree burns covering a substantial percentage of the body can kill.

Third degree burns involve damage to all the layers of skin, usually including the nerve endings and other underlying tissues and organs. Characterized by charred tissue often surrounded by white  waxy areas of dead skin with damaged nerves, third degree burns will always need emergency medical attention and in the long term will often require plastic surgery.

AREA OF THE BODY BURNED. Generally, the larger the area of the body burned, the more serious the burn. Any burn to the face or neck need urgent  medical attention. As a general principle, if the victim has other injuries, appears to be in great deal of pain, is showing signs and symptoms of shock, is having difficulty breathing, or you have other reasons to suspect that his or her condition is more serious, then call an ambulance whatever the extent or depth of the burn.

HOW DO YOU TELL HOW SEVERE A BURN IS?

Many burns are minor and can be safely treated at home  or with help from a local doctor or pharmacist.

     However, the size and depth of the burn will tell you if it needs urgent medical treatment.

TREATING OTHER TYPES OF BURNS

The general principle of treating burns remains to cool and cover the affected area but some types of burn need extra consideration. With burns to the neck and mouth, beyond the risk of shock and infection, the greatest potential problem is the risk of airway obstruction due to swelling. The obvious additional danger with electrical burns is the combination of water as a treatment and electricity as the cause.

TREATING BURNS TO THE NECK AND MOUTH

1. Check the victim's airway and breathing and be prepared to resuscitate if necessary.
2. Call an ambulance and reassure the victim until help arrives.
3. Get the victim into a position where his breathing is comfortable (this will usually be sitting up).
4. Loosen any constriction around the neck to ease breathing. Keep the airway clear.
5. Cool any burns continuously-- do not attempt to cover.
6. Maintain a check on the victim's airway and breathing.

LIGHTNING

Although rare, lightning strikes do happen and can kill. If caught outside in a thunderstorm, seek shelter in a car or building .

If there is no shelter, make yourself as low as possible, minimize your contact with the ground by crouching and avoid single trees, bodies of water, and tall objects.

If a person has been struck by lightning, check their airway and breathing, be prepared to resuscitate, treat any burns, and call for help.

ELECTRICAL BURNS. If a victim has suffered from an electrical shock, do not attempt to touch the person unless you are absolute certain that he or she is no longer contact with live equipment. If the person is still attached to an electrical current, your best option is to turn the electricity off at the main breaker. If you cannot access the breaker, you may be able to turn off electrical equipment at the wall socket but particularly careful that you do not touch the victim or any live equipment.

     If there is no way to turn the electricity off, you can attempt to move the victim away from the point of contact using a non-conducting material such as a broom handle, be possible by wearing rubber gloves and shoes, and by standing on a telephone directory.

Electricity demands respect-- if in doubt, call in professional help. Do not put yourself in any danger.

TREATING ELECTRICAL BURNS

A victim suffering from an electrical burn may well have respiratory or circulatory difficulties. An electrical discharge across the heart can make the heart stop beating, so be prepared to resuscitate the victim over and above the treatment of any burn that may be present.

1. Make absolutely sure that there is no further risk from the electricity.
2. Check to see whether the victim is conscious. If unconscious, check airway and breathing and take action as appropriate.
3. Treat any burns with cold water if safe to do so.
4. Cover burns as appropriate with sterile, non-fluffy dressings.
5. Seek urgent medical attention. Stay with the victim and reassure him until medical help arrives.

HIGH-VOLTAGE ELECTRICITY

High voltage electricity (power lines, subway tracks, overhead power cables, etc.) usually kills immediately, causing severe burns, heart problems, and potentially even broken bones and internal injuries as the victim is thrown by the shock.

If somebody has been hit, your first priority is to keep yourself and other bystanders safe. High-voltage currents can jump some distance so keep people back at least 60 feet and call for professional help via 911.

HOW TO TREAT BURNS AND SCALDS

The general treatment of all burns is very simple : cool and cover the affected part, and seek appropriate medical help. Before you do anything else, make sure that you protect yourself. This is particularly important at accident scenes. Ensure that the fire is out, any electrical equipment is safely disconnected, and that any chemical spills are not going to affect you.

TREATMENT

1. Monitor the victim's airway and breathing. This is particularly important if the victim has burns to the mouth and airway. Be prepared to resuscitate if necessary.
2. If possible lay the victim on the ground to help reduce the effects of shock.
3. Douse the burned area with cool liquid. Cooling the burn will reduce the pain, swelling, and risk of scarring. Restrict the cool liquid to the injured part wherever possible because over cooling could lead to hypothermia, particularly if the surrounding air temperature is low. If applying water from a shower, hose, or tap, ensure that the pressure is minimal because water hitting burned skin at speed will add to the pain and the damage.
4. Make an assessment about whether or not an ambulance is needed and call for help. If in doubt, call 911.
5. Keep cooling the injured part until the pain stops. Often 10 minutes is sufficient but if the victim still complains of pain after this time then continue with the cooling treatment.
6. Remove rings, watches, and other potential constricting items such as burns swell up. Take care to return these items to the casualty.
7. Once the pain has eased, cover the wound to prevent infection. These should be done with a sterile bandage if possible, tied very loosely over the burn. If in any doubt as to whether material may stick to the wound, do not attempt to cover but continue to cool the burns continuously until medical help arrives. If you are having to improvise, any clean, non-fluffy material can be used-- ideal examples are clean handkerchiefs, cotton pillowcases, or plastic wrap.
8. If possible, raise the injured part as this can help to reduce swelling.

Stay with the injured person until help arrives or, if the burn is less serious, accompany her to further medical attention.

• Continue to treat for shock
• Maintain a check on the victim's airway, breathing, and circulation
• Keep checking bandages to ensure that they are not too tight.

WARNING!

• Do not over-cool the victim.
• Do not apply water under pressure.
• Do not remove burned clothing if it is sticking to the wound.
• Do not put cotton wool or any other fluffy material on to a burn as it will stick to the injury.
• Do not put any creams or ointments on to a burn because these will need to be removed at the hospital.
• Do not burst blisters because this may increase the risk of infection.

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Frederick Luneta is a 24-year old guy and he is a Computer Engineering student and a young part time blogger. Currently lives in the Philippines. He knows a lot about computer.