Degrees of burns:
First-degree burns affect the outer layer of the skin, causing pain,
redness, and swelling. Second-degree burns affect both the outer and
underlying layer of the skin, causing pain, redness, swelling, and
blistering. Third-degree burns extend into deeper tissues, causing brown
or blackened skin that may be numb.
Considerations:
Before giving first aid, consider how extensively burned the victim is and
try to determine the depth of the most serious part of the burn. Then
treat the entire burn accordingly. Knowing how the burn occurred is
helpful, since different sources cause different types of burns. If in
doubt, treat it as a severe burn.
Giving immediate first aid before professional medical help is received
may lessen the severity of the burn. prompt medical attention to serious
burns can help prevent scarring, disability, and deformity.
If the burn does not heal normally, get medical advice. For extensive but
superficial burns, keep dressings clean and dry and change them as needed.
If signs of infection develop get medical help immediately. Signs of
infection include increased pain, redness, swelling, drainage from the
burn, swollen lymph nodes, or red streaks spreading from the burn toward
the heart. Make sure the victim is up-to-date on tetanus immunization.
Victims under age 4 or over age 60 have a higher incidence of
complications and, consequently, a higher death rate.
Burns on the face, hands, feet, and genitalia are most serious, because of
possible loss of function.
Causes:
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Thermal burns, the most common type, are frequently the result of
residential fires, automobile accidents, playing with matches,
improperly stored gasoline, space heaters, electrical malfunctions, or
arson.
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Burns can be caused by dry heat (like fire), wet heat (such as steam
or hot liquids), radiation, friction, heated objects, the sun,
electricity, or chemicals.
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Airway burns can be caused by inhaling smoke, steam, superheated air,
or toxic fumes, often in a poorly ventilated space.
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Other causes include improper handling of firecrackers, scalding
accidents, and kitchen accidents (such a child climbing on top of a
stove or grabbing a hot iron).
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Burns in children are sometimes traced to parental abuse.
Symptoms:
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blisters
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pain (the degree of pain is not related to the severity of the burn;
the most serious burns can be painless.)
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peeling skin
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red skin
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shock (watch for pale and clammy skin, weakness, bluish lips and
fingernails, and decreasing alertness.)
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swelling
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white or charred skin
Symptoms of an airway burn:
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charred mouth; burned lips
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burns on the head, face or neck
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difficulty breathing; coughing
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singed nose hairs or eyebrows
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dark, carbon-stained mucus
Do Not:
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DO NOT apply ointment, butter, ice, medications, fluffy cotton
dressing, adhesive bandages, cream, oil spray, or any household remedy
to a burn. This can interfere with proper healing.
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DO NOT allow the burn to become contaminated. Avoid breathing or
coughing on the burn.
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DO NOT disturb blistered or dead skin.
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DO NOT give the victim anything by mouth, if there is a severe burn.
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DO NOT apply cold compresses and do not immerse a severe burn in cold
water. This can cause shock.
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DO NOT place a pillow under the victim's head if there is an airway
burn and he or she is lying down. This can close the airway.
Call If:
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the burn is extensive or severe.
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there is a chemical or electrical burn, or if there is uncertainty
about the burn's severity.
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the victim shows signs of shock.
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the victim has an airway burn.
First Aid:
FOR MINOR BURNS:
1. If the skin is unbroken, run cool water over the area of the burn or
soak it in a cool water (not ice water) bath. Keep the area submerged for
at least 5 minutes. However, if the burn occurred in a cold environment,
do not apply water. A clean, cold, wet towel will also help reduce pain.
2. Calm and reassure the victim. Burns can be extremely painful.
3. After flushing or soaking for several minutes, cover the burn with a
sterile bandage (if available) or clean cloth.
4. Protect the burn from pressure and friction.
5. Over-the-counter pain medications may be used to help relieve the pain;
they may also help reduce inflammation and swelling.
6. Minor burns will usually heal without further treatment. However, if a
second-degree burn covers an area more than 2 to 3 inches in diameter, or
if it occurred on the hands, feet, face, groin, buttocks, or a major
joint, then treat the burn as a major burn (see below).
FOR MAJOR BURNS:
1. If someone is on fire, either douse him or her with water if it is
available, wrap the victim in thick, non-synthetic material such as a wool
or cotton coat, rug, or blanket to smother the flames, or lay the victim
flat and roll him or her on the ground. If your clothes catch fire, STOP,
DROP, and ROLL.
2. Do not remove burnt clothing (unless it comes off easily), but do
ensure that the victim is not still in contact with smoldering materials.
3. Make sure the burn victim is breathing; if breathing has stopped or if
the victim's airway is blocked then open the airway and if necessary,
begin rescue breathing and CPR.
4. If breathing is not a problem, cover the area of the burn with a cool,
moist sterile bandage (if available) of clean cloth (do no use a blanket
or towel; a sheet will do if the burned area is large). Do not apply any
ointments. Avoid breaking burn blisters.
5. If fingers or toes have been burned, separate them with dry, sterile,
non-adhesive dressings.
6. Elevate the burned area and protect it from pressure and friction.
7. Take steps to prevent shock. Lay the victim flat, elevate the feet
about 12 inches, and cover the victim with a coat or blanket. Do not place
the victim in the shock position if a head, neck, back, or leg injury is
suspected or if it makes the victim uncomfortable.
8. Continue to monitor the victim's vital signs (pulse, rate of breathing,
blood pressure)
until medical help arrives.
Prevention:
In the U.S., about 2 million people suffer burns each year. Of these,
300,000 are burned seriously and over 6,000 are fatalities, making burns
this nation's third largest cause of accidental death.
To help prevent injuries from burns:
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Install smoke alarms in your home.
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Take time to teach children about the proper fire safety precautions,
fire escapes, and the hazards of matches and fireworks.
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Know and practice fire escape routes.
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