A burn is an injury to the skin or other organic tissue primarily caused by heat or due to radiation, radioactivity, electricity, friction or contact with chemicals. A fire burns can caused due to excessive fire at workplace or industries.
The first step in treating a burn injury is determining whether it is a minor or major one. That determination will direct action and treatment.
Categories of Burns
First-degree or superficial, second-degree, or partial thickness burns and third-degree or full thickness burns. How these types of burns are treated initially will determine whether there is a successful outcome.
- First Degree Burn: (The epidermis – the outer layer of skin)
- Second Degree Burn: (The dermis – the layer of tissue just beneath, which contains blood capillaries, nerve endings, sweat glands and hair follicles)
- Third Degree Burn: (The subcutaneous fat, or sub cutis – the deeper layer of fat and tissue)
First-degree burns affect only the outer layer of skin, the epidermis. Long-term tissue damage is rare and often consists of an increase or decrease in the skin color. The skin is usually still intact, but may appear to be red, very warm or hot to touch and painful. There may also be small blisters, and swelling in and around the area of injury. Initial first-aid treatment for a first-degree include the following:
- Stop the burning process: cool the burn with running cool (not cold) water for at least 5 minutes. But do not use ice, as this may cause further skin damage. Do not over cool! If the victim starts to shiver, stop the cooling process.
- Remove all jewelry, watches, rings and clothing around the burned area as soon as possible.
- Administer an over-the-counter pain reliever such as ibuprofen or acetaminophen for pain control.
- Follow the directions on the label. Consult a physician or health care provider if pain is not relieved.
- Cover the burn with a sterile gauge bandage or clean cloth. Wrap the burned area loosely to avoid putting too much pressure on the burn tissue.
- Minor burns will usually heal without further treatment. For small area burns, apply soothing lotions that contains Aloe-Vera to the burned area to help relieve the pain and discomfort.
- Seek medical attention if there is a persistent fever not relieved by medication or redness that may extend beyond the border of the burn or pain is not controlled by ibuprofen or acetaminophen.
- Drink plenty of fluids (electrolyte containing solutions such as gator aid) if the person appears to be dehydrated.
- Do not apply ice – this may cause further damage to the skin.
- Do not use any butter, ointments or other home remedies on the burn. Such substances may trap the heat in the tissue and makes the burn worse.
- Do not break any blisters…leave intact.
- Do not delay seeing medical attention if the burn is larger than the size of the victim’s palm.
- Don’t contaminate the burn with potential germs by breathing or coughing on it.
- Don’t give the burned person anything to ingest.
- Don’t put a pillow under their head if you think they have an airway burn.
It occurs when the second layer of skin (dermis) is burned. This is usually has the following characteristics: very red, blister formation, extremely painful and a fair amount of swelling. Some blisters pop open, giving the burn a wet or weeping appearance. Over time, thick, soft, scab-like tissue called fibrinous exudate may develop over the wound.
In general, if a second degree burn is smaller than 2-3 inches (7 centimeters) it may be treated as a minor burn. If the area burned is larger than this, or involves functional parts of the body such as feet, face, eye, ears, and groin or located over major joints, more in-depth medical attention is needed. Take the person to the nearest emergency room, family doctor or minor emergency clinic to have the burn evaluated. Failure to do so may result in permanent disfigurement or loss of function.
Some second-degree burns take longer than three weeks to heal, but most heal within two to three weeks without scarring, but often with pigment changes to the skin. In some severe cases, skin grafting is required to fix the damage. Skin grafting takes healthy skin from another area of the body and moves it to the site of the burned skin.
As with first-degree burns, avoid cotton balls and questionable home remedies. Treatments for a mild second-degree burn generally include:
- running the skin under cool water for 15 minutes or longer
- taking over-the-counter pain medication (acetaminophen or ibuprofen)
- applying antibiotic cream to blisters
These are not minor burns and should be evaluated and treated by a healthcare provider. A third-degree burn is a very serious burn, no matter what the size or area of the body that may be involved. A third-degree burn involves all layers of the skin and can cause permanent tissue damage. The skin may appear to be charred, blackened, or white. The skin texture may be very dry or leathery. All third-degree burns should be evaluated by a healthcare provider immediately.
First Aid Measures
Contact the Red Crescent immediately and take the following measures until they arrive:
- Check the patient’s vital signs like breathing.
- Protect the burned person from further harm by keeping them away from flammable substances, smoke or sources of heat.
- Elevate the burned area above the patient’s heart level, if possible.
- Cover the burn using a damp sterile bandage or a cool clean cloth.
- Don’t remove burned clothing stuck to the skin.
- Don’t place larger burned areas of the body in cold water as this may cause shock (sudden drop in body temperature).
- Don’t cover the burn with adhesive bandage.
- Don’t apply any ointments or use butter or toothpaste or any other burn remedies.
- Don’t place thin cotton on the burned area as it could irritate the skin.
It may take several days for a mild first-degree or second-degree burn to heal. During that time, it is important that the affected area is observed for infection, such as redness extending beyond the burned area, changes in the appearance of the wound or slight fever not relieved by Tylenol. As your skin begins to heal, you may also notice that it will itch, which can be very uncomfortable at times. This is normal and will eventually decrease. Frequent application of lotion can help keep the skin hydrated and minimize the itching process. If the itching is too severe, an over-the-counter medication such as Benadryl® may be helpful in easing the discomfort.
Remember…always follow the directions on the label. The wound should be kept clean with daily dressing changes. If you have any concern or questions, consult your healthcare provider. Once the burn has healed, limit the exposure of the burn skin to direct sunlight. Always wear sun protection.
Burns are preventable. High-income countries have made considerable progress in lowering rates of burn deaths, through a combination of prevention strategies and improvements in the care of people affected by burns. Most of these advances in prevention and care have been incompletely applied in low- and middle-income countries. Increased efforts to do so would likely lead to significant reductions in rates of burn-related death and disability.
Prevention strategies should address the hazards for specific burn injuries, education for vulnerable populations and training of communities in first aid. An effective burn prevention plan should be multisector and include broad efforts to:
- Improve awareness
- Develop and enforce effective policy
- Describe burden and identify risk factors
- Set research priorities with promotion of promising interventions
- Provide burn prevention programme
- Strengthen burn care
- Strengthen capacities to carry out all of the above.