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Aug 11, 2019 Dr Zulfikar Bux, Features / Columnists
The vast majority of burns and scalds are caused by accidents. However, occasionally burns and scalds can be caused deliberately, especially in children and vulnerable adults. Whatever the reason, knowing how to treat it initially and the steps after that are vital in preventing complications and even death.
Today we will expand on what you should and should not do if you or someone you know gets burnt.
WHAT ARE THE TYPES OF BURNS?
Burns are classified according to how severe they are. Below is a simple way to classify it:
• Superficial burns affect the top layer of skin only. The skin looks red and is mildly painful. The top layer of skin may peel a day or so after the burn but the underlying skin is healthy. It does not usually blister or scar. A good example is mild sunburn.
• Partial-thickness burns cause deeper damage. The skin forms blisters and is painful. However, some of the deeper layer of skin (the dermis) is unharmed. This means the skin usually heals well, sometimes without scarring if the burn is not too extensive.
• Full-thickness burns damage all layers of skin. The skin is white or charred black. There may be little or no pain, as the nerve endings are destroyed. These often require skin grafting.
• Electrical burns can cause damage inside the body even if there is little damage to the skin.
What you should do if you or someone gets burnt:
Always remember that safety first should be priority number one. The following are helpful steps if you or someone gets burnt:
• Stop the burning process and remove any sources of heat.
• Put out the flames with water or smother with a blanket. If the victim’s clothing is burning, roll the victim on the ground to smother the flames.
• Remove clothes that are over the burn. Clothing can retain heat and so should be removed as soon as possible. However, do not pull off clothing that has stuck to the skin. This may cause skin damage. You should also remove rings, bracelets, watches etc. These can start to squeeze the skin after burns and make things worse.
• Burns caused by tar should be cooled with water but do not remove the tar itself.
• For electrical burns – disconnect the victim from the source of electricity before attempting first aid. If the person has been injured by a low-voltage source (220-240 volts, domestic electricity supply) then remove the person from the electrical source, using a non-conductive material such as a wooden stick or wooden chair. Do not approach a person connected to a high-voltage source if you cannot turn it off.
• For chemical burns – remove the victim’s affected clothing. Brush the chemical off the skin if it is in a dry form. Then wash the burn with lots and lots of water.
Treat the burnt area immediately with cool water
Preferably, use running water, for at least 20 minutes. For example, put the burnt area under a running cold tap. A shower or bath is useful for larger areas. Do not use very cold water, ice or any objects from a freezer – this can damage the skin. Ensure the person is otherwise kept warm to avoid hypothermia (getting too cold). Chemical burns should be washed with lots of water and for longer than 20 minutes.
Cover the burn
It is important to cover the burnt area to prevent direct exposure to the air. Using a sterile (free of germs) covering is ideal. Most often, a clean plastic can be used. When the patient reaches the hospital, nurses will often use specialized medical dressings to cover the burn.
Give painkillers
Panadol or ibuprofen may help to ease pain for small burns. A doctor may give stronger painkillers, if required. Ensure the patient is not allergic to the painkillers that you may be giving them.
What you shouldn’t do:
Avoid the following when treating burns:
• Prick any blisters. It is better to leave them intact until medically assessed, to lessen the risk of infection.
• Apply creams, ointments, oils, grease, etc.-the exception is for mild sunburn. A moisturizer cream may help to soothe this.
• Put on an adhesive, sticky or fluffy dressing.
WHEN SHOULD YOU SEEK MEDICAL HELP?
See a doctor if you are unsure about what to do after a burn. However, you may be able to manage small, mild/ superficial burns at home. Mild sunburn, small mild burns, or mild scalds are best left uncovered. They will heal more quickly if left to the fresh air. Even a small blister is best left uncovered to heal.
You should go to a doctor right away for:
• An electrical burn
• Full-thickness burns – even small ones. These burns cause white or charred skin.
• Partial-thickness burns on the face, hands, arms, feet, legs or genitals. These are burns that cause blisters.
• Any burn that is larger than the size of the hand of the person affected.
• If you suspect breathing in smoke or fumes (smoke inhalation) has occurred. The effects on the lungs from smoke inhalation may be delayed by a few hours so a person may appear well at first. Symptoms such as sore throat, cough, wheeze, burnt nasal hair, facial burns or breathlessness may suggest there may have been smoke inhalation.
• The burn becomes infected. Infection causes a spreading redness from the burn, which becomes more painful.
• You are not up to date with tetanus immunization.
• Blisters occur. You may be happy to deal with a small burn with a small blister. However, a blister means a partial-thickness burn and it may be best to see a doctor.
Doing the correct things upfront may prevent unnecessary complications or better yet, be able to save a life.
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