Burns and Scalds: – Do you know what to do?
Firstly, a burn is caused by dry heat such as an iron or fire. Scalds are caused by wet heat such as hot water or steam. Both however cause a great deal of pain and discomfort the range of which depends on the severity of the wound. Be aware the you can also sustain electrical and chemical burns.
In the UK burns are usually described in 3 categories.
- Superficial – Dry, redness, mild swelling, with or without blisters
- Partial – Moist, splotchy, swelling, blisters
- Full thickness – Moist, white, leathery, painless
Symptoms can include red or peeling skin, blisters, swelling, or white and charred skin. There are a few important things to remember when treating a burn:
So what do we do?
- Treat burns using cool/room temperature water NOT cold or ice – Although this might seem counter-intuitive, studies suggest that cold water and ice may cause additional tissue damage.
- When cooling a burn it is important to keep it under the running water for 20 minutes. A good way to check is by using your phone timer to keep on track; it’s longer than you think!
- ONLY remove clothing and jewellery around the affected area and ONLY if necessary. Don’t attempt to move anything that is stuck to the skin.
- Avoid using creams, plasters or ointments on a burn (that includes butter for all the old school people out there!). The best option is to loosely wrap the affected area with cling film.
Is it too obvious to say that we immediately need to get the person away from the source of the heat. Luckily for us with those minor burns our natural body’s reflex system will pull away from pain. Hot water, iron’s, ovens and dare i say hair tongs!!
With superficial burns then dowsing the area in water will take the heat out of the damaged area. There may be some blistering but the skin is not broken so cooling is the best option. With this type of burn although it may be initially painful, the pain can subside fairly quickly after the water has been applied. the
With partial burns there is more damage the outer layer of the skin is more burnt and broken resulting in blistering, swelling, more pain and a rawness of the damaged area. In this case after we have taken the heat out of the wound cover with a sterile dressing. Please be careful not to use fluffy dressing which could become embedded into the damaged area. There have been many advancements in the types of dressings available for burns, such as the aloe vera infused dressings although many others are available.
With full thickness burns the damage is more severe as the damage is likely to have penetrated multiple skin layers. Once again dowse the area in water to take the heat out of the damaged area. It is important to prevent infection due to the severity of the injury. A layer of cling film or a clean plastic bag if available can provide temporary protection against dirt or infection. If cling film is used just a layer is preferable rather than multiple layers of wrapping. Strangely enough the first 2 categories of burns tend to be the most painful whereas with a full thickness burn although more serious tends not to hurt as all the pain receipting nerve endings have been damaged. Full thickness burns will require hospital attention
A handy little tip to remember when trying to decide how serious the damage is. Firstly understand which category the burn fits. Then decide if the casualty is an adult, child or infant. As a rough guide:
Adult – if the burn area is larger than the size of a palm print
Child – if the burn area is larger than the size of a 50 pence piece
Infant – if the burn area is larger than the size of a 5p coin
Then these burns should be seen at the hospital
Chemical burns can occur when chemical products are misused. By using chemical products without knowing the hazards associated with the products or simply when you come into contact by accident. Have you heard of the term COSHH ( a proper Health & Safety term i know ) it simply stands for the Control of Substances Hazardous to Health. In plain persons language its a set of instructions which tell you what to do if you get the product on your skin, in your eyes or if you swallow it. With most domestic products the COSH instructions come either inside the packaging and on the container itself.
Some of the more common household and workplace products to be aware of that are linked to chemical burns include:
- car battery acid
- swimming pool cleaners
- toilet and drain cleaners
- oven cleaners
- metal cleaners
- concrete mix
- paint thinners
In the case of a chemical calamity the COSHH instructions are a valuable source off information as to what to do. Please be aware the water may react to the chemical which might make the situation worse.
As the heading describes an electrical burn is as a result electrical currents passing through the body. Electrical burns occurs less often but can still happen.
Some of the more common household instances where electrical burns occur is when
- Children bite on electrical cords
- Utensils or other metal objects are poked into electrical outlets or appliances, such as a plugged-in toaster
- The power supply is not shut down before making home repairs or installation
- A plugged-in appliance is dropped into water
The more dangerous considerations with electrical burns is the damage to internal organs ( possibly even heart failure ). Electrical burns can still fall into the three categories we have discussed The key is to remove the electricity, throwing a switch or circuit breaker, or unplugging the power. It is really important that you do not endanger yourself. Call for emergency medical services right away. The treatment once the casualty has been hospitalised will depend on the extent of injuries.