Burns and Scalds
Burns are injuries that result from dry heat like fire/flames, pieces of hot metal, contact with live wires, etc. Scalds are caused by moist heat due to boiling water, steam, oil, tar etc.
Chemical Burns are caused by strong acids like Sulphuric or Nitric Acid or by strong alkalies like Caustic Soda.
Nuclear Burns are caused by the instantaneous flash of intense heat given off by a nuclear explosion. It causes burns on the skins of people several miles away.
Degrees of Burn
The degree of burns indicates the degree of damage to the tissues. There are three degrees of burns. They are:
First Degree Burns: The skin is reddened.
Second Degree Burns: There are blisters on the skin.
Third Degree Burns: There is destruction of deeper tissues with scarring.
The danger from burns depends more on the extent of the burns than on the degree. Superficial burns over a large area are more dangerous than complete charring of a part of a limb. On any one person, different parts of the body may show varying degree of burns.
To calculate the extent of burns the "Rule of Nines" is used. The figure below explains the "Rule of Nines".
Why are burns Dangerous?
Burns are dangerous because:
They can very quickly lead to shock in the immediate period following the burn due to loss of excessive fluids from the body.
They produce intense pain.
They lead to infection in the affected area.
When they heal they leave scars behind, which
are disfiguring and can restrict movements.
Management of Extensive Burns
Keep the patient quiet and reassure him.
Wrap him up in a clean cloth.
Do not remove adhering particles of charred clothing.
Cover the burnt area with a sterile or clean dressing and bandage. In the case of burns that cover a large part of the body it is sufficient to cover the area with a clean sheet or towel.
Keep the patient warm but do not over heat.
If the hands are involved, keep them above the level of the victim's heart.
Keep burnt feet or legs elevated.
If the victim's face is burnt, sit or prop him up and keep him under continuous observation for breathing difficulty. If respiratory problems develop, an open airway should be maintained.
Do not immerse the extensively burnt area or apply ice water over it because cold may intensify the shock reaction. However a cold pack may be applied to the face or hands or feet.
Do not open the blisters on the victim's skin.
Treat for shock.
Remove quickly from the body anything of constricting nature like rings, bangles, belt and boots. If this is not done early, it may be difficult later on as the limbs begin to swell.
If medical help or trained personnel cannot reach the scene for an hour or more and the victim is conscious and not vomiting, give him a weak solution of salt and soda (one level teaspoonful of salt and half a level teaspoonful of baking soda to each quart of water, neither hot nor cold) at home and enroute to the hospital. Allow him to sip slowly.
Give about four to five ounces to an adult over
a period of 15 minutes, two ounces to a child between one and twelve
years of age and one ounce to an infant below one year. Discontinue the
fluid if vomiting occurs. Do not apply ointments, grease or any other
material over the wound.
Management of Minor Burns and Scalds
- Clean the area gently with clean water.
- Submerge the burnt area in cold water.
Do not apply cotton wool directly over the burnt area.
- Do not apply any greasy substance.
- Give the patient warm drinks.
Management of Chemical Burns
Wash off the chemical with a large quantity of water by using a shower or hose if available as quickly as possible. This flooding with water will wash away much of the irritants.
- Cut out contaminated clothing.
- Do not touch the burnt area.
- Treat as for burns.