Index
This topic covers the identification and management of burns and scalds.
Different types of object will make different types of burn and scalds.
Excessive heat burns are caused by such things as matches or hot drinks. A rope or slippery slide causes a friction burn. A chemical burn is caused by such things as acid or paint stripper. An electrical burn is caused by things like lightning or power points and radiation burns can be caused by the sun or ray lamps.
Radiation is caused by indirect heat from the sun or sun lamps etcetera.
Excessive heat burns occur when fire, steam, hot objects or liquids come into direct contact with the body.
Friction is caused when heat is generated through the rubbing of skin on materials such as rope and carpet
Many common chemicals in the home cause burns, for example: pool acid, caustic soda.
Electrical energy from the mains or lightening can produce very serious burns.
Intense heat or prolonged contact in any of the types of burns listed can create very serious life threatening injuries.
Superficial: Superficial burns involve only the top layer of the skin and may be caused by
sunburn, scalds of 45o-50oC, minor flash burns or friction (as with rope burns). The area is red, painful and tender to the touch. Sometimes there are blisters. It will usually heal within 5-10 days without leaving a scar.
Partial Thickness: Superficial partial thickness burns extend into the lower layers of skin. They are commonly caused by flash injury, scalds of 50o-70oC, or brief exposure to flame.
The area is red or mottled red and white, blistered with a lot of tissue fluid present, and very painful. It heals within 10-21 days, usually with minimal scarring.
Deep Partial Thickness: Deep partial thickness burns involve most of the lower layers of skin. They are caused by scalds of longer duration or temperature greater than 70oC, flashes of higher intensity and exposure to flame. The area is dark red or pale yellow, and the surface layer of skin is burned away leaving a moist surface with reduced sensitivity. They take 3-6 weeks to heal and may require skin grafts.
Full Thickness: Full thickness burns extend right through the lower layers of skin and into the fat layer. They are caused by flames, contact with hot metal, immersion scalds, strong chemicals or electricity. The area is pearly white or charred, feels dry and leathery and is pain free (due to destruction of nerve endings). These burns can only be healed from the edge or by skin grafting.
Critical: Critical burns extend into the fat, muscle and bone.
All electrical burns, most chemical burns, burns that interfere with breathing, burns to young people and people over 50 years old and burns to the face, feet, genitals, neck, knees and elbows are classified as critical. They require extensive plastic surgery.
Management
No matter what level a burn may be, your first task as a first aider is to remove the heat.
This means not only eliminating the cause of the burn but also cooling the burn itself.
The best method of removing heat from a burn is to gently run cold water over the burnt area.
Most burns, cool for 10 minutes
Chemical burns: 20 minutes
Bitumen burns: 30 minutes
Some First Aid Kits contain special burns dressings, but if you do not have one of these, you should cover the burn with a normal, non-stick dressing.
If a First Aid Kit is not available, you could place a moist cloth over the burn.
If the casualty is still in pain, you can pour more water over the dressing.
The casualty may drink frequent small amounts of water, if they are conscious and thirsty.
DO NOT:
· Put butter or other fats on burns
· Apply lotions, ointments or oily dressings
· Prick or break blisters
· Give Alcohol
· Overcool casualty
· Use towels, cotton wool, blankets or adhesive dressings directly on burn
· Remove clothing stuck to burnt area
Seek medical aid if:
· Burn is deep, even if casualty does not feel any pain
· A burn is bigger than a 20c piece
· Burn involves airway, hands, face or genitals
· You are unsure of severity of burn
· It is an electrical burn
· Casualty is a baby
If a casualty’s clothes are on fire:
· STOP casualty running around
· DROP casualty to the ground and wrap in a blanket, coat or rug
· ROLL casualty along the ground until flames are smothered
An electrical burn may be more serious than it appears:
· Check for danger for yourself and bystanders
· Switch off power if possible
· Remove casualty from electrical supply without directly touching the casualty e.g. Using a dry wooden broom handle
· Follow DRABCD
· Wash and cool burnt area under running water
· Apply a non-adherent dressing
· Call 000 for an ambulance
Summary
Burns can come from a wide variety of sources but they can do irreparable damage to the human body.
Apart from small superficial burns and sunburn, you should always seek medical aid for burns.
You must remove the heat from the area of the burn. The best method is to allow cold water to gently run across the area for at least:
· 10 minutes - excessive heat, friction, electrical and radiation burns.
· 20 minutes - chemical burns.
· 30 minutes - bitumen burns.
For further information on burns and scalds, see Australian First Aid Chapter 12.
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