Burns are among the most common household injuries, especially in environments where cooking and heating involve open flames or hot surfaces. According to the Australian Institute of Health and Welfare, there were 5500 hospitalisations in 2022 due to burns.
Knowing how to provide immediate and effective first aid for burns is crucial because the first few minutes after a burn can significantly influence the severity of the injury and the speed of healing. Prompt and correct first aid intervention can help reduce the risk of serious injury, prevent complications such as infections, and promote faster healing.
Understanding the appropriate responses to different types of burns whether thermal, chemical, or electrical is vital for ensuring safety at home, in the workplace, and in public spaces. By being prepared to act swiftly and knowledgeably, you can make a significant difference in mitigating the impact of burn injuries.
Identifying the Severity of Burns
Assessing the severity of a burn involves determining the depth and extent of tissue damage, which helps in guiding appropriate treatment and care. Burns are typically classified into three categories: first-degree, second-degree, and third-degree burns, each with distinct characteristics:
First-Degree Burns
These are the mildest form of burns, affecting only the outer layer of the skin (epidermis). Signs of a first-degree burn include:
- Redness: The affected area appears red and dry.
- Pain: The burn is usually painful to touch.
- Swelling: Mild swelling may occur.
- No blisters: First-degree burns do not usually form blisters.
Healing typically occurs within 3 to 7 days, often without scarring.
Second-Degree Burns
Second-degree burns affect both the outer layer (epidermis) and the underlying layer (dermis) of the skin. These burns are more serious and exhibit the following signs:
- Blisters: Rapidly developing blisters are characteristic of second-degree burns.
- Redness and swelling: The skin appears intensely red and swollen.
- Pain: These burns are very painful, often more so than first-degree burns due to nerve injury in the dermis.
- Wet or moist appearance: The burn area may look shiny and wet due to leaking fluid (plasma).
Second-degree burns can take several weeks to heal and may result in some scarring and changes in skin color.
Third-Degree Burns
These are the most severe types of burns, involving all layers of the skin and potentially affecting underlying tissues such as fat, muscle, or bone. Signs include:
- Charred or white skin: The burn area may appear black, brown, white, or leathery.
- Lack of pain: Surprisingly, these burns may not be painful initially because the nerve endings are destroyed.
- No blisters: Third-degree burns do not blister since the damage extends through the full thickness of the skin.
- Insensitivity to touch: The area may not respond to light touch.
Third-degree burns are medical emergencies. They require professional medical treatment to prevent complications and promote healing, often requiring skin grafts and long-term rehabilitation. When assessing a burn, consider the size and depth of the burn, the location on the body, and the age and health status of the individual. If there is any doubt about the severity, or if the burn involves critical areas such as the face, hands, feet, or genitals, or large surface areas, seek medical attention immediately.
Superficial Burns (First-Degree Burns)
Superficial burns, commonly known as first-degree burns, are the least severe type of burns as they affect only the outermost layer of the skin, known as the epidermis. The most noticeable feature of a superficial burn is the reddening of the skin.
This redness occurs because the burn causes the blood vessels in the skin to dilate, increasing blood flow to the area as part of the body’s inflammatory response to injury.
Swelling is another common symptom of superficial burns. It is caused by fluid accumulating in the tissues around the burn as the body reacts to the damage and begins the healing process. This swelling is typically mild and resolves as the burn heals.
Superficial burns are painful, primarily due to the irritation of nerve endings in the affected skin. The pain is usually a sharp or stinging sensation that is most intense when the burned area is touched or exposed to heat. The pain from a superficial burn is generally manageable and tends to decrease as the burn heals.
Partial Thickness Burns (Second-Degree Burns)
Partial thickness burns, commonly known as second-degree burns, are more severe than superficial burns because they extend beyond the top layer of the skin, affecting both the outer layer (epidermis) and the underlying layer (dermis).
One of the hallmark signs of second-degree burns is the formation of blisters. These blisters form as a result of fluid accumulation between the epidermis and the dermis. They are a protective response by the body, cushioning the underlying tissue from further damage and infection.
The affected area exhibits a deep, intense redness, which is more pronounced than in first-degree burns. This redness is due to increased blood flow to the area as the body attempts to heal the damaged tissues.
Partial thickness burns are extremely painful. The pain is more intense than that of first-degree burns because the burn affects nerve endings located in the dermis. The sensitivity of these nerves to heat, touch, and chemicals is heightened, leading to significant discomfort.
There is often considerable swelling in and around the burn area. This swelling is due to inflammation and fluid accumulation as the body responds to the tissue injury.
Full Thickness Burns (Third-Degree Burns)
Full thickness burns, commonly referred to as third-degree burns, are the most severe type of burns as they involve all layers of the skin and potentially damage underlying tissues such as fat, muscles, or even bones. These burns require immediate medical attention due to their severity and the significant complications they can cause.
The skin may appear charred (blackened), white, or leathery. These colour changes occur because the burn has destroyed the skin cells and the blood supply to the affected area. The charred appearance is due to the carbonization of tissue caused by extreme heat.
Surprisingly, third-degree burns may not be as painful as less severe burns. This lack of pain is not an indication of a minor injury but rather results from the destruction of nerve endings in the skin that transmit pain signals. The areas surrounding the burn may be very painful, however, as they often include second-degree burns.
First Aid Treatment for Different Types of Burns
Effective first aid for burns depends on the type of burn. Each kind of burn thermal, chemical, electrical, and sunburn has specific characteristics and requires tailored first aid responses.
Thermal Burns (Heat Burns)
Caused by: Hot liquids, steam, fire, or other heat sources.
First Aid Treatment:
- Cool the Burn: Immediately run cool (not cold) water over the burn for several minutes or apply a cool, wet compress to relieve pain and reduce heat.
- Cover the Burn: Use a sterile, non-fluffy dressing or a clean cloth to protect the burn.
- Avoid Ice: Never use ice as it can cause further damage to the skin.
- Pain Relief: Consider over-the-counter pain relievers like ibuprofen or acetaminophen.
Chemical Burns
Caused by: Acids, alkalis, or other corrosive substances.
First Aid Treatment:
- Remove the Chemical: Quickly remove any contaminated clothing or jewelry while avoiding further contact with the chemical.
- Rinse and Clear: Flush the affected area with cool running water for at least 10-20 minutes to dilute and wash away the chemical. Alkali burns may require longer flushing.
- Seek Medical Help: After rinsing, cover the burn with a clean cloth and seek professional medical attention immediately. Chemical burns can continue to damage tissue over time.
Electrical Burns
Caused by: Exposure to electrical current.
First Aid Treatment:
- Ensure Safety: First, ensure the source of electricity is turned off before touching the victim to avoid electrocution.
- Call for Help: Electrical burns often cause internal damage that is not visible. Call emergency services immediately.
- Do Not Cool the Burn: Unlike other burns, cooling is not recommended as it may complicate the assessment of internal injuries.
- Cover the Burn: Use a clean, dry cloth to cover the burn until medical help arrives.
Treating Major Burns
Major burns, including extensive second-degree burns and all third-degree burns, require immediate and specialized medical treatment due to the severity and potential complications associated with them. There are many key insights into the treatment protocols for these types of burns that you should know.
Fluid Resuscitation
- Major burns lead to significant fluid loss through the damaged skin, risking dehydration and shock. Fluid resuscitation is critical and typically involves the administration of intravenous fluids based on formulas (like the Parkland formula) that calculate the amount based on the burn’s extent (total body surface area burned) and the patient’s weight.
Wound Care
- Cleaning and Debridement: This involves the cleaning of the burn areas to remove dead tissue and any potential contaminants that could cause infection. Debridement is crucial for promoting healing and preparing the wound for further treatment.
- Topical Antibiotics: The application of topical antimicrobial agents helps prevent infection and prepares the wound bed for healing or grafting.
- Dressing the Burns: Burns are dressed with materials that promote healing, reduce pain, and minimize infection risks. Modern dressings like silver-impregnated dressings or biologic dressings can be used.
Pain Management
· Effective pain management is vital, as burns can be excruciating. Pain relief typically involves the use of opioids and non-opioid analgesics. Continuous assessment and adjustment of pain management strategies are necessary.
Surgical Intervention
- For many major burns, surgical intervention such as skin grafting is required. This involves taking healthy skin from an unburned area of the patient’s body (autograft) and transplanting it to the burn wound. In severe cases, temporary coverage might be achieved using allografts (skin from donors), xenografts (animal skin), or synthetic materials until autografts are possible.
Rehabilitation
- Early initiation of physical and occupational therapy is crucial to address the functional and psychological aspects of recovery. Therapy focuses on maintaining range of motion, preventing contractures (permanent tightening of skin, muscles, or tendons), managing scars, and providing support for psychological needs, including coping strategies for trauma and disfigurement.
Major burn treatment is complex and multidisciplinary, often requiring a team that includes burn specialists, surgeons, nurses, therapists, and social workers. The goal is to minimize complications, promote healing, preserve function, and improve the patient’s quality of life.
Treating Minor Burns
When dealing with minor burns, timely and proper first aid can prevent further damage and accelerate the healing process.
Cooling the Burn
- Run Cool Water: Immediately after a burn, run cool (not cold) water over the affected area for at least 10 to 20 minutes. This helps reduce the skin temperature, lessens the depth of the burn, and alleviates pain.
- Use Cool Compresses: If running water isn’t available, apply a cool compress to the burn. Be sure to cool the compress frequently to keep it effective.
Covering the Burn
- Choose the Right Dressing: After cooling the burn, cover it with a sterile, non-adhesive bandage or dressing. This protects the burn from infection and avoids further irritation.
- Avoid Tight Dressings: Ensure the dressing is loosely applied. Tight dressings can restrict blood flow and worsen the injury.
- Change Dressings Regularly: To maintain cleanliness and monitor the healing process, change the dressing according to your healthcare provider’s instructions or if it becomes wet or soiled.
Managing Pain
- Over-the-Counter Pain Relievers: Oral pain medications such as acetaminophen or ibuprofen can help manage the pain associated with burns. Follow the dosage instructions on the package or as advised by a healthcare provider.
- Avoid Applying Ice: Never use ice directly on a burn as it can cause further damage to the skin and worsen pain after initial relief.
- Cooling Gels: Aloe vera or other cooling gels designed for burns can soothe the skin and provide temporary pain relief. Ensure these products are alcohol-free to avoid irritation.
Monitoring for Signs of Infection
- Watch for Red Flags: Signs of infection include increased redness, swelling, fever, pus, or discharge from the burn site, and increased pain.
- Keep the Area Clean: Regularly clean the burn with mild soap and water during dressing changes to prevent infection.
- Seek Medical Advice: If any signs of infection appear, consult a healthcare provider immediately.
When to Consult a Healthcare Provider
- Burn Severity: Seek immediate medical attention for all third-degree burns, chemical burns, electrical burns, and any second-degree burns covering a significant area of the body or located on sensitive areas such as the face, hands, feet, or genitals.
- No Improvement: If the burn does not start to heal within a few days, or if symptoms worsen, it’s crucial to see a doctor.
- Pain Management Issues: If pain is not manageable with over-the-counter options, medical intervention may be needed.
Effective first aid can significantly influence the healing process and outcome of burn injuries. Always err on the side of caution and consult a healthcare provider when in doubt to ensure appropriate care and prevent complications.
When to Seek Medical Attention for Burns
Burns can vary significantly in severity, and knowing when to seek professional medical treatment is crucial for effective care and recovery. While minor burns can often be treated at home, there are specific scenarios where medical intervention is absolutely necessary.
Infections
Infections in burn wounds can rapidly lead to serious complications. Professional medical treatment should be sought if you observe any of the following signs:
- Increased pain, which might indicate that the infection is spreading or worsening.
- Redness and swelling that expands beyond the initial burn area.
- Fever, suggesting a systemic infection.
- Pus or discharge from the burn, which is a clear indicator of infection.
- Unpleasant odor coming from the burn site.
The size and depth of a burn are critical factors in deciding the need for professional care. Large Burns that cover more than 10% of the body’s total surface area should be treated in a medical facility due to the high risk of dehydration and shock. Deep Burns resulting in third-degree burns, regardless of size, require immediate medical attention. These burns affect all layers of the skin and possibly the underlying tissues and can lead to significant functional and cosmetic damage.
Location of burns
Burns located in areas of the body where function and sensitivity are critical also necessitate professional medical evaluation.
- Face and Neck: Burns here can affect breathing and swallowing, and pose a risk to the eyes and ears.
- Hands and Feet: Burns to these areas can impair function, necessitating specialized treatment to preserve movement and dexterity.
- Genitals: Burns in this area are particularly prone to infection and can affect urinary and reproductive functions.
- Major Joints: Burns over major joints like the shoulders, elbows, knees, and hips can limit mobility due to scarring and contracture.
In any of these situations, delaying medical treatment can lead to severe complications or death. Even if a burn initially appears minor, if it worsens or shows signs of infection, it’s vital to seek medical attention. Remember, proper assessment and treatment by healthcare professionals play a critical role in the outcome and recovery from serious burns. Always err on the side of caution and consult medical professionals to ensure the best care for burn injuries.
Empowering You to Make a Difference: Mastering First Aid For Burns
Whether you’re a parent, a professional, or simply a responsible adult, learning first aid for burns is an indispensable skill. We encourage you to take the next step in your preparedness journey by enrolling in a first aid course with Life Saving First Aid.
Stay informed, stay prepared, and turn your knowledge into action that could one day make a crucial difference in an emergency. Check out some of our other articles HERE
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Til next time…
