Burns, First Aid

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A burn is an injury to the skin resulting from direct contact or exposure from extreme heat or cold, friction, electricity, or chemicals. First-degree burns are superficial with red skin, pain, and no blistering. Second-degree burns involve destruction of the second layer of skin, causing blistering, swelling, and pain. Third-degree burns involve destruction of all layers of the skin, including fat, muscle, blood supply, and sometimes bone. Third-degree burns do not have pain associated with them.

Airway burns can affect the nose, throat, and windpipe and are typically caused by inhaling smoke, steam, or toxic fumes. The airway swells, which can cause suffocation. It is often difficult to determine the extent of airway burns.

It is important to try to assess the seriousness of a burn, which is determined, primarily, by the size of the burn and its depth. When in doubt, treat as a serious burn.

All first-degree burns and all second-degree burns that are smaller than 2–3 inches in diameter are considered minor burns, and they can be treated as specified in the First Aid Guide below. Seek professional medical care for burns that do not fit the above criteria.

First Aid Guide
General self-care measures for minor (first-degree and some second-degree) burns are as follows:

  1. Run the affected area under cold water, or immerse the area in cold water for 10–15 minutes. Note: Unless the burn is in the mouth, do not apply ice directly to the affected area.
  2. Gently pat the area dry with a clean or sterile cloth, and cover the area with a nonadhesive, sterile, dry dressing.
  3. Take a pain reliever such as acetaminophen (eg, Tylenol), ibuprofen (eg, Advil, Motrin), naproxen (eg, Aleve), or aspirin (but never use aspirin in children or adolescents aged 18 years or younger).
  4. Until the burn has healed, continue to apply clean, dry dressings, and change them daily.

For severe (extensive second-degree and all third-degree) burns, contact emergency help immediately. While awaiting professional medical care, self-care measures are as follows:

  1. Avoid further contact with smoke or heat, but do not remove the person's clothes and do not immerse the burn areas in cold water.
  2. Conduct CPR if necessary.
  3. Cover the affected area with a cool, moist cloth or bandage.

Burns caused by chemical exposure require quick first aid while awaiting medical care; doing so can lessen the chemical's harmful effects. Your local Poison Control Center can best provide this information. The following general measures can be taken while awaiting professional care.

  1. Remove the chemical, including clothing or anything on the person that came in contact with it, taking care to not spread the chemical elsewhere.
  2. Continually flush the affected area with fresh water.
  3. If 15 minutes have passed, apply cool, wet compresses to help relieve pain.
  4. Protect the burn area from friction by covering it with a loose, dry, sterile dressing.

Note: Do not leave the victim alone, and watch for signs of shock.

In the case of burns to the eye, if the white around the eye swells, if there are visual problems, or the burn is otherwise serious, seek medical attention. General first aid is as follows:

  1. Flush the eyes with cool water; if water increases pain symptoms, stop.
  2. Using light pressure, apply a cool compress to the eye.

Note: Do not rub the eye, and do not cough or breath on the burn.

Who's at risk?

Burns affect all people of all ages, races, and sexes.

Burns can happen at any time.

Signs and Symptoms

Burns can appear in a variety of ways, depending on the extent and severity of the burn, but red, white, or charred skin with peeling, swelling, and blisters is typical.

  • Minor burns are the size of a quarter or smaller. All first-degree burns and any second-degree burns that are smaller than 2–3 inches in diameter that are NOT on the hands, feet, face, groin, buttocks, or over a major joint are considered minor burns.
  • Severe burns are deep and may cover a large portion of the body or more than one area of the body. Second-degree burns that are larger than 2–3 inches in diameter that are on the hands, feet, face, groin, buttocks, or over a major joint and ALL third-degree burns are considered severe burns.

Airway burns can include a charred mouth; singed facial hair; visible burns on the head, face, or neck; and coughing or difficulty breathing.

When to Seek Medical Care

If a burn is a third-degree burn or if it is a second-degree burn that is larger than 2–3 inches in diameter; involves the hands, feet, face, groin, or buttocks; or is over a major joint, get medical help immediately. Do not use the level of pain as a determining factor in seeking medical care, as most severe burns are painless.

If a burn has resulted in shock (a person with pale, clammy skin, bluish color to the lips and fingernails, decreased alertness, and overall weakness), seek medical help immediately.

If a burn shows signs of infection (eg, increased pain, redness or red streaking toward the heart, swelling, discharge, or swollen lymph nodes), seek medical attention.

Treatments Your Physician May Prescribe

The physician will likely determine the extent of the burn. In the case of an airway burn, bronchoscopy or lung scan may be done. The wound will be cleansed with bactericidal solution, if necessary, the dressing for the wound will be changed, and instructions for home care will be given. If necessary, a tetanus vaccine will be given and surgical procedures will be discussed (eg, skin grafts).