Burns are due to dry heat (including friction) whereas scalds are due to wet heat. It is most important that burns and scalds are treated promptly and correctly so as to limit the effects of injury and to prevent possible long-term scarring.
Assessing a burn/scald
There are two factors in assessing the severity of burns and scalds;
depth and extent of the injury.
Depth of burns/scalds
The skin is reddened and may be swollen. This type of burn/scald is painful.
The skin is blistered and raw. This type of burn/scald is painful. Extensive burns/scalds of this type can be fatal.
The skin is burnt away and the damage extends into the muscle and fat layers. There is a pale, waxy look to the burn with charred areas also possible. Because the nerve endings have been damaged, these type of burns/scalds involve little or no pain.
Type of Burn
|Superficial||9% or less||Own doctor|
|Partial Thickness||1-8% 9% or more||Own doctor 101|
|Full Thickness||Any size||101|
Extent of burns
To assess the extent of burns, the body is divided into percentage areas. Using the chart, you can assess what level of care your casualty requires.
Very often two or three categories of burn may be found within one wound; always treat as for the most serious type present.
TYPE OF BURN EXTENT REFERRAL
Superficial 9% or less Own doctor
Partial thickness 1-8%
9 % or more Own doctor
Full thickness Any size Ambulance
NB : When assessing the size of the casualty’s burns remember that 1% =the size of the casualty’s hand.
WHEN TO SUSPECT BURNS/SCALDS TO THE THROAT AND MOUTH
The face has been burnt.
There is soot around the mouth or around and in the nostrils.
The history of the incident suggests that the casualty has been inhaling hot fumes.
The casualty’s voice starts to become hoarse.
Burns to the mouth and throat
Swelling occurs rapidly following a burn/scald. For this reason, any burn to the mouth or throat must be treated as an emergency. Whenever all of the face has been burnt/scalded always presume the mouth and throat have also been affected.
Call for an ambulance immediately.
Loosen tight clothing, around the neck, chest and waist.
If the casualty becomes unconscious.
If the burn/scald is due to chemical contamination, be sure that you are not placing yourself at risk before starting resuscitation.
Check whether Resuscitation should be given and treat as appropriate .
Call for an ambulance immediately.
Gently flood the affected areas with copious amounts of water ( or other cold, non-inflammable liquid e. g. beer, or milk.)
Remove any clothing that is not sticking to the burn/scald.
Cover the affected area as soon as possible and continue to apply water over the covering.
Treat the casualty for shock.
This is very important so as to stop the area becoming infected. Use:
Non-fluffy material ( e.g. pillow case or similar).
Kitchen film (discard the first 2 turns from the roll ).
Hands and feet can be enclosed in a clean plastic bag.
Do not waste time by trying to secure such coverings in place.
Be very careful not to lower the casualty’s body temperature to the point where hypothermia sets in.
Follow these rules when cooling a casualty.
Wrap the casualty in a blanket ( or similar ).
Use buckets or jugs of cold water to douse the affected area - even over the covering.
Do not immerse the casualty in a bath full of cold water.
Do not apply lotions, creams, butter, cooking fat etc.
They do not cool the burn and have to be cleaned off in the hospital.
Do not completely enclose burned limbs with kitchen film or other materials;
as the limb starts to swell it is possible that the circulation to the area beyond the burn may be cut off.
Minor burns and scalds
These are very common and will heal well provided first aid is carried out promptly and efficiently.
Hold the affected area under a running cold water tap for at least 10-15 minutes, or until the pain stops.
Remove any jewellery from the affected area before swelling starts.
Do not use any creams, lotions, butter or cooking oil to assist with cooling; they often make matters worse.
Blistered or raw areas;cover with a non-fluffy dressing such as a sterile dressing or plaste. If the area becomes infected, seek medical advice.
DOS AND DON’TS FOR MINOR BURNS AND SCALDS
Do not burst any blisters.
Do not use adhesive tape to hold a dressing in place.
Do not use any creams, lotions,buttter or cooking oils to ’cool’ a burn/scald.· Do seek medical help if you are worried for any reason about a burn/scald.
The electrocuted casualty
The major concern when dealing with a casualty who has received an electric shock is safety.
Ensure that the current is switched off before touching the casualty. Do this either at the wall switch or fuse box.
If this is not possible use a non conducting object such as a wooden pole to knock the source of electricity from the casualty.
Do not approach any casualty who is in a sub-station or on a railway line until the current has been turned off and you are given permission to do so by a person in authority.
Chemicals in common use around the home are not very corrosive but never the less should be treated with care.
In case of a chemical burn, flood the affected area with water until professional help arrives (wear rubber gloves if you are helping someone else).
Beware of fumes and further contamination.
NB: CALL FOR AN AMBULANCE IN ALL CASES OF ELECTRICAL AND CHEMICAL BURNS
When someone’s clothing is on fire, the action you take will be vital to his/her well-being. Of course, your chief concern will be to put the flames out.
IF SOMEONE IS ON FIRE
Lay the casualty down with the burning uppermost.
Douse the flames with any non-flammable liquid, e.g. water, milk, etc
Wrap the casualty up tightly in a blanket, coat, rug, etc. (not nylon, polyester or other man made fabrics).
Lay the wrapped casualty on the ground.
The flames will be starved of oxygen and will go out.
Do not allow the casualty to rush around.
Do not beat at the flames with a coat, etc.
Do not roll the casualty along the ground.
If you do any of the above, the flames will jump around -they will spread, causing further burns.
Once the flames are out -treat the casualty for burns .
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