Burns, Scalds and Scorches

A very recent incident involving a friend of mine and the subsquent discussions online in social media between several current and ex first aid instructors highlighted some important factors to consider when dealing with burns.

Severity of Burns

All burns should be immediately assessed to determine the depth to which a burn has occurred.

• Superficial burns only affect the outer most layers of skin. The injured area will be sore and bright red. Contact can be painful. No blistering is present and the skin is still intact.
• Partial thickness burns have penetrated down into deeper tissue. The skin can blister and peel leaving the body wide open to infection.
• Full thickness burns are painless. They can be moist, oozing, dry or cracked. The skin may be scorched and blackened, white and waxy, or they can be a combination of both.

Amount of Burn

The best method of determining the total body surface area of the burn is using the “Rule of 9’s”. This rule is internationally recognised and allows hospitals and paramedics to manage fluid support for patients. A reasonable assessment of the burn by a first aider goes a long way to helping paramedics plan their treatment prior to arrival. For further information, try the following link Emedicine Health – Rule of Nines. Any burn bigger than the size of a 50 cent piece should be medically assessed for serverity and potential depth of the burn.

Cause of Burn

Consider how the burn ocurred as it may increase the severity for the patient. For example, chemicals can be absorbed and become a poisoning as well as being a potential hazard to everyone dealing with them. Electrical burns often can include full thickness burns to internal organs. Tar or even jam will trap high temperatures against the skin and can be hard to remove without causing severe damage. Burns completely circling a limb can swell and cut off blood supply.

Burns should never be underestimated. Treat with a minimum of 20 minutes of cool or tepid flowing water. Personal experience has shown that the use of cold water can send a patient into shock. Ice should never be used as it can also lead to burns.

Always follow your first aid training with regard to burns and if in any doubt, dial 000 and ask for Ambulance.

My thanks to Caroline E and Stephen S for discussion and review of similar teachings from Australia and the UK.