Family Health Magazine - FIRST AID
First aid for a serious injury
Severe burns can be life-threatening and should always receive prompt medical attention.
Learn how to prevent burns around the home. Burns are a leading cause of injury in the home. Young children and the elderly are especially at risk of being burned. Most burns in the home can be prevented.
Put only a light dressing on severe burns. A good burn dressing is sterile, lint-free and will not stick to the injury.
Burns can be caused by several types of contact but heat burns are the most common. These occur as a result of too much heat close to the body. Common heat sources include open flames, like candles or fires, and hot objects like stoves or car engines. A scald is a burn caused by hot liquid or steam. Heat burns can also be caused by friction.
Severity of a burn
Burns are classified as either critical, moderate or mild. The severity depends on the characteristics listed below.
- the depth of the burn - this is called the degree of the burn.
- the amount of the body surface that is burned.
- the part(s) of the body that is burned.
- the age and physical condition of the burned person.
The skin has a top layer and a second layer. Underneath the second layer is fat and below that, muscle. The skin protects the body from bacteria, helps control body temperature and keeps fluid in the body. When the skin is damaged by a burn it cannot do these functions properly, and sometimes not at all.
The depth of tissue damage done determines the degree of the burn. The deeper the burn, the more serious it is. There are three degrees of burns - first, second and third. Third-degree burns are the most serious.
- first-degree burn - only the top layer of the skin is damaged.
- second-degree burn - both layers of the skin are damaged.
- third-degree burn - the full thickness of the skin, including tissues under the skin are damaged.
Use the size and symptoms of the burn to determine its degree. The cause of the burn will also give clues as to its severity and whether the injury is critical.
First-degree burn (Diagram A)
- skin color is pink to red.
- slight swelling.
- skin is dry.
- tenderness to severe pain in the injured area.
Second-degree burn (Diagram B)
- skin looks raw and is mottled red in color.
- skin is moist.
- blisters that contain clear fluid.
- severe to extreme pain.
Third-degree burn (Diagram C)
- skin is pearly-white, tan-colored or charred.
- skin is dry and leathery.
- you may see blood vessels and bones under the skin.
- little or no pain (nerve endings are destroyed).
The burns listed below are critical, meaning they may be life-threatening or can cause serious, life-long disability or scarring: any burn that interferes with breathing including burns to the face and throat and inhalation injuries.
- any burn where there is also a serious soft tissue injury or fracture.
- burns going all the way around the neck and/or trunk.
- all burns to areas where the skin bends, including the elbows, neck and knees, eyes, ears, hands, feet and sexual organs.
- burns to anyone under two or over 50 years of age - these people don’t tolerate burns well.
- burns to anyone who has a serious underlying medical condition including immunodeficiency, diabetes, seizure disorders, hypertension, respiratory or mental illness.
Burn injuries often affect much more than just the burned area. In critical burns, all the major systems of the body can be affected. For this reason, anyone who has more than a first degree burn should receive medical help immediately so the extent of the injury can be properly assessed. Common complications of burns include:
- shock caused by loss of blood and/or other body fluids. Shock can be aggravated by the pain of the burn.
- infection because burned skin isn’t a good barrier to bacteria.
- breathing problems if the face or throat is burned, or if the person has inhaled smoke, fumes or steam.
- swelling because tight clothing and jewelry may cut off circulation when the burned area swells.
First aid for burns
First-degree burns where the skin is not badly damaged can be treated at home.
- Cool the burn right away - immerse it in cool water. If you cannot do this, pour cool water on the area or cover it with a clean, wet cloth.
- immerse the burned area in cool water.
- pour cool water on the burn.
- cover the burned area with cloths soaked with cool water.
- Loosen or remove anything that is tight on the burned area - this means jewelry and clothing. Do this as soon as you can, before the injury swells. Do not remove anything that is stuck.
- When the pain has lessened, loosely cover the burn with a clean, lint-free dressing. A good burn dressing (e.g. TELFA™) is sterile, lint-free and will not stick to the injury. If you do not have a proper dressing, use something clean and lint-free, like a linen sheet.
- If there is any doubt about the severity of the burn or if it covers a large area, the person should receive medical attention. In this case, cover the area with a clean dressing or, if the area is large, use a sheet. Secure the dressing with tape, making sure there is no tape on the burned area.
- Give ongoing care including arranging for medical help, first aid for shock, keeping the person comfortable and observing carefully.
Precautions for first aid for burns
- Do not breathe on, cough over or touch the burned area.
- Do not cover a burn with cotton wool or other fluffy material.
- Do not break blisters.
- Do not use adhesive dressings.
- Do not remove clothing that is stuck to the burned area.
- Do not cool the person too much. Once the burn is cooled, take action to keep the person warm
- Do not use butter lotions,* ointments* or oily dressings on a burn.
- * sunburn lotions and ointments can be used on minor sunburn
How to exit a smoke-filled room
- If you can, cover your mouth and nose with a wet cloth.
- Hot smoke rises - keep your head low as you crawl under the smoke.
How to prevent burns
- Set water tank thermostats no higher than 54°C (130°F). At this temperature it only takes about four minutes of exposure to cause a significant burn.
- Prepare a child’s bath with cold water, then add hot water to reach the desired temperature and finish with cold to cool the taps.
- Keep hot liquids (such as coffee, tea) out of the reach of children. Temperature-test all foods, especially those heated in a microwave oven. For instance, a baby bottle heated this way may be only warm to the touch while the formula inside may be scalding hot.
- Teach children the dangers of heat from stoves, ovens, fireplaces, candles, lighters and matches. In the kitchen, keep pot handles pointed away from the front of the stove. As well, many electrical appliances, including curling irons, hair dryers and irons hold their heat for a long time after use.
- Ensure clothing is not flammable (especially for small children and the elderly). Workers in high-risk jobs should wear flame-resistant clothing.
- Guard children and the elderly from stoves and open flames, especially when they are wearing loose clothing or nightgowns.
- Use child-protective electrical outlet covers.
- Supervise the use of stoves, fires and smoking materials - keep matches, lighters, and all smoking materials out of the reach of children. Do not store or save oily rags.
- Install smoke detectors and check them weekly. Change batteries every six months. Plan and practise a family fire evacuation route.
The advice given in this article cannot, nor is it intended to, replace the first aid skills that can only be learned in an approved first aid course. Readers are encouraged to take a first aid course from their local St. John Ambulance Branch or other recognized organization.
While effort is made to reflect accepted medical knowledge and practice, articles in Family Health Online should not be relied upon for the treatment or management of any specified medical problem or concern and Family Health accepts no liability for reliance on the articles. For proper diagnosis and care, you should always consult your family physician promptly. © Copyright 2015, Family Health Magazine, a special publication of the Edmonton Journal, a division of Postmedia Network Inc., 10006 - 101 Street, Edmonton, AB T5J 0S1 [CH_FHc96]