All burns are serious, and emergency treatment will increase the patient’s chance of recovery. Never neglect burns. All are serious. Large burns may be lethal, and shock from fluid loss and toxins and nervous reactions may occur.
The more extensive the burn the more serious it is and the more urgent is medical attention. Treat all burns and scalds with respect and urgency. Burns should be cooled for up to 10 minutes then covered. Seek medical aid.
Infections following destruction of skin and probably deeper structures not only cause blood vessel destruction (and tremendous loss of fluids from damaged capillaries), but allow bacterial contamination. Therefore, keep movement to a minimum, and cover surfaces with as near to sterile coverings as possible. This is essential.
Pain and swelling may be severe, and in the airways this may be fatal. It is important to make certain that airways are clear, and respiration is being maintained.
It is essential to encourage patients and give as much positive psychological build-up as possible. They are already very scared, and may fear they are dying. Cold, running water for at least 10 minutes is part of the procedure for treating burns and scalds.
- Burnt area may be red and painful and blisters present in small superficial burns.
- In deep burns, when full thickness of skin is burnt with underlying tissues also, area yellowish white and probably less painful as nerve-endings are destroyed.
- Victim may still be on fire.
- Skin may be blackened, hair charred—all degrees according to the nature and extent of burn and the circumstances. Clothing may be seared into skin.
- Burnt areas may be swollen and blistered. If around the face, neck and respiratory tract, death may result from swelling of air passages, occluding normal breathing – this usually follows sometime later.
What to Do in the Case of Burns
- It is essential that you act promptly in a calm, efficient manner. Check for danger.
- Take extra precautions if approaching victim who is still on fire (see notes over). Put out burning clothes.
- Wash burns liberally with cold, gently running water for up to 10 minutes.
- Cover lightly with a sterile, nonstick, clean dressing, and bandage lightly.
- Do not apply greasy ointments, oils or lotions.
- Leave blisters intact. Do not break.
- Give fluids if patient is thirsty, but not if unconscious.
- Seek medical aid as a matter of urgency. The best place is not a doctor’s surgery (especially with extensive burns), but the emergency ward of a major hospital.
Bathe the burnt area in cool water. Remove any debris or burnt clothing if possible. Cover with a piece of clean cloth and wrap firmly with a cotton bandage. In many cases the burn will settle down in a few days. Mild ones will simply heal. Deeper ones may blister, the fluid may escape or be absorbed, the old skin will ultimately come off and new pink skin will appear several days later.
Any burn that is more than these simple types needs prompt medical attention. My advice is to take the child directly to the emergency ward of a large well-equipped hospital for immediate attention. Here doctors are geared to cope with serious burns and have the facilities at their disposal to provide the most efficient care that is possible. Please never neglect burns in children – or in anybody for that matter. They are potentially serious.
Do not apply butter, fat, flour or oils. These ideas are not regarded as useful. We used those years ago, but today avoidance of greasy applications is advised.
Encouragement, kind words and a cheery voice are all helpful at this critical time.
If you see the victim burning, approach warily, holding a blanket or rug or coat in front of yourself. Wrap this around the casualty and lay him or her on the floor, smothering flames. If there is much smoke about, keep close to the ground (air freshest there), and if possible keep your face (nose and mouth) covered with a moist rag to avoid hot air being inhaled and damaging your airways.
Remove electrical contacts in event of electrical fires, and do not use water. Get rid of burning clothes after flames have stopped and if they are still smoldering, for added heat increases dangers. Sunburn is similar in treatment. Apply frequent cool packs. Give copious fluids.
Chemical burns – apply copious fluids for up to 20 minutes. Remove contaminated clothing. Seek medical aid. Heat exhaustion may occur when exposed to high temperatures and when humidity is high. This causes excessive loss of fluid and salts from the body, causing headaches, feeling hot and dizzy, cramps, and probable faintness. Resting in a cool place, drinking plenty of fluids (containing salt and glucose), and cool sponging helps.
Heatstroke is the next consequence if exhaustion is not attended to. The brain’s heat-regulatory mechanism does not work efficiently, and the body temperature rises, causing headaches, faintness, nausea, vomiting, dizziness and possible collapse. The temperature rises, and mental acuity wanes. Treatment consists of cooling the patient down as quickly as possible. Clothing may be removed, body rubbed down with cold water or ice, fanned or covered with a wet sheet. Sips of cold water or chipped ice may be given. Transfer to the emergency ward of a hospital as a matter of urgency.
Scalds, resulting from contact with moist heat such as boiling water or oil, are similar to burns in their effect. The treatment for burns outlined above is the procedure to be followed with scalds.