The most widely used classification system for burns categorizes them according to size and depth. Since first aid treatment depends on a burn’s severity, it is important to check the center of the wound. This is usually where the burn will be deepest, and its appearance will give indication of the type of treatment the burn needs.
What Not to Do to a Burn
Do not open blisters. When sealed, they normally provide excellent protection for the underlying skin. However, in some situations a physician may rupture and remove the covering of a blister using a sterile technique, especially if infection is evident.
Do not attempt to remove clothing that is stuck to a burn because this could peel away the skin.
Do not use butter, antiseptic creams, or any other folk remedies on burns. These items may significantly slow the healing process and can actually cause or contribute to infection.
First-Degree (Superficial) Burns
First-degree burns are the most common and the least severe. They can be caused by sun exposure or brief contact of skin with hot water or a hot surface such as the burner on a stove.
- bright redness of the affected area, but no blisters
- mild swelling
- minor pain – because first-degree burns irritate nerve endings
- Hold the affected area under cold running water for several minutes.
- Do not use ice, which might reduce the local blood supply.
- To soothe the pain, use a nonprescription pain reliever.
Second-Degree (Partial-Thickness) Burns
These are generally caused by contact with hot liquid and occasionally by sunburn.
Second-degree burns are characterized by blisters that form because the burn penetrates more deeply into the skin, causing body fluids to be released.
- Immediately submerge the burned area in cold water.
- Keep cold water in contact with the burn for at least five minutes or until medical help is given.
- If the burn is minor, treat it the same as a first-degree burn.
- If the burn is more widespread, apply cool, wet cloths to the affected areas and see a doctor immediately. A sizable burn will require medical follow-up, including regular dressing changes, topical medication if appropriate, adequate pain relief, and possibly antibiotics. Extensive partial-thickness burns can be serious or even fatal and may require specialized medical care. Very often this is carried out at a regional burn center.
Third-Degree (Full-Thickness) Burns
These are the most serious and, if extensive, can be fatal. All skin layers are destroyed, and the surface will usually appear charred or white. Paradoxically, full-thickness burns do not hurt as much as the others because the nerve endings in the skin are no longer functioning.
Do not attempt to treat this type of burn; call for medical attention immediately.
Burns of varying size and depth can occur in the following ways:
Scalds, the most common thermal burns, are usually caused by contact with hot water. Exposing skin to water at 140°F for three seconds or 156°F for one second will result in a scald. (Coffee is usually about 180°F when freshly brewed.) Immersion burns (such as those that occur in a hot bathtub) involve longer contact and usually burn a wider area. Because grease or hot oil is around 400°F and may not run off of skin as quickly as water does, it tends to cause deeper burns.
Flame or flash burns are the next most common thermal burns, and these result from or explosions. It is important to remove the person immediately from the heat source
Take off burning or smoldering clothing. A person with flash burns should be observed with wheezing or difficulties breathing. Contact burns are often deep and are caused by touching hot surfaces such as curling as, stoves, hot coals, etc.
Treatment for any thermal burns includes immediate application of cool water, which will decrease pain and may reduce the extent of skin damage. Do not apply sprays, creams, or butter to this (or any other) type of burn.
Electrical burns can cause more damage internally than might be suspected from the appearance of the skin surface.
Separate the victim from the electrical source.
Do not touch the victim until it is certain that she is no longer in contact with the source of electricity.
Check for a pulse and administer CPR if necessary.
Because of the possibility of internal damage, a person who has sustained an electrical burn should see a physician even if she does not feel any immediate discomfort.
Chemical burns are commonly caused by household cleansers and solvents. Alkali burns are said to be more serious than acid burns.
Carefully remove contaminated clothing.
Flush thoroughly with water for at least 10 minutes.
Call your child’s physician or take the child to the nearest emergency facility.