Burns

Skin Conditions

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Burns

Overview

A burn is a type of injury to the skin caused by heat, cold, electricity, chemicals, or radiation (e.g. a sunburn).

Serious burns, especially if they cover large areas of the body, can cause death; any hint of burn injury to the lungs (e.g. through smoke inhalation) is a medical emergency.

Chemical burns are usually caused by chemical compounds, such as sodium hydroxide (lye), silver nitrate, and more serious compounds (such as sulfuric acid). Most chemicals (but not all) that can cause moderate to severe chemical burns are strong acids or bases. Nitric acid, as an oxidizer, is possibly one of the worst burn-causing chemicals. Hydrofluoric acid can eat down to the bone and its burns are often not immediately evident. Most chemicals that can cause moderate to severe chemical burns are called caustic.

Electrical burns are generally symptoms of electric shock, being struck by lightning, being defibrillated or cardioverted without conductive gel, etc. The internal injuries sustained may be disproportionate to the size of the "burns" seen - as these are only the entry and exit wounds of the electrical current.

Survival and outcome (scars, contractures, complications) of severe burn injuries is remarkably improved if the patient is treated in a specialized burn center/unit rather than a hospital.

Types of Burns

First-Degree Burns

First-degree burns involve the top layer of skin. Sunburn is a first-degree burn.

Signs:

  • Red
  • Painful to touch
  • Skin will show mild swelling

Treatment:

  • Apply cool, wet compresses, or immerse in cool, fresh water. Continue until pain subsides.
  • Cover the burn with a sterile, non-adhesive bandage or clean cloth.
  • Do not apply ointments or butter to burn; these may cause infection.
  • Over-the-counter pain medications may be used to help relieve pain and reduce inflammation.
  • First degree burns usually heal without further treatment. However, if a first-degree burn covers a large area of the body, or the victim is an infant or elderly, seek emergency medical attention.

Second-Degree Burns

Second-degree burns involve the first two layers of skin.

Signs:

  • Deep reddening of the skin
  • Pain
  • Blisters
  • Glossy appearance from leaking fluid
  • Possible loss of some skin

Treatment:

  • Immerse in fresh, cool water, or apply cool compresses. Continue for 10 to 15 minutes.
  • Dry with clean cloth and cover with sterile gauze.
  • Do not break blisters.
  • Do not apply ointments or butter to burns; these may cause infection
  • Elevate burned arms or legs.
  • Take steps to prevent shock: lay the victim flat, elevate the feet about 12 inches, and cover the victim with a coat or blanket. Do not place the victim in the shock position if a head, neck, back, or leg injury is suspected, or if it makes the victim uncomfortable.
  • Further medical treatment is required. Do not attempt to treat serious burns unless you are a trained health professional.

Third-Degree Burns

A third-degree burn penetrates the entire thickness of the skin and permanently destroys tissue.

Signs:

  • Loss of skin layers
  • Often painless. (Pain may be caused by patches of first- and second-degree burns which often surround third-degree burns).
  • Skin is dry and leathery
  • Skin may appear charred or have patches which appear white, brown or black

Treatment:

  • Cover burn lightly with sterile gauze or clean cloth. (Do not use material that can leave lint on the burn).
  • Do not apply ointments or butter to burns; these may cause infection
  • Take steps to prevent shock: lay the victim flat, elevate the feet about 12 inches.
  • Have person sit up if face is burned. Watch closely for possible breathing problems.
  • Elevate burned area higher than the victim’s head when possible. Keep person warm and comfortable, and watch for signs of shock.
  • Do not place a pillow under the victim’s head if the person is lying down and there is an airway burn. This can close the airway.
  • Immediate medical attention is required. Do not attempt to treat serious burns unless you are a trained health professional.

 
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