Burns: Types, Symptoms and Treatment

A burn is defined as an injury to tissue caused by heat, chemicals or electricity. While the skin is the most commonly burned tissue, some internal burns can occur, such as from smoke inhalation in a fire which burns the lungs or swallowing hot liquid which burns the esophagus.

Electrical burns frequently injure the underlying tissue as well as the skin at the point of entry. Chemical burns are unique in that they can cause slowly spreading tissue necrosis hours after the initial injury. Chemical burns are washed with large amounts of water continually until a professional has determined that the chemical has been purged from the affected area.

Regardless of the cause, the symptoms of burns are described according to their severity. These terms are generally familiar to most people. First-degree burns are the mildest injuries. The skin is red, painful and slightly swollen. Touching the area will leave a white mark for a second, referred to as blanching. There is no blistering. Second-degree burns involve red or white blisters that are very painful and contain thick liquid. There may or may not be blanching when the area is touched. Third-degree burns are the most severe and the deepest. This level of injury, depending on the extent of the body that has been affected, can be potentially fatal due to loss of fluid. Third-degree burns are often painless because the nerve endings have been completely destroyed by the burn. The appearance of the skin can be still be red or white or even black and charred, but the important thing to notice is that it will not blanch when touched. Blistering is common here also.

Minor burns can usually be taken care of at home. Burns covering a large area of the body or burns that seem to border between second- and third-degree rating should be seen by a professional. As is sometimes the case with small children who are not yet talking, you may not know the source of the burn. If you don’t know if the burn was heat-induced or chemical, it might be a wise to take them to see a doctor as quickly as possible. If you can find the container from which the chemical came, follow directions on the label for treatment. If a chemical burns someone’s eyes, first flush them for 30 minutes and then get emergency medical treatment.

One potential side effect of burns is shock. Even minor burns can bring on shock. Symptoms include cold or clammy skin, weakness, nausea, and a rapid pulse. If you notice these symptoms, keep the person comfortably warm (not hot) and lying down, and get medical help immediately.

Electrical burns are a special case. The first thing to do is to move the victim away from the source of the current without hurting yourself. Check to see that the victim’s breathing and pulse are regular (you will need to report the victim’s status to the emergency medical personnel. Treat for shock as described above and get medical attention if necessary (again, if the burns are extensive and in this case, if breathing or hear rate aren’t normal). Check the places where the electricity entered and left the body. Treat minor burns there with cool water.

For minor burns, immersion in cold water is the first order of business. Ice is too cold for the newly-sensitized skin of a burn. Ice could make things much worse, so remember to just run cool water over the area. If the skin has been broken, as often happens when blistering occurs, it is important to keep the area clean. Wash the area with soap and water and be sure to brush out (gently!) any dirt or debris with a washcloth or a soft-bristle toothbrush.

Infection is common when burn blisters break because the body’s first line of defense against bacteria – the skin – is gone. If an infection does occur, soak the area daily in warm water with epsom salts dissolved in it, typically for 15-20 minutes, depending upon the thickness of the scabbing. If the area can’t be submerged in water, create a compress of epsom-salt-water by soaking a washcloth in the solution and holding that to the area for 15-20 minutes at a time. This is the most painless way to dissolve the crust of the infection to prevent scabbing, which in turn reduces the chances and severity of scarring. You’ll have to wipe a little to remove the yellow pus of infection, but this is necessary. Dry the area gently, cover with antibiotic ointment of some sort and bandage with nonstick sterile gauze. Because the seepage of burns, especially infected ones, tends to crust, it is important to use a nonstick bandage to avoid added pain later! Where blistering is severe, silver sulphadiazine is an effective antibiotic cream. This is a cream used in hospitals for more serious burns, and from personal experience, I can tell you that it is extremely effective at cooling and soothing the area as well.

Here are the first-aid steps for minor burns in a quick list. Print the list and tape it to the inside of your first aid kit at home or work.

First Aid For Minor Burns

Remove any clothing that covers the burned area.
Place a cloth saturated with cold water over the burn or run cool water over it.
Clean the burn with cool soapy water and pat dry with a clean cloth.
Apply antibiotic ointment, such as Mycitracin or Bacitracin, to small burns with broken skin.
DO NOT break any blisters. Just keep the area covered with a clean dressing.
Acetaminophen can be taken to reduce swelling and pain.
Seek medical attention for extensive burns and blisters (i.e, if the burned area is larger than the size of your palm).
Burns may worsen in appearance 24 to 48 hours after injury. Seek medical attention if this occurs.

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