General first aid management of burns

You take a walk down your favorite lane on a particular evening. You wonder afar cognitively as the evening breeze bellows wildly, evident by the sound of the caressing leaves. Alas, a perfect evening you thought. Suddenly, you hear a cry. It is a group of young boys playing around with fire which has unfortunately lite up one of them. What will you do in this situation to assist the helpless boy?

Introduction

Photo by MedlinePlus
The Skin is a vital organ that protects the body from injury and infection. It consists of two layers, the epidermis (above-dermis) which is the outer layer and the dermis, the inner layer. The topmost part of the epidermis is made of dead ‘squamous’ (flattened) cells, usually shed and replaced by new cells from the lower part of the epidermis.

The dermis consists of nerves, blood vessels, sweat glands, hair follicles (hair roots), sebaceous glands, muscles etc. The nerves mentioned here are responsible for recording sensations from the body surface. From extreme sensations to the slightest ones (You probably wonder how these nerves are able to receive such mild sensations with a layer of dead cell lining the top of the skin), be it heat, cold or pain. There is however a layer of fat which lie beneath the dermis called the subcutaneous fat.

Any physical damage to the skin, mucous membrane or conjunctiva caused by heat, cold, electricity, radiation or caustic chemicals can be referred to as burns.

The most common cause of burns is heat. This could be dry burn (caused by flames, contact with hot objects or friction) or scald (caused by hot liquids such as hot water, steam). Other forms such as cold (freezing metal etc.), chemical (industrial and domestic chemicals e.g. bleach), radiation (sunburn, radioactivity etc.), and electrical (lightning strikes, high voltage) may be less rampant but also causes a significant amount of injury to lots of people.

Classification of Burns

Burns is classified according to the depth of skin damage. There are 3 classifications, superficial, partial thickness, and full thickness.

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Superficial burns (First Degree Burns); This involves only the epidermis. It heals well if first aid is given promptly and if blisters do not form. It is characterized by redness, swelling and tenderness.

Partial thickness burns (Second Degree Burns); It involves the epidermis and part of the dermis, and are very painful, the skin becomes red and blisters formed over the skin due to fluid released from the damaged tissues.

Full thickness burns (Third Degree Burns); This affects all layers of the skin, usually causing loss of pain sensations as it may cause damage to some nerves, fat tissues, muscles and blood vessels.

Estimating the area of skin burnt

In determining the severity of burn, it is best to calculate by the size of area burnt than the depth of tissue destroyed. The size of the area is determined by the Wallace’s rule of nine.

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  • Whole of each upper limb = 9%. Therefore both limb equals 18%
  • Whole of head and neck = 9%
  • Whole of each lower limb = 18%. Therefore both limb equals 36%
  • Front of trunk = 18%
  • Back of trunk = 18%
  • Perineum = 1%

If 15% of the body of an adult or 10% of the body of a child is burned, the condition should be considered serious and require immediate hospital treatment.

General First Aid Management of Burns

As a first aider, always assess the situation and make a plan.

The aim of management in a case of burns is not to provide complete treatment but to manage the situation until professional help arrives or the casualty is transferred to a hospital.

Aim;

  1. to stop the burning.
  2. to relieve pain.
  3. to maintain an open airway (in cases of burning of the throat).
  4. to manage associate injuries.
  5. to minimize the risk of infections.
  6. to arrange for transport.

What to do?

  • Quickly remove the casualty from the source of the burns, whether fire or liquid. Take your own safety into consideration when doing this, a dead first aider cannot really offer much help. Can they?
  • In trying to stop the burning, roll the casualty on the ground to stop the fire if clothing is till on fire.
  • Burns can be extremely painful, position the casualty to ensure comfort. If the casualty feel more comfortable in a certain position that doesn’t worsen their condition, allow them to do so.
  • Watch for signs of smoke inhalation such as dyspnea.
  • Remove any constriction but do not remove any clothing that is stack to them as you may end up pealing off some skin off of their body.
  • Carefully remove any clothing or jewelry from the area before it starts to swell.
  • Cover the burn and the surrounding area with a sterile or clean dressing.
  • Monitor and manage for shock.
  • Transport to hospital.

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