More than 2.5 million Americans suffer significant burns each year; 100,000 are hospitalized, and 4,000 die. Victims of house fires, electrical shock, chemical explosions and scalding can suffer burns that run the gamut from superficial skin damage to those that sear through skin and tissue down to the bone.
Damaged skin puts these victims at high risk of shock (poor distribution of the body's blood) and hypothermia (low body temperature). Severe respiratory distress, caused by smoke inhaled during a fire, can threaten as well.The first person to care for a burn victim may be the most important one. If you arrive at the scene of a fire, your first step is to stop the burning process. If an individual is aflame, wrap him or her in a blanket, rug or heavy coat and push him or her to the ground, or shout at the victim to roll around on the ground to extinguish the fire. As soon as it's out, pour cool water from a faucet or garden hose over the burned skin.
Don't try to wipe the burned area; doing so could further damage the skin. Do not apply ice; it accelerates the loss of body heat through broken skin, causes further tissue damage and increases the risk of hypothermia and shock.
Check the ABC's (airway, breathing and heartbeat). Call 911 or the local emergency telephone number. If possible, remove the victim's jewelry and clothing covering the burned area; they can trap heat and constrict circulation. Take them off carefully to prevent further tissue damage.
If the victim has suffered a chemical burn, you will also have to move quickly to prevent further skin damage. Chemicals often continue to burn until they have been completely washed off. If traces of a chemical powder remain, carefully brush it off before irrigating the burned area. Protect yourself from contacting the chemical.
If the victim's eyes have been injured by chemicals, flush them with lots of water at a low flow rate to prevent further damage to the eye. The victim's head should be turned to one side and you should irrigate from the inner eye out so that chemicals do not flow from one eye to the other. Continue irrigation until the victim no longer feels pain or burning.
An inhalation injury requires 100 percent oxygen. First aiders will not ordinarily have access to oxygen, so let the EMS ambulance provide not only the transportation but the oxygen. Signs and symptoms include: changes in breathing, sore throat, hoarseness, singed nasal hairs, blistering around the mouth and blue skin.
Since a burned victim is susceptible to hypothermia, cover him or her with a blanket.
Partial-thickness burns (also known as first- and second-degree) usually are the result of too much sun. They are characterized by pain, pink or light red skin if the victim is light-skinned, and dry areas without blisters. For dark-skinned victims, pain is the main indicator.
More serious or partial-thickness (also known as second-degree) burns are caused by brief contact with hot liquids, flames or diluted chemicals. The injured skin is bright red, wet and weeping or blistered, and very painful to the touch.
Full-thickness (also known as third-degree) burns are caused by brief contact with hot liquids, flames or diluted chemicals. The injured skin is bright red, wet and weeping or blistered, and very painful to the touch.
Full-thickness (also known as third-degree) burns are caused by flames, high-voltage electrical current, concentrated chemical exposure or contact with hot metal or scalding liquids. Because nerve endings are destroyed, the victim feels no pain. However, the outer edges of a full-thickness burn may be painful because it is surrounded by partial-thickness burns. Skin grafts are usually necessary.
Some basic DO NOT procedures include:
- Do not apply cold to more than 20 percent of the body surface because widespread cooling can cause hypothermia.
- Do not apply ice directly to the burn. If using an ice pack, apply it for only 10 to 15 minutes.
- Do not apply any type of ointment at first. Later, an antibiotic ointment such as bacitracin can be used on first- and second-degree burns.