About 1.25 million burn injuries occur annually in the United States, with 10 percent of burn victims requiring hospitalization.
There are three types of burns: first degree, second degree and third degree. The severity of a burn depends on the amount of skin burned, the location of the burn and the depth of the burn.
With first-degree burns, the damage is limited to the outer layer of skin resulting in redness and pain (like a sunburn). With second-degree burns, the injury involves deeper skin layers causing blisters, swelling, severe pain and some weeping from the wound. Third-degree burns destroy the full thickness of the skin. The area looks leathery, waxy or pearly gray and sometimes charred. It has a dry appearance.
First-aid procedures include removing the victim from any smoke or fumes; reducing the effect of heat on the skin; relieving pain; preventing fluid loss; preventing infection; and in the case of more serious burns, treating for shock and obtaining medical care.
Do not attempt to remove substances, such as tar, that have melted and adhered to the victim. Doing so may cause more tissue damage. To prevent further tissue damage, cool adherent substances with water. Once the burn patient arrives in the hospital emergency department, medical personnel will use an ointment or solvent to remove the substance.
If the victim's clothing is on fire, push the victim to the ground. If necessary, roll the victim over to smother burning clothing. Do not remove burned clothing once the flames have been extinguished. The burned clothing can help protect the wounds against infection and prevent fluid loss. Clothing may also adhere to the burn, and removal can be painful and requires expert medical care. If the victim's clothing is saturated with hot liquid, remove the clothing quickly but carefully.
For large burns, the victim may be in a state of shock and will require immediate medical attention.
For small burns, cold water will stop further tissue damage and lessen the pain and reduce swelling. Oral pain medications may also be given. Apply cold water to the burned skin only if the burn is less than 20 percent of the victim's body surface area. (The burn patient's palm size roughly equals 1 percent of their body surface area.) Applying cold water over large areas of the body promotes hypothermia and can lead to circulatory collapse and potential complications.
Small or minor burns can be cared for at home. Dressings over the wounds should be changed daily. (Remember to wash your hands before changing the dressings.) If the old dressings stick to the burn, soak them off with cool, clean water. Clean the burned area with mild soap and water and pat dry with a clean cloth. Apply an antibacterial ointment over the burn and cover with clean dressings.
Do not break blisters — unbroken blisters protect the skin while its healing. Watch for signs of infection (swelling, pus, fever, increased pain or increasing redness around the burn). If signs of infection appear, seek medical care.
Alton Thygerson, professor of health sciences at Brigham Young University, is the National Safety Council's first aid and CPR author and technical consultant. For more information, the National Safety council First Aid Handbook by Thygerson is available in local bookstores.