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Burns
Burns

A burn is where tissue damage occurs after being exposed to heat, cold, electricity or chemicals.

Heat burns and cold burs are the most similar, and are treated much the same. Heat burns can be caused through direct contact with heat (ie a hot stove), through radiation (ie sunburn) or through steam. Cold burns are often known as frost nip or frost bite, and can be caused by direct contact with a cold surface or substance, or from being exposed in a cold environment. Heat and cold burns are often referred to as thermal burns. Chemical burns can occur from substances that are caustic, and can also cause poisoning if the substance enters the blood stream. Heat, cold and chemical burns often cause mostly external damage, while electrical burns can cause significant amounts of internal damage while leaving very little external damage.

There are 3 different classifications for thermal and chemical burns and 4 different degrees of burn. The point of entrance and exit for an electrical burn is treated as a thermal burn.

Superficial or 1st degree burns – These burns are minor and only affect the top (or superficial) layer of the skin.
Partial Thickness or 2nd degree burns – These burns are moderate in severity, they affect the top layer of the skin and part of the underlying layers of the skin.
Full Thickness or 3rd degree burns – These burns are major in severity, they affect all the layers of the skin and the subcutaneous fat layer underneath the skin.
4th degree burn – This is a type of full thickness burn that affects all layers of the skin and fat, and extends into the underlying structures of the body such as muscles, tendons, ligaments or organs. This type of burn is rare, but can be seen in extreme cases of thermal or chemical burns, or in the entrance and exit points for electrical burns.
More severe burns are often surrounded by areas of lesser burns, so a 3rd degree burn may be surrounded by areas of 2nd and 1st degree burns.

Heat and cold burns can cause the following problems and complications:

- Scaring and build up of scar tissue.
- Loss of mobility and/or sensation in area burned.
- Tissue death (necrosis) and infection.
- Amputation of affected limb.
- Heart and organ problems (from the chemicals released by the burned cells)
- Lung problems (when exposed to very hot air)
- Coma and Death in cases where a significant part of the body is burned.
Electrical burns can cause the following problems and complications:
- Tissue death (necrosis) and infection.
- Damage to internal organs from the electrical current passing through them.
- Heart arrhythmias (from the electrical current).
- Extreme damage to the entry and exit points of the body.
- Burns to internal organs, muscles and other structures.
- Bone damage from expose to electrical current.
- Seizures, coma and death
Chemical burns can cause the following problems and complications:
- Tissue death (necrosis) and infection.
- Lung problems (if material is inhaled)
- Organ damage (from absorption of the chemical into the blood stream)
- Brain damage (from absorption of the chemical into the blood stream)
- Seizures, coma and death.
The signs and symptoms of a burn can vary depending on how the burn was caused, and the severity of the burn.

Common signs and symptoms of a thermal burn:

1st degree

Signs
- Redness at area exposed.
- Area feels slightly warmer than other areas.
- Skin will be soft.
- No blistering
Symptoms
- Moderate to mild pain that fades fairly quickly.
2nd degree

Signs
- Redness at and around area exposed.
- Blisters will develop over time and have clear/yellowish fluid in them.
- Skin will be soft.
- Peeling skin (develops over time)
Symptoms
- Severe or moderate pain that fades in a couple of days.
3rd degree

Signs
- White or charred skin at the area exposed, with redness around the area.
- Immediate blisters
- Skin feels hard, tough or leathery to the touch.
- Peeling skin (happens quickly)
Symptoms
- Minimal or no pain at the site of injury (due to nerves being damaged)
- Severe or moderate pain surrounding the area burned.
Airway burn

An airway burn can occur anytime a person is exposed to superheated gases, such as in a fire, or when exposed to steam.

Signs
- Burned/singed facial hair
- Burns to the face or neck.
- Discoloration inside the mouth and/or nose
- Coughing, coughing up dark mucous.
- Dark or blue tinged lips or finger nails.
Symptoms
- Difficulty breathing.
- Pain when breathing.
Common signs and symptoms of an electrical burn:

Signs
- Exposure to electrical current.
- Areas of thermal burn where current entered and exited the body.
- Altered level of consciousness
- Seizures
- Unconsciousness
- Absence of pulse and/or breathing
Symptoms
- Difficulty breathing
-Chest pain
- Headache
- Extreme pain
Common signs and symptoms of a chemical burn

Signs
- Exposure to chemical
- Areas of burned skin
- Skin that is coming off or bubbling
- Skin discoloration
Symptoms*
- Blurred vision.
- Headache
- Difficulty breathing.
- Coughing up blood.
- Nausea, vomiting, diarrhea.
- Continuing burning and/or itching sensation.
*Please note that symptoms depend on the chemical exposed to and some chemicals may not affect you until hours or days after being exposed.


Treatment of thermal burns:


DO remove the source of the burn
DO stop the burning process by cooling the area with clean, cool water for 10 minutes.
DO keep the person warm while you are cooling the burn.
DO remove clothing and jewelry around the burn.

DO NOT immerse a person in cold water, or use ice on a burn. This may cause shock.
DO NOT wrap a person in wet blankets/wet dressings. This can cool them too much.
DO NOT remove anything stuck, imbedded, or melted to a burn.
DO NOT pop blisters.
DO NOT put butter, lotion, Vaseline, sprays, creams, adhesive or cotton dressings or anything else on a burn to help cool it. These items can trap heat in or contaminate a wound.
DO NOT ever dress a burn in anything except for a medically approved antibacterial cream.
DO NOT ever move a person who has severe burns over a large percent of their body.

A thermal burn needs to get checked out by a doctor ASAP if:

It is a 3rd degree burn and is larger than 2 fingers put together. It is a 2nd degree burn and is larger than 3 fingers put together. It is a 1st degree burn and is larger than 4 fingers put together. The burn is on a joint, the hands, feet, genitals, face or the burn has jewelry, dirt or anything else stuck in it. The burn goes all the way around a part of your body.

If a burn is smaller that any of those listed above, or is not contaminated can be dressed at home.

Call an ambulance if:


The person was involved in a building or car fire.
The burn is a large 2nd or 3rd degree burn.
The person’s airway is affected affects or they are having difficulty breathing.
The burn goes all the way around the torso or an appendage.
The person has an altered level of consciousness.
The person is under age 12, is elderly, or immunosupressed.

Treatment of electrical burns:


DO try and remove the source of the electricity
DO check and make sure the person has a pulse and is breathing
DO call your local emergency number right away.
DO start CPR if you are trained they do not have a pulse or respirations.

DO NOT endanger yourself trying to remove the source of the electricity.
DO NOT touch the person if they are still in contact with the source of the electricity.
DO NOT touch the person if they are in or near water.
DO NOT move the person.

Call an ambulance for every electrical burn.

Treatment for chemical burns:


DO try and remove the source of the burn.
DO call your local emergency number right away.
DO flush a person’s eyes with clean water if they have chemicals in their eyes AND instructions on the chemicals package say so.
DO encourage the person to remove contaminated clothing and place it in a bag if possible.

DO NOT EVER contaminate yourself with the chemical in the process of helping someone else.
DO NOT EVER get powdered chemicals wet, brush them off to remove them.

Call an ambulance for every chemical burn.
This is to prevent contaminating your personal car, or public transportation with the chemicals you have on you.

What to expect at the doctors of hospital:

Thermal burns –
You may be asked questions like how it happened, how long ago it happened, and what you have done to treat it. They may continue to cool or burn more and then dress it if it is a minor burn. For more severe burns you may be put on an IV drip and given medication. They may give you a shot to numb the area around the burn. They may have to clean the burn out if there is dead tissue, clothing or debris in the burn. You may also get a tetanus shot if you have no had once recently. For severe burns you may be kept in the hospital for treatment, require surgery to fix the burn, or to help cover the area that was burned.

Electrical burns – You may be asked questions like how it happened, how long you were exposed to the electricity, what voltage the electricity was, and how you are feeling now. Treatment will depend on how much electricity you were exposed to, and how much damage is suspected.

Chemical burns – You may be asked questions like how it happened, what chemical you were exposed to, how long you were exposed to it, what you have done to treat it, how the burn is feeling now. You will probably be decontaminated depending on what chemical you were exposed to, and how much of it. That means you will be washed specially to get rid of the chemicals. You may be put on an IV drip and given medication to counteract the chemical or for pain. Once the chemical has been neutralized they will probably treat the burn like they would a thermal burn.



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