Burns and Scalds

A burn is an injury caused by:

a. Dry heat, such as fire, a piece of hot metal or the sun.
b. Contact with any object charged with a high tension electric current; or by lightning.
c. Friction, for example, by contact with a revolving wheel (brush burn) or fast-moving rope or wire.
d. Corrosive chemicals:
(i) Acids, such as sulphuric, nitric and hydrochloric.
(ii) Alkalis, such as caustic soda, caustic potash, strong ammonia or quicklime.

A scald is an injury caused by moist heat, such as boiling water, steam, improperly applied poultice, hot oil or tar. The effects of a burn or scald are the same. There may be reddening of the skin or blister formation or destruction of the skin or deeper tissues. Pain is very severe in second degree burns.

Degree of Burns
First degree burns: There is only reddening of skin without damage to deeper tissues.
Second degree burns: Second degree burns often result in vesication and exposure of nerve endings and are most painful in nature.
Third degree burns: Here even the nerves are burned off. These burns are not painful, but life threatening as they inevitably cause shock.

The dangers of a burn increase with its surface area (even if it is only superficial) and if one-third or more of skin area is involved, the condition of the patient can be described as critical. In small children and especially in infants, even small burns should be regarded as serious injuries and medical aid sought without delay.

Immediate treatment for a burn patient

1. If a person's clothing catches fire, approach him holding a rug, blanket, coat etc. and wrap it around him, lay him flat and smother the flames.
2. If a person catches fire, when he is alone, he should roll on the floor, smothering the flames with the nearest available wrap and call for assistance, on no account should he rush into the open air.
3. Immerse the affected area in cold water for at least 10 minutes. Alternatively cover the area with a thick clean cloth soaked in water. Keep it damp.
4. Avoid handling the affected area more than is necessary. See that your hands are thoroughly washed as burnt area is highly prone to infectious micro-organisms.
5. Do not apply lotions of any kind.
6. Do not remove burned clothing adherent to the burned skin and do not attempt to break blisters.
7. Cover the burnt area with a clean dry dressing and guard against stock by keeping the patient warm.
8. Lay the patient down and remove anything which might constrict, if the burnt area swells.
9. Don't apply any creams or ointment to burnt area.
10. If a limb is burned, keep it elevated to reduce swelling.
11. Burns offer an exception to the general first aid rule of not giving anything by mouth to the injured person. The burn patient should be give half a glassful of slightly sweetened tepid water, every 15 or 20 minutes. These liquids helps to replace body fluids that have been lost as a result of plasma loss caused by the burn and reduces the risk of development of shock.
12. If there is possibility that medical help will be delayed, give the patient half a glass of salt and soda solution (half teaspoon table salt + half teaspoon baking soda per litre/2 pints of water). Give a child about two fluid ounces and an infant about 1 fluid ounce. Discontinue fluids if vomiting occurs or if the patient indicates that he does not feel well.
13. Remove the patient to a hospital, as quickly as possible.

Burns by Corrosive Chemicals
When the corrosive is an acid:

1. Thoroughly flood the burnt part with water.
2. Bathe the part freely with an alkaline solution such as two teaspoons of baking soda or washing soda in one pint of warm water.

When the corrosive is an alkali:

1. Thoroughly flood the part with water.
2. Bathe the part freely with a weak acid solution, such as vinegar or lemon juice diluted with an equal quantity of water.

Sunburn
Serious discomfort and even superficial burns with blister formation can be caused by direct rays of the sun. In hot countries even short periods of exposure to the midday sun can cause quite severe bums. If need be, the general rules for the treatment of burns and scalds should be applied by the First Aider.