Burns

All About Burns…

What happens when skin gets burned?

If excessive heat is applied to the surface of the skin it penetrates to the blood vessels below the skin causing them to dilate and allowing the colourless part of the blood (the plasma) to escape. When an adult or child receives a minor burn, the first and most obvious sign is a blister on the surface of the skin. This is caused by the escaped plasma becoming trapped on the surface of the skin.

In burns of a more serious nature, where the surface of the skin is removed, the plasma weeps from the raw area. Although there will be no bleeding since only the clear part of the blood is lost the effect of this loss is a reduction in the total volume of fluid available to the body for circulation. This explains why people who suffer from extensive burns so often go into shock and have to receive extra fluids via transfusion when they are hospitalised.

How will I know if a burn is serious?

Always judge a burn by the area of the skin, which it covers, not by its depth. If it covers more than the size of your hand it would be wise to seek medical attention.

Always err on the side of caution with a burn especially if the patient shows signs of going into shock as a result of their injury.

What should I do?

One of the first things most of us do when we get a minor burn is to immediately run it under a cold tap. This makes very good sense as it stops the heat from the burned skin penetrating any deeper into the tissues below the surface, and cools down the whole area instantly. It also has the effect of easing the pain because the cold water acts as a temporary local anaesthetic.

'Cold water stops the burn from penetrating the deeper layers'.

For burns, which do not require hospital treatment and can be treated at home, the most important rule to remember is never interfere with a blister. It protects the raw skin underneath from becoming infected and prevents further plasma leaking out from the tissues under the skin. Do not apply any ointment to the blister. The only thing it needs is a clean, sterile dressing to prevent it from bursting.

If an adult or child has been subjected to an electrical burn, the only evidence may be a blackened area of skin since the electrical contact will have closed up the skin's blood vessels at the point of contact. Don't be fooled by this, however, as below the surface of the skin there may be a much larger area of burned tissue which may be potentially serious. ALL electrical burns should be seen by a doctor as soon as possible.

For burns which require hospitalisation, apply cold water to the affected area while you are waiting for medical assistance and wrap the cooled area in a smooth fabric (e.g. a cotton handkerchief; pillowcase or sheet) to protect the raw skin from becoming infected.

What is the difference between a burn and a scald?

Burns and scalds can cause similar damage to the skin. A scald is a form of burn that is due to the application of moist heat to the skin.

Are burns and scalds really that painful?

Yes and yes again. The extent of the pain experienced as a result of even the most minor of burns may be quite intense. Prescription painkillers may be needed in some cases for several days after the injury. Young children will be particularly distressed at the level of pain, so a great deal of patience and understanding is called for during the recuperation process.

Some essential safety tips

Since the vast majority of domestic burning and scalding accidents involve young children, every parent who has young, active children in the home should observe the following list of essential safety tips:

  • Never leave electrical cords dangling within reach of a young child. This particularly applies to the cord on an electric kettle, but the cords attached to irons, toasters, microwave ovens, food mixers etc., can all inflict serious damage as well.
  • Make sure that all open fires in the home are protected by safety-approved fireguards, which are securely affixed to the wall. There are many excellent fireguards on the market, which are especially designed to be childproof, so if you have toddlers around the house, invest in one immediately.
  • Always turn the handles of pots, pans and saucepans inwards and use the back burners on the cooker as often as possible. Never leave a toddler in the kitchen when food is being cooked on the stove. Frying oil can hop and spit, or even go on fire, and burns from boiling oil are even more serious than those from boiling water.
  • Never fill a hot-water bottle with boiling water, which can scald young children (or even adults) if the bottle leaks or bursts. In fact, it is a good policy to only use a hot-water bottle to heat the bed and to remove it as soon as the child gets into bed.
  • If you are a smoker, remember to exercise great caution in extinguishing all cigarettes and to keep matches and cigarette lighters out of the reach of curious young children.
  • Remember that tea and coffee which isn't even boiling can still badly scald a young child. Keep all hot beverages well out of reach of little hands and never serve tea or coffee on a low table in a house where there are young children.
  • If you have a tablecloth on your kitchen table, make sure that it is securely affixed to the table or it (and that scalding pot of tea) may suddenly be whipped off by a pair of eager young hands!

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