Burns

Burns are classified as to how far they burn into the skin.

• First-degree burns affect just the outer layer of the skin – the skin is usually red, with swelling and pain sometimes present.
• Second-degree burns are when the first layer of skin has been burned though and the second layer is also burned. The skin may be red or have a ‘splotchy’ appearance and be blistered. There may be severe pain and swelling.
• Third degree burns destroy all layers of the skin and there may be no pain at all, if all the nerve endings have been destroyed. Burnt areas may appear charred black or dry and white. Immediate hospital treatment is required.

What to do

For minor burns (first-degree and second-degree burns less than 2-3 inches in diameter):

• Remove any jewellery or clothing in the affected area.
• Cool the burn by holding under cold, running water for at least 10 minutes, or until pain subsides. This prevents the burn from spreading to surrounding areas and helps to ease the pain.
• If you cannot hold the burn under running water, immerse the burn in cold water or cool it with cold compresses (e.g., a wet towel). Do not put ice on a burn.
• Cover the burn with a clean, gauze bandage. The dressing should be smooth and not fluffy, as materials like cotton wool can cause friction or stick to the exposed skin. The bandage will prevent infection and protect blistered skin.
• Take a painkiller if necessary.
• As the burn heals, watch for signs of infection, such as increased pain, redness, fever, swelling or oozing. Seek medical help if an infection does develop. Do not break blisters – blisters protect the raw skin underneath from infection.

For major burns (third-degree and extensive second-degree burns):

• If a person is on fire, remember to STOP, DROP and ROLL: tell the person to stop moving/running, drop to the floor, then wrap the person in thick, non-synthetic material (e.g., rug, blanket, or wool or cotton coat) and roll him or her on the ground to stop the flames.

Dial 999 (or 112) for an ambulance. Until the ambulance arrives:

• Check for signs of breathing and circulation and carry out cardiopulmonary resuscitation (CPR) if necessary.
• Remove jewellery and clothing from the affected area, UNLESS it is stuck to the skin.
• Cool the burn by covering the area with a cool, moist sterile bandage, cloth or towel. Do not immerse severe, large burns in cold water, as this could cause shock.
• Take steps to prevent shock.

Chemical burns

• If chemical is a powder, first brush the powder off the skin.
• Hold the affected areas under cool, running water for 15 minutes or more to wash off the chemical.
• Remove any clothing or jewellery that may still be contaminated with the chemical.
• Wrap the affected area with a dry, sterile dressing.

Most chemical burns will heal without further medical assistance. However, if the victim has signs of shock, the burn is deep or extensive, or if it occurs on the eye, hands, feet, face, groin, buttocks or over a major joint, seek medical assistance.

Electrical burn

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.

Shock

Shock can develop following a major injury. It results in an inadequate supply of oxygen to the tissues of the body. It is therefore important to be on the look-out for symptoms of shock in any person who has undergone a major injury.

Symptoms

• Cool and clammy skin – can appear pale
• Weak and rapid pulse
• Fast, shallow breathing
• Dizziness or confusion
• May lose consciousness

What to do

• Lay the person down on their back, with their legs raised higher then the head.
• Keep the person warm and comfortable
• Do not give anything to eat or drink
• Check for signs of breathing and begin CPR if necessary
• Seek medical help