The basics on burns and how to treat them
Posted on 26 August 2016
The causes of burns range from chemical, gas and steam to thermal (heat), electrical and sunburn. But do you know how to identify the severity of a burn or how to treat it? Willem Stassen, an ER24 Critical Care paramedic, tells us more.
The 3 main types of burns
1. Superficial burns (first degree): The burn affects only the epidermis (top layer of skin). Symptoms are some reddening, inflammation and pain but no blistering.
2. Partial thickness burns (second degree): The burn reaches into the dermis (second layer of skin). Symptoms are redness, inflammation and pain, and fluid-filled blisters are present.
3. Full-thickness burns (third degree): The burn has gone through all the layers of skin. There is no reddening or swelling, and the skin appears greyish-white and leathery. There may also be some some charring.
Treating a burn
The central part of a burn is normally the deepest and most severe. This central area is typically surrounded less severe or more superficial burns. Cooling the burn prevents this central, deeper area from expanding and thereby worsening the burn. The first and most important thing is to cool the burn area down quickly, but how you do that depends on what caused the burn.
• Thermal burns (caused by direct heat like fire, steam or oil): Place the affected area under cool running water from the tap until the area is cool to the touch. Don’t use ice (or iced water), as it could cause freeze-burn.
• Electrical burns (caused by electric shock): If the live electrical device is still close by, make sure you turn the power off and safely remove it before treating the patient. The wound will have an entry and exit wound on the body, which will need treatment. The most important thing about electrical burns is that they can affect your heart rhythm and other organs in the body, often causing an irregular heartbeat, cardiac arrest or unconsciousness.
If the patient is unconscious and not breathing, start CPR immediately and call an ambulance on 084 124. If the patient is conscious, cool the entry and exit wounds and cover with a dry, clean dressing before seeking medical attention.
• Chemical burns (caused by toxic or corrosive substances, usually at work): It’s vital to remember that different chemicals react differently to water and some are actually worsened by it. Therefore water may not be a treatment or cooling option.
First, determine the source of the burn and call the Poisons Control Centre on 0800 333 444 or Poisons Information Centre on 021 931 6129 for advice on what to do. If your skin has been burnt by a household chemical like bleach, pool acid or hair removal cream, rinse off under cold water and cover with a clean, dry dressing before seeking medical attention.
What not to apply to a burn
Never apply ice; fats like butter, olive oil or peanut butter; or toothpaste. The latent heat in the burn will heat up the oil and you’ll be effectively ‘cooking’ yourself.
When to seek medical care
If in doubt, get it checked out! Otherwise, burns to the face, hands, genitals and over main joints, as well as chemical and electrical burns, and burns on babies, young children or elderly people, should get immediate medical attention at an emergency room or burns centre.