10. FIRST AID FOR BURNS
(A lot of mis-typings in this file to review)
Today we will go through burns, their types, the signs of burns, and learn the first aid algorithm in thermal and chemical burns. A burn is a result of only one second of carelessness. Whether you touch the hot iron, splash hot tea on your knees, or grab the hot pot handle, the result will be a burn. A burn is damage to body tissues caused by local action of high temperature or chemical substances, an electric current, or ionizing radiation. In 75% of all burns, the upper extremities or hands are affected. Every third burn is a child. These are the following types of burns, thermal, chemical, radiation, electric.
The most common are thermal burns with flames. They are the most severe, because the flame temperature is between 2000 and
3000 degrees Celsius. In addition to flames, burns in 20% of cases are caused by hot liquids. Hot objects and other thermal factors cause every tenth burn. Thermal burns also include sunburn, which occurs after excessive exposure of the sun's rays on the skin. The skin turns red, sometimes bubbles appear, especially when the skin is sensitive to the sun. Typically a large body surface is irradiated, so the burn has these general symptoms; body temperature increases, shivering, and weakness. A solar burn is not just overheating, it is an ultraviolet burn, so we can also get it in the solarium. Furthermore, except for the burns, ultraviolet rays can provoke skin cancer development, one of the most common cancers.
Acids and alkalis, which are most often drunk by mistake, are the typical cause of chemical burns. In this case, the burn is localized in the mouth, esophagus, and stomach. In total, chemical burns account for 5-7% of all burns. Depending on the depth, the burns are divided into superficial, first degree, moderately deep, second degree, and deep, third degree.
To understand the classification of burns according to the depth, you need to consider the skin structure. Skin is the largest organ of the human body and consists of three layers; epidermis, dermis, and subcutaneous fatty tissue or hypodermis. The outer layer, the epidermis, is the epithelium that covers the body from the outside and forms a barrier function, protecting the body from the environment. There is a thick layer of dense unformed connective tissue called dermis or skin under the thin epidermis. This layer contains sensitive nerve endings as well as hair follicles, sweat, and subcutaneous glands. Under the dermis there is the subcutaneous fatty tissue or hypodermis. Surface burns only damage the epidermis, the most common example of first degree burn is sunburn. The sun damaged skin is bright red, swollen, and painful. Moderately deep burns affect the entire epidermis and dermis at the different depths.
Second degree burns are characterized by skin redness, swelling, and thin-walled bubbles filled with yellowish fluid. Deep burns will affect all layers of the epidermis, dermis, and underlying tissues.
Third degree burns may look black or white and dry, like parchment. If the deepest layer of skin is affected, the victim will feel no pain, since the nerve endings are damaged. The burn severity is estimated not only by the depth of the damage, but also by the area. The burn injury area can be estimated using the rule of nines. You have to divide the body areas, each of which is about 9% of the body surface, the perineum and external reproductive organs 1%. This rule is used to determine the area of second and third degree burns. The area of small burns or burns with a round shape can be estimated with the help of the victim’s palm together with his fingers, which is about 1% of the body surface total area, the rule of the palm. Even small burns can be dangerous if certain parts of
the body are involved in violating their function.
First aid, regardless of the cause of the burn, should begin immediately. Each second exacerbates the damage, increases its area and depth, and worsens the victim's prognosis.
The algorithm of actions for thermal burns should be as follows: When you find the victim, look around before approaching him, take care of your safety. Remove the factor that provoked the burn. Remove the victim from the hot water, put out the flame by throwing a blanket, or cold water. In case the victim is on fire, he should put out the flame by rolling on the ground.
If possible, wear gloves and use other devices to protect yourself and the victim from infection. Remove clothing and jewelry from the victim by cutting them with scissors if necessary. The only exception is not trying to remove synthetic things that have melted and stuck to the skin. Cut off only loose areas of clothing. Check the basic vital signs, consciousness and breathing. Then call an ambulance. If the victim is unconscious and does not breathe, proceed to CPR after the emergency call. The main action in first and second degree burns is the cooling of the burn surface. Even after the removal of the thermal agent, the tissue damage continues. Due to the high temperatures, tissues get heated and accumulate energy so cooling the tissues is a compulsory component in first aid. Start immediate cooling relief.
You can cool the burn surface with running water, or submerge the burnt part of the body in cold water. Cooling usually takes no more than 10 minutes. In case of extensive burns, it is essential to cool down reasonably preventing hypothermia of the affected tissues. No ice frigid water should be used. The burned place should be left open for 10-15 minutes to cool the damaged tissues without a bandage, it will allow cooling it in the ambient air.
In the case of deep third degree burns, cooling the burn surface with running water is not applied because the endings are already affected and cooling makes no sense. Always remember that it is strictly forbidden to open the blisters, no matter how terrible they may seem, as long as the blisters are intact, the skin prevents infection from penetrating deep into the tissues. After opening blisters, bacteria will reach the wound surface and cause infection resulting in trauma. If you cool the burn, cover the surface with any clean sterile I class of bandage. Attention never lubricate, or cover burns with grease, oil cream or any other means that Google recommends. It slows down the burn surface cooling. Besides, they worsen the penetration of drugs that the victim will get in the hospital.
Another factor in burns is severe pain, which not only causes suffering but also worsens the general condition of the victim. If the burns are extensive, then in addition to the probability of burn shock, there is a risk of pain shock. So the main thing in providing first aid is pain relief. The ability to use painkillers depends on the country. And approved national first aid standards. After first aid, it is necessary to get the patient to a medical facility as soon as possible so that the victim can get professional help.
A chemical burn is another type of problem and has its own first aid algorithm. First of all, do not forget about your safety. Wear protective gloves, goggles and respirator if necessary. In some cases you may need to wear a protective anti chemical suit. You should then remove all clothing on which the chemicals have gotten to the victim. If possible, place the belongings in a plastic container to limit contact with the chemical. Then wash the chemicals off the victim, then wash with plenty of water from any available source.
In case of contact with dangerous powdery substances on the skin, do not immediately flush the contaminated area with water. Remove the powder beforehand with a dry cloth or brush, as in this form, the substances can very quickly damage the skin and penetrate deep into the tissues. After removing the chemical agent apply a dry bandage to the affected area. If necessary, use painkillers depending on your country’s standards.
Further treatment is determined in a medical clinic warning do not neutralize the acid with alkali and vice versa and do not use baking soda. Such utilization generates heat, so the thermal factor will join the chemical burn, only exaggerating the damage. Try to prevent substances from getting in contact with the skin when assisting. We looked at thermal and chemical burns, but it's not just the skin that’s often affected by burns. Most burns combined with damage to the upper respiratory tract, which can appear if the victim was in a burning room. A closed smoky space may indicate possible smoke poisoning or other inhalation injuries. Since many objects are made of plastic in the modern world, burning plastic releases toxic gases that can cause damage the lungs.
The main signs that may indicate a respiratory tract burn is difficulty breathing. A hoarse voice, soot around the nose and mouth, burnt nose, hair damage, skin. Around the mouth, redness, swelling, or burnt tongue. First aid in these type of burns starts from moving the victim away from the fire area. It is compulsory to provide access to fresh air, determine the consciousness and breathing. If the victim is unconscious but still breathing, it is necessary to ensure that he can breathe more easily.
If there is no consciousness and breathing, begin the CPR. If the victim’s eyes are thermal affected, they should be cooled with water. In case of chemical burn, rinse the eye abundantly with running water. It is necessary to wash both sides of the eyelid, so that the water does not get on the face, skin and healthy eye. Apply a bandage and call an ambulance.
Let's summarize the video. You have learned what burns are, there types and signs, and learn the algorithm of first aid for different types of burns.