BURNS, FIRST AID, FLAME BURNS, SCALD BURNS, CHEMICAL BURNS AND ELECTRICAL BURNS

BURNS, MINOR BURNS, MAJOR BURNS : FIRST AID

Dear Burn Surgeon,
Can you please tell me about the first aid for burns and how to avoid burns in general?
Susan A.
California.

please see my previous blog on burn prevention
http://asktheburnsurgeon.blogspot.com/2009/12/burn-prevention-1.html
for the second part of the question.

Before I write on first aid – if you see an accident or fire anywhere, anytime- call your local emergency number immediately. You will have saved someone’s life!!! One day this may save your life too!!!+

First aid is the assistance given to a burn victim from the immediate time of the incident till his arrival to a proper medical centre.


First aid for flame burns 1. Remove the victim from the scene of fire or incident to avoid more damage. Don’t burn yourself in the bargain.
2. Put out the flames and lower the temperature to normal. The greater the duration of contact, and higher the temperature, the more severe will be the injury. Stop, drop and roll is the standard advice. Roll on the floor, use water if available, or use a blanket if available. Do not run as you will end up fanning the flames. you could use burnaid or water jel blankets if it available.
3. Now that the flames have been put out- remove all the burnt clothing. This prevents continuing contact burn. Cover with a clean sheet and transport him immediately to the closest medical facility. If creams like first aid burn cream are available use them or use burn aid dressings or water jel dressings as is available to help relieve the pain and comfort the patient.
4. For pain give ibuprofen, paracetamol or diclofenac sodium or whatever analgesic is available at hand.

First aid for scald burn (burn with hot liquids, soup, boiling water, oil etc) 1. Remove from site of incident
2. Remove the clothes which are soaked with the hot liquids causing continuing damage.
3. Pour cold water over the burnt area to lower the temperature
4. Do not immerse the victim in water for the fear of hypothermia (low body temperature that can be fatal).
5. If a limb is involved- hold under running water, if face is involved- wet cloth and place over face, or wash face.
6. Cover with clean sheet.
7. Do not apply oil or butter- you may apply wet towel or cloth or water jel if available to ease pain while transport.
6. Transport to the nearest medical facility.
7. For pain give ibuprofen, paracetamol or diclofenac sodium or whatever analgesic is available at hand.


First aid for chemical burns

1. Remove from site of incident
2. Remove the clothes which are soaked with the chemicals causing continuous damage.
3. Unlike flame and scald burn, pour water or wash or hold under running water continuously for 20- 30 minutes the burnt area. This is because the process of chemical injury continues to damage the tissue even after the agent is removed. Continuous washing helps to dilute and remove the chemical and decrease the severity of damage.
4. Cover the burn area with a wet soaked cloth (if small) (or use clean sheet to cover the burn area.
5. For pain give as acetaminophen (Tylenol), ibuprofen (advil), paracetamol or diclofenac sodium or whatever analgesic is available at hand. Avoid aspirin in children.


First aid for electrical burns: ‘Safety first- heroism later’
Be careful when dealing with electrical burns- You wouldn’t want to end up being the centre of attraction in a burn ward!

1) Before you attempt to remove the victim from the scene of an accident switch of the electric current to avoid the victim from further injury and the rescuer from being electrocuted

2) You can use a wooden pole to remove the victim from direct electrical contact

3) If only a fire or electrical flash has caused the burn and not a direct current then the first aid is similar to that for flame burns

4) If direct electric current and not fire or electric flame is the cause try to transport the patient immediately to the nearest hospital

In all these situations whether flame, scalds, chemical or electrical burns:
1) Check how responsive the victim is. If the patient is unresponsive then while you wait for help after calling your local emergency number or 911 do the following
a) turn the head backwards and listen for breathing

b) If you find that the victim is not breathing normally, then pinch the nose and cover the mouth with your mouth and blow until you see the chest rise or expand. Give two breaths and each breath should take 1 second.
c)if you find that the victim is still not breathing or coughing or showing any movement, then one has to start chest compressions immediately. push down on the chest 1½ to 2 inches about 30 times right between the nipples. You should adjust this pumping action at the rate of 100/minute, faster than once per second. You should continue with a ratio of 2 breaths and 30 chest compressions until help arrives or the victim is revived. Check the victim's carotid artery for pulse and any signs of consciousness every four cycles. The victim's heart should be beating and he should be breathing. If two persons are available to give first aid then the person pumping the chest stops while the other gives mouth-to-mouth breathing but the ratio remains the same as above.
If the victim vomits, turn the head to the side and try to remove or wipe out the vomit to avoid the victim suffocating himself and then continue with CPR or cardiopulmonary resuscitation as described above.
2)Look for any injuries that the victim may have suffered additionally that may also need first aid like bandages to avoid blood loss or a splint support in case of a fracture of the arms or legs


I feel that every person should have some basic training in first aid and cardiopulmonary resuscitation (CPR). This will help save someone's life someday. These courses are available with the red cross society and the american heart association besides others.


First aid and cpr training should be part of basic college education.