Care for burns Part (2)

Burn care aims to reduce pain, protect against infection, and determine the need for medical assistance. Most burns are minor and can be cared for without medical care. If clothing is burning, have the victim roll on the ground using the “Stop, Drop, and Roll” method. Smother the flames with a blanket or douse the victim with water. Notify 997 of the emergency and evaluate the victim’s injuries.
While care for burns follows general accepted practices, some differences in thought do exist in managing burn injuries. These are the treatments for the general public when caring for burns as recommended by the American College of Emergency Physicians. First-degree burns (superficial) affect the skin’s outer layer. Characteristics include redness, mild swelling, tenderness, and pain. Sunburn is a common example of a first-degree burn.

Treatment for this injury should follow the recommended practice:
Cool the burn with water until the part is pain free (at least 10 minutes). After the burn cools, apply an aloe vera gel to moisturize the skin and reduce the pain. If available, Ibuprofen can be taken to relieve pain and inflammation. It is recommended to give children acetaminophen.
Second-degree burns (partial thickness) extend through the skin’s entire outer layer. Blisters, swelling, weeping of fluids, and pain identify these burns. Follow the recommended treat for these injuries:
If the affected area is less than 20 percent of the total body surface area, remove clothing and jewelry from the burned area. Cool the burn with cold water until the part is pain free (at least 10 minutes). After the burn has been cooled, apply an antibiotic ointment. Cover the burn loosely with a dry, nonstick, sterile or clean dressing to keep the burn clean, prevent evaporative moisture loss, and reduce pain. If available, Ibuprofen can be taken to relieve pain and inflammation. It is recommended to give children acetaminophen.
If the affected area is greater than 20 percent of total body surface area, notify 997. Monitor breathing for difficulty or distress. Remove clothing and jewelry that is not stuck to the burn area. Cover the burn loosely with a dry, nonstick, sterile or clean dressing. Care for shock if present (lay down the victim with his/her feet elevated and body covered). Seek medical attention. Third-degree burns (full thickness) are severe burns that penetrate all the skin layers and underlying muscle and fat. The skin looks leathery, waxy, or pearly grey, and sometimes charred.

Care for third degree burn includes the following:
Notify 997 and monitor breathing for difficulty or distress. Remove clothing and jewelry that is not stuck to the burn area. Cover the burn loosely with a dry, nonstick, sterile or clean dressing. Care for shock if present (lay down the victim with his/her feet elevated and body covered). Seek medical attention.
Burn injuries can be overwhelming to deal with, as they are visually distracting and very painful. The best approach is a focused and calm evaluation of the victim and to look for life-threatening injuries. It is easy to get distracted by the burn and miss another serious condition, which might lead to the death of the victim. Remember to protect yourself and bystanders from further injury. Next week we will discuss the management of electrical and chemical burn injuries. Have a safe summer.

Kenneth D’Alessandro is EMS (emergency medical service) program adviser at the office of the director general of EMS administration, Saudi Red Crescent Authority.
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