Burn injuries can be classified as thermal, chemical, or electrical. Thermal, or heat burns are most commonly caused by bodily contact with hot objects such as pots and pans on the stove, or fire. Chemical burns are caused by agents, which can result in tissue damage and death if they are in direct contact with the skin. Acids, alkalis, and organic compounds are responsible for most chemical burns. Electrical burns cause severe injury and even death resulting from contact with an electrical source such as an outlet or frayed wire from an appliance. The severity of the injury from contact with electric current depends on the type of current, the voltage, the area of the body exposed, and the duration of the contact.
Burns are evaluated and rated into three categories based upon the depth of the injury sustained. First-degree or superficial burns affect the skins outer layer. Characteristics include redness, mild swelling, tenderness, and pain. Sunburn is a common example of a first-degree burn.
Second-degree burns extend through the skin’s entire outer layer. Blisters, swelling, weeping of fluids, and pain identify these burns. Intact blisters provide a sterile, waterproof covering and should not be broken by lay rescuers. If a blister breaks, a weeping wound results, and the risk of infection increases greatly. Large second-degree burns require medical attention. Third-degree burns 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.
Determining the extent of area injured by a burn is of great importance. You can use the rule of Palm to estimate the size of the burned area. A victim’s hand, excluding the fingers and the thumb represent about 1 percent of the total body surface area. Remember that all burns involving the face, hands, feet, or genitals are considered severe and should be addressed by a medical professional. The general rule of severity defines greater than 30 percent first-degree burns, greater than 20 percent second-degree burns and greater than 10 percent third-degree burn is considered severe and victims should seek the attention of a medical professional.
If any of the following conditions apply to the victim, seek medical attention:
• The victim is younger than 5 or older than 55 years old
• The victim has difficulty breathing
• Other injuries exist
• An electrical injury is present
• The burn is third degree.
Remember to protect yourself and others from injury when dealing with a burn situation. This is especially important when dealing with and electrical injury or chemical exposure where contact with the victim may cause you severe injury or even death. Next week we will discuss the care of burn injuries in detail.
