First Aid for Burns

Burns are ugly, they hurt, and they are scary. But they can be treated with simple first aid steps. In fact, they are the one injury that must be treated before medical help arrives. The fact is that burns, unless treated right away, will get worse. They'll get deeper below the surface of the skin because the heat continues to do damage.

You might not think of your skin as an organ; after all, it hardly looks like a kidney or a heart. But the skin is a system of the body, and it's the largest organ of the body, too. It's the first shield against aliens, a natural-growing, one-person army of protection, germ warfare, and elimination. If something happens to the skin, the rest of your body is much more vulnerable to infection, shock, and disease. A burn, which affects that skin, is its worst nightmare come true. Unless you act fast, a burn can seep into the skin and invade your entire body.

The next few sections cover each degree of burn and specific first aid treatment for it.

The Three Goals in Treating Burns—No Matter the Degree

There is a light (excuse the pun) at the end of the tunnel when it comes to burns. The fact is that burns can be treated successfully if first aid is administered quickly. By reading this, you are already ahead of the first aid burn game. You will know how to act fast in case of emergency. You will know how to treat a burn, regardless of the degree or cause, while you wait for help to arrive.

1. Prevent shock.
2. Ease pain.
3. Reduce the risk of infection.

The “Thou Shalt Not” Commandments for Burn Treatment

The first aid measures you don't take can be as important as those you do take, especially when it comes to burns. For example, earlier you learned that treating bruises is different than treating cuts, despite the fact that you can follow basic, general outlines for both. In short, there are always exceptions to every rule. And, when it comes to burns, these exceptions can save a life! Here's the “short list” on what not to do:

• Do not pierce or open blisters. It leaves the burned person “wide open” for infection.
• Do not peel off burned dead skin. It not only leaves the new skin underneath too vulnerable to infection, but it can cause scarring.
• Do not attempt to peel away any clothing stuck to the burn. Pulling away the cloth can also peel away any healing skin. And, as anyone who's ever had a bandage pulled off knows, it can hurt too!
• Do not use butter, antiseptic creams, or any other “folk remedies” on burns. They can actually cause the infection you're trying to avoid! None of these remedies, especially butter, will do anything beneficial for major burns.

In the First Degree

Accidentally touching a hot burner, getting too much tropical sun, and holding a scalding hot pot are all ways you can get first-degree burns. First-degree burns are the most benign and most common burns of all. However, because first-degree burns irritate nerve endings (especially fingertips), they can hurt a great deal. Luckily, healing is very quick because only the outermost layer of skin is affected.

You can tell these burns not only by the amount of howling the sufferer does when the accident occurs, but also by the resulting red skin. There will be no blisters on a first-degree burn, nor will the skin be broken. There may be some swelling on and around the burned area. This kind of burn affects only the outermost layers of the skin.

First-degree burns have
slight redness or discoloration,
along with a bit of swelling and pain.

First-degree burns do not usually need professional medical attention. Simply cool the burn under cold, running water for several minutes to stop the burn from getting worse. You can give the injured person an aspirin (if he or she has no medical complications) and soothe the area with some aloe vera ointment or burn cream.

Second-Degree Burns

By the very nature of their place on the “burn hierarchy,” these burns require some medical treatment. You can get a second-degree burn from too much sun, scalding hot soup, coffee, tea, or quick flash burns from gasoline or kerosene lamps.

Second-degree burns are distinguished by the blistery, red blotchy marks they leave on skin. Blisters form in these burns because the burn penetrates deeper into the layers of skin, releasing body fluids that erupt and cause blisters on the surface. Sometimes the burned area will swell or ooze, and it is painful.

Second-degree burns look red
or mottled, and generally have
blisters. These burns may ooze
or swell.

Pain from second-degree burns can be vastly reduced by preventing air from getting at those tender, exposed nerve endings and tissues. Here's the best emergency first aid, step-by-step:

1. Submerge the burned area in cold water (as cold as possible). If the burn occurred on the chest or back, pour cold water from a bucket or a hose directly onto the burn.
2. Keep the cold water on the burn until medical help arrives. If the burns are minor, keep them in cold water for at least five minutes.
3. If the burns are extensive, you can apply a cool, wet cloth to the affected area—but only if the dressing is wrapped in plastic. Cloth tends to adhere to burns, and it can worsen the pain if a physician has to pull it off to treat the burn.
4. If the burns are minor, you can treat them in the same way you'd treat first-degree ones. You won't need medical help. Simply pat the area dry and place a loose sterile cloth over it.

Burns in the Third Degree

Third-degree burns are serious—deadly serious. If you encounter someone who has a third-degree burn, get medical attention fast! How do you know a third-degree burn from a first- or second-degree one? The injured person is literally burned, the skin is charred and white. All of the layers of skin are destroyed (sometimes quite obviously) with this kind of burn.

Third-degree burns come from situations like the ones you read about in the paper. Fireman rushing from burning buildings. People rolling on the ground with their clothes on fire. Pots of boiling water spilling on vulnerable skin. Accidents involving electrical outlets. Any of these can cause serious burns and shock.

If the burned person shows any of the signs of shock, immediately treat that before taking care of the burn. See Performing Mouth-to-Mouth Resuscitation for step-by-step instructions on treating shock.

As we've already mentioned, third-degree burns are the most severe of all burns. They require medical treatment and precise first aid care. If you know what you are doing, you can help prevent infection from spreading.

Third-degree burns look like deep
wounds and often appear to be white
and charred.

1. Call for medical attention if access is immediately available.
2. Treat for shock, if necessary. This is especially true if the burn is caused by electric shock.
3. If you suspect chemical burning, especially from dangerous acids, you need to take first aid care one step further in order to stop the burn from spreading. As soon as you've called for medical help, pick up the phone and call the local poison control center. As with any type of poison ingestion or inhalation or burn, these specialists can tell you exactly what you need to do. (See Poisoning: When to Induce Vomiting, and Treating the Most Common Overdoses for more on poisoning.)
4. Remove any tight clothing or jewelry that's not on the actual burned area. With third-degree burns, there's always the danger of swelling which can cause blood vessels to constrict and create other complications.
5. You can submerge the burned area under cold running water, but avoid ice. Too much cold can exacerbate shock.
6. Pat the area dry and place a loose, sterile cloth over the area.
7. If hands are burned, elevate them, keeping them higher than the heart. This can be done by gently placing pillows under the injured person's arms.
8. Burned legs and feet should also be elevated to keep blood flowing smoothly.
9. Keep the injured person still. Do not let him or her walk around.
10. If the face is burned, keep checking for breathing complications. If airways seem to be blocked, follow the instructions for performing mouth-to-mouth resuscitation.
11. Above all, get the burned victim to a hospital. Third-degree burn victims are prime candidates for infection, pneumonia, and other complications, and they need medical attention fast.

Excerpted from The Complete Idiot's Guide to First Aid Basics © 1996 by Stephen J. Rosenberg, M.D. and Karla Dougherty. All rights reserved including the right of reproduction in whole or in part in any form. Used by arrangement with Alpha Books, a member of Penguin Group (USA) Inc.

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