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First Aid for Burns

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.
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 cool water. If the burn occurred on the chest or back, pour cool water from a bucket directly onto the burn.
  2. Keep the cool water on the burn until medical help arrives. If the burns are minor, keep them in cool 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.

First Things First

Did you know that third-degree burns hardly ever hurt at all, at least not initially? That's because nerve endings have been completely burned, and the brain hasn't yet received the painful message.

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.
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 cool 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.

More on: First Aid


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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