Burns and Treatment of Burns - Frequently asked Questions
On the Arrive Alive website, we share important information on safety from a fire at our homes as well as the Safety from Burns and Burn Wounds.
There are, however, always some questions the public will rise to gain more information on the treatment of a variety of burns.
These questions may be the consequence of a nasty burn next to the road from an overheated radiator, or something as simple as a burn from stepping on hot coal next to the braai.
It could also be the burns from veld and forest fires or those suffered when making a firebreak or controlled fire on a farm.
We decided to approach our EMS specialists as well as our colleagues from Burnshield with some information on how to effectively respond to the treatment of burns.
What is the major difference between a HOT and WET burn and are they treated the same or differently?
All burns are caused by a heat source. Thus HOT. And all burns weep, thus WET. A burn is caused by dry heat, such as an iron or fire, while a scald is a burn caused by something wet such as a liquid or hot vapour/steam.
Types of Burns
There are five types of burns namely Thermal Burns, Chemical Burns, Electrical Burns, Friction Burns and Radiation Burns. All of them are treated in the same way. Thermal and chemical being the most visible, while electric and radiation are more internal with some external evidence.
Definitions of them are as follows:
Thermal burns occur when you come in contact with something hot.
Typically, you will suffer a thermal burn when you touch:
Flames or fire
Hot, molten liquid or steam (referred to as a scald)
Hot objects, such as cooking pans, irons, or heated appliances.
Treatment for thermal burns depends on the location and severity of the burn. For moderate to severe burns, you should immediately call 911.
Then take these steps:
Put out any fire or flames and stop contact with the hot or heated source.
Use cold water to cool the burned area. Do not use ice, as it may further damage the skin.
For mild burns, you can find pain relief by applying a cool, wet compress and/or taking acetaminophen or ibuprofen as directed on the bottle. Later, burn creams and ointments can help these burns heal.
For more severe burns, loosely apply a sterile bandage or clean cloth to the burned area. Do not remove parts of your skin or pop blisters. Seek medical attention for further treatment.
You may receive a chemical burn if your skin and/or eyes come in contact with a harsh irritant, such as acid.
Some substances that can cause chemical burns include the following:
Strong or harsh cleaners
Take these steps if you have been burned by a chemical: Rinse the burned area under running water for at least 10 minutes. If the chemical has entered your eye, rinse your eye for about 20 minutes to remove traces of the chemical.
Then, call Emergency Medical Services or go to the hospital if the burn is:
Larger than three inches
On your face, hands, feet, groin, or buttocks
Still very painful after taking over-the-counter pain medication
On a major joint, like the knee
Medical treatment for both thermal burns and chemical burns is similar and may include:
Wound cleaning and removing dead skin or tissue
IV fluids to regulate body temperature and speed healing
Antibiotics to prevent or fight infection
Skin grafting (covering the wound with healthy skin from another area of the body to close the wound)
Electrical burns happen when the body comes in contact with an electric current. Our internal systems are not resistant to electricity, so you may be injured if a strong jolt enters your body.
The most common cause of an electrical burn is coming in contact with an extension cord where the insulation material has worn away. Low-voltage electrical burns can also occur in the mouth, most commonly when young children place non-insulated cords in their mouth.
A burn may appear on your skin if an electric current runs through your body. These burns can be treated like a thermal or chemical burn. However, if you come in contact with an electric current, you should seek emergency medical attention immediately. Electricity can affect internal tissues and muscles and have long-term, negative effects on your health.
A friction burn can occur when skin repeatedly rubs against another surface or is scraped against a hard surface. Like other burns, friction burns are categorized into degrees.
Many friction burns are first degree and often heal on their own within three to six days. You can use a moisturizing cream at home to care for it. For more serious friction burns, you should seek medical care immediately.
Cancer patients undergoing radiation therapy may suffer from an injury known as a radiation burn.
High-energy radiation is used to shrink or kill cancerous cells, and when it passes through the body, skin cells may be damaged. If you’re frequently receiving radiation treatments, your skin cells may not have enough time to regenerate, and sores or ulcers may develop.
The term "burn" is a misnomer for these wounds, because the skin has not been burned. However, the wounds can look and feel like burns.
Skin must regenerate for the wounds to heal, which can take two to four weeks for mild skin reactions or a few months for more serious reactions.
Care for radiation burns includes:
Cleaning and moisturizing wounds
Wearing loose clothing or bandages over the wound
If you have an injury from radiation, you may also have internal complications and should seek medical treatment immediately.
Types of burn wounds:
Superficial burn (first degree)
This is purely a surface burn affecting the first layer of skin, where the skin appears red, is painful to the touch and maybe slightly swollen but the skin remains intact. An example is a sunburn.
Simply run cold water over the affected area for five to 10 minutes and cover the burn with a sterile dressing. The cold will help remove the excessive heat from the skin and reduce the damage.
Partial-thickness burn (second degree)
Damage includes dermis and epidermis. The skin is red, blistered, swollen and extremely painful, for example, a burn from hot water.
Seek medical assistance. Once blistering occurs or the burn is on the face, neck, hands or feet you need to get your child to a healthcare practitioner. The priority is to ensure the wound is cleaned and dressed correctly.
Full-thickness burn (third degree)
All the layers of the skin are damaged, the burn goes through the dermis and affects deeper tissues. The skin appears pale, waxy and charred. Surprisingly, this burn is often not painful, as most of the nerve endings have been damaged. The patient is very cold as the protection from the environment (provided by the skin) has been damaged by the burn injury.
These injuries are extremely serious. Immediately seek medical assistance. If the burn covers a large part of the body, gently cover it with a clean sheet soaked in cold water. Gently remove clothing, shoes and jewellery from the area unless it is stuck and wait for medical assistance.
Does a "grass burn" or the injury from falling from a moving bike or bicycle qualify as an actual "burn"?
These injuries do not fall under the burns category. These injuries would fall under general wounds and are rather called abrasions or abrasion injuries. It behaves like a partial thickness burn because the top layer of skin removed. But technically it's not a burn as no heat source per se.
There may be a minor amount of heat when falling, such as the case in a moving motorbike, but this would be a small amount.
Even though we acknowledge that it is always better to get proper medical advice - what are the tell-tale signs or symptoms that a burn requires expert evaluation instead of a DIY treatment?
People do not realise the seriousness of burns and often think that medical treatment is not required.
As a guide, burns that are larger than your palm, and or that form blisters need treatment. All airway burns need medical treatment. People who have pre-existing medical conditions are at greater risk to suffer greater side effects from burns.
Also, note some of the referral criteria to a specialized unit.
Here are a few:
Full-thickness burn. For example, caused by fire. It is often recommended that burns over a large area, as well as burns that are partial or full-thickness, should be attended to by a medical professional. These burns can be very serious, and if not treated properly, can lead to serious injury, scarring and even death in extreme cases.
Burn-in special areas like hands, face and perineum for instance.
Burnshield is most effective in the emergency phase (the first 24 -36 hours). It immediately cools, soothes and rehydrates the burn. This significantly reduces the damage caused by the burn.
There are different degrees of skin burns so if there is still pain and heat coming from the wound area after the initial 12-24 hours seek medical attention.
Are there specific body parts that would require special attention when suffering from a burn wound?
There are certain areas of the body that, if burned, should be treated and cared for by a medical professional.
These body parts would include the hands and feet, genitalia as well as the head area and area over the joints. Burns to these body parts can be very serious, and if not treated properly, can also lead to serious scarring.
Also, burns on the head area can be an indication that there may be burnt to the patient's airway. This can be very serious and even deadly.
One should always seek medical advice when a burn is sustained especially if the burn is deep, causes the skin to be dry and leathery, may appear charred or have patches of white, brown or black and are larger than 8 centimetres in diameter or cover the hands, feet, face, groin, buttocks or a major joint, affect your breathing.
Treatment with Burnshield:
Burnshield caters for general burns with our Hydrogels and Dressings. (A dressing is a foam/cotton material soaked in the hydrogel). Burnshield has a variety of dressings in different sizes to treat small, medium, and large burns e.g. the Burnshield Digit Dressing. This is a long dressing (25mm x 500mm) that is specifically used for burns on the toes and fingers.
These specific areas if burnt can bind together, so the digit dressing was designed to individually wrap around the fingers and toes to prevent that from happening and promote healing in the process. We have Burnshield Face Mask Dressings (with ventilation holes over the mouth and nostril areas), Burnshield Limb Dressings, Burnshield Burn Vests (available in 3 paediatric sizes)
What do we need to keep in mind when treating younger burn victims?
Should your child suffer a burn, there are certain things that you should and shouldn't do to help him or her immediately.
Younger children should preferably be seen by health professionals. If it's not serious it can rather be discharged than to sit and delay complications.
By giving immediate first aid you can lessen the severity of the burn while rushing the child to the closest most appropriate emergency department. Prompt medical attention to serious burns can help prevent scarring, disability, and deformity.
Children are curious and like to explore their surroundings. A child’s sensitive skin burns far more easily than adult skin. Burns and scalds are a major cause of serious injury in children from newborn and upwards.
A severe scald can inflict a serious injury and may mean a long stay in the hospital. It may also require painful skin grafts and years of treatment and can result in permanent scarring. A severe scald over a large skin area can even cause death.
Much will depend on the size of the burn, the depth and the age of the child.
Keep in mind that burns are extremely painful. [Pain control needed]
With a larger burn, more fluid is lost. This needs to be properly replaced. There is a special formula for it.
Move out of the danger area.
Remove tight clothing and jewellery.
The wound must be kept clean as an infection is a major risk
Cool the burn with water only or approved burn dressing.
Maintaining body temperature.
Burnshield is safe and can be used for children of all ages. As stats have shown us domestic burns are on the rise mainly involving children. Burnshield has specially created a Burn Vest for this reason.
The vest comes in 3 sizes, 6-12 months, 24-36 months, 4-5 years. This covers the torso, back and upper arm area.
If a burn is treated at home - what are the deciding factors as to how long it needs to be wrapped/ covered and when the wound should be allowed to remain open [ without plaster/ bandages etc]
All burn wounds need to preferably be examined by a medical professional, even if you think it is minor at least have the pharmacist have a look at it and have them advise on dressing from the pharmacy as home remedies are not advised. Medication for pain management is also most often required.
The decision whether to bandage or cover a burn will depend on the type of the burns [cause, size and depth of the burn] as well as the general condition of the skin.
If there are blisters, and these have not burst, you may not necessarily need to bandage these immediately. If the area does become dry or dirty, a bandage can be used.
A dressing, with gauze, should be used. The bandage should be applied with slight pressure with moist gauze. This will stop the dressing from adhering to the burn area.
We cover all burns in the hospital as it heals better that way and has less scarring.
Faces are more vascular and are sometimes left open. All other wounds are covered until the skin has grown back.
If it's a deeper burn it might not heal spontaneously, and surgery might be needed.
If a burn needs to be covered for some time, this is an indication that the patient should seek medical attention.
Treatment for very minor burns:
Cool the burn. Hold the burned area under cool (not cold) running water or apply a cool, wet compress until the pain eases.
Remove rings or other tight items from the burned area. Try to do this quickly and gently, before the area swells.
Don't break blisters. Fluid-filled blisters protect against infection. If a blister breaks, clean the area with water (mild soap is optional). Apply an antibiotic ointment. But if a rash appears, stop using the ointment.
Apply lotion. Once a burn is completely cooled, apply a lotion, such as one that contains Aloe Vera or a moisturizer. This helps prevent drying and provides relief.
Bandage the burn. Cover the burn with a sterile gauze bandage (not fluffy cotton). Wrap it loosely to avoid putting pressure on burned skin. Bandaging keeps air off the area, reduces pain and protects blistered skin.
If needed, take an over-the-counter pain reliever
A burn needs immediate attention.
First and foremost cool and soothe the burn.
The second important action is to rehydrate the burn area, this helps the recovery.
Burnshield covers all actions in one solution.
All Burnshield products contain our sterile gel (96% water, Melaleuca Alt. (Tea Tree) Oil, Gelling Agent). It absorbs and dissipates heat which minimises burn damage. Provides cooling for pain relief and shock reduction.
It is clear and easy to assess the wound. The gel is non-stick and will not adhere to the wound. It is a natural anti-bacterial: reduce infection. Non-toxic. Non-irritant. Safe to use on Children.
As long as pain or heat is coming from the burn area, keep applying Burnshield.
We recommend to lightly applying a non-absorbent bandage to secure the gel/dressing to the wound area.
The burn should be kept moist/wet for as long as possible to aid the recovery process. If pain and heat persist seek medical attention.
For further information and general enquiries contact www.burnshield.com or call 08610 BURNS
A word of appreciation to the following for their Assistance
Shawn Herbst Netcare911
Russel Meiring ER24
Robert McKenzie KZN EMS
Burnshield [Pty] Ltd