Burns

Treating thermal, chemical, and electrical burns.

Types of Burns

By Cause

By Depth

By Severity

Minor burns:

• First-degree (any size)
• Second-degree less than 3 inches
• Not on face, hands, feet, genitals, or joints

Major burns (call 911):

• Third-degree (any size)
• Second-degree larger than 3 inches
• Burns on face, hands, feet, genitals, joints
• Burns encircling a limb
• Inhalation injury
• Chemical or electrical burns
• Burns in very young or elderly

Thermal Burns

Immediate Actions

STOP the burning process:

1. Remove from heat source
2. Remove hot clothing (unless stuck to skin)
3. Remove jewelry near burn (swelling will occur)

First-Degree Burns

Treatment:

1. Cool with running water (10-20 minutes)
   • NOT ice (causes further damage)
   • NOT butter or grease
2. Apply aloe vera or burn cream after cooling
3. Cover loosely with sterile bandage
4. Over-the-counter pain medication
5. No need for medical care unless large area

Second-Degree Burns

Treatment:

1. Cool with running water (10-20 minutes)
2. Don't break blisters (protective)
3. If blister breaks:
   • Clean gently
   • Apply antibiotic ointment
   • Cover with non-stick dressing
4. Elevate if possible
5. Seek medical care if:
   • Larger than 3 inches
   • On face, hands, feet, genitals, joints
   • Signs of infection

Third-Degree Burns

Call 911 immediately.

Treatment:

1. Don't remove stuck clothing
2. Cover with clean, dry cloth (not fluffy)
3. Elevate burned area
4. Prevent heat loss (cover with blanket away from burn)
5. Monitor for shock
6. Do NOT apply water, creams, or ice
7. Monitor breathing (especially if face/neck burned)

Inhalation Injury

Signs

• Burns around face, nose, mouth
• Singed nose hairs or eyebrows
• Soot around nostrils or mouth
• Hoarse voice
• Difficulty breathing
• Coughing, wheezing

Treatment

1. Call 911 immediately
2. Move to fresh air (if safe)
3. Monitor airway closely
4. Be prepared for CPR
5. Keep calm and seated if conscious

This is life-threatening. The airway can swell shut.

Chemical Burns

Immediate Actions

Dry chemicals:

1. Brush off powder BEFORE adding water
2. Remove contaminated clothing
3. Flush with large amounts of water

Liquid chemicals:

1. Remove contaminated clothing
2. Flush with large amounts of running water
3. Continue flushing for at least 20 minutes
4. For eyes, flush for 20+ minutes

Specific Chemicals

After Flushing

1. Cover with clean, dry dressing
2. Do NOT apply neutralizing agents
3. Seek medical care for all chemical burns
4. Bring chemical container if possible (for identification)

Electrical Burns

Scene Safety First

Do NOT touch victim if still in contact with electrical source.

To make scene safe:

• Turn off power at source
• Disconnect plug
• Use non-conductive object to separate (dry wood, rubber)
• Call 911

Understanding Electrical Burns

What you see is not what you get:

• Entry and exit wounds may look small
• Massive internal damage possible
• Path of current determines injury

Internal damage includes:

• Muscle damage
• Organ damage
• Blood vessel damage
• Nerve damage
• Cardiac arrhythmias

Treatment

1. Call 911 for all significant electrical burns
2. Check responsiveness and breathing
3. Start CPR if needed (electrical injuries often cause cardiac arrest)
4. Look for entry AND exit wounds
5. Treat visible burns
6. Immobilize if fall occurred (spinal injury possible)
7. Monitor for delayed symptoms

Lightning Strike

Treat similarly to electrical burns:

1. Call 911
2. Check responsiveness
3. Start CPR immediately if needed
4. Treat burns
5. Monitor for cardiac issues

Note: Lightning strike victims are safe to touch (no retained charge).

Special Situations

Sunburn

Prevention:

• Sunscreen SPF 30+
• Reapply every 2 hours
• Protective clothing
• Avoid peak hours (10 AM - 4 PM)

Treatment:

• Cool water or compresses
• Aloe vera
• Stay hydrated
• Over-the-counter pain relief
• Don't pop blisters
• Seek care if severe blistering, fever, or dehydration

Burns in Children

Children have:

• Thinner skin (burns more easily)
• Higher body surface area ratio (greater fluid loss risk)
• Higher risk of scarring

Lower threshold for medical care in children.

Burns in Elderly

Higher risk for:

• More severe burns from same exposure
• Complications
• Delayed healing

What NOT to Do

Burn Care After Initial Treatment

Daily Wound Care

1. Gently clean with mild soap and water
2. Apply antibiotic ointment (if recommended)
3. Cover with non-stick dressing
4. Change dressing daily or when soiled
5. Watch for infection signs

Signs of Infection

Seek medical care if:

• Increased pain
• Increased redness spreading
• Fever
• Swelling
• Pus or foul odor
• Red streaks from wound

Long-Term Considerations

• Scarring (may need specialized treatment)
• Sensitivity to sun (protect healed burns)
• Psychological support (severe burns are traumatic)
• Physical therapy (for burns over joints)

Key Points

1. Cool thermal burns with running water - 10-20 minutes, NOT ice
2. Call 911 for third-degree, large, or critical-area burns
3. Flush chemical burns with water - 20+ minutes
4. Don't touch electrical burn victims until power is off
5. Look for internal damage with electrical burns
6. Don't break blisters - They're protective
7. Don't apply butter, grease, or ice
8. Watch for inhalation injury - Swelling can be fatal
9. All chemical and electrical burns need medical evaluation