This week I wanted to talk about burn first aid. Pretty soon people are going to be doing more outdoor activities with the weather change, including camping, hiking, yard work, etc. Many people will be burning their raked-up leaves or increase their grilling since it isn’t so hot outside. I just wanted to a little bit about how to treat burns what to avoid.
People are more familiar with the old classification of 1st, 2nd, 3rd, or 4th degree burns. They can also be classified as superficial (1st), partial thickness (2nd), and full thickness (3rd or 4th). The treatment for burns starts with determining the type of burn. 1st degree burns typically can be treated at home and include mild sun burn, hot stove burns, etc. 2nd through 4th require medical attention, but I will describe first aid for them below.
1st degree or superficial burns affect the epidermis, our outer layer of skin. Burns here will usually be red, painful, dry, and without blistering. You can place the burn site under cool running water, cool wet compress, or use first aid burn spray. You may cover it with sterile gauze if needed. Vaseline may give some relief also, but don’t put other items like butter, oil, or scented lotions on it. Over the counter pain medicine like Tylenol or ibuprofen will help.
2nd degree or partial thickness burns go through the top layer and down into the dermis. They will be painful and red, with possible blistering and swelling. It is important to leave the blisters intact. They are sterile and opening them will allow bacteria to get inside the skin. First aid includes submerging in cool water for 10-15 minutes. Protect the skin with loose non-stick bandages secured with tape. Depending on the extent of injury to the whole body, you may have to look for shock. Lay the person flat, elevate the feet 12 inches, elevate the burned area above the heart if possible, and cover the person with something to keep them warm. The victim will need to see a medical provider.
3rd degree or full thickness burns destroy both layers (epidermis and dermis), reaching into the subcutaneous or fat layer. These burns can look white, blackened, charred. 4th degree is full thickness of the skin (3rd degree) plus involvement of layers below the skin, including muscle, bone, and other tissues. These burns may not even be painful because the nerves have been destroyed. The first step for both 3rd and 4th degree burns is to call 9-1-1. These victims will need to be evaluated in a burn unit or emergency room, so it is important not to delay care. While someone contacts 9-1-1, you can protect the burn area by covering it with a sterile, non-stick bandage, sheet, or other clean material that won’t leave lint. Do not soak in water or apply any ointments, creams, etc. Treat for shock as described above. However, if they have an airway burn, don’t place a pillow or anything under their head, which could cut off their airway. People with facial burns should be sitting up. Keep a close eye on their pulse and breathing while waiting for EMS.
If you have any questions about this topic, please see me at 45 Urgent Care. Be safe with fires and take care.
-Jarrod Beachum, PA-C