First Aid Burns:

How to Treat Burns with First Aid

By Dr. Ben Kim
DrBenKim.com

You can get burned by a number of different sources, the most common of which are hot liquids, hot objects, chemicals, steam, electricity, the sun, and fire.

For diagnostic and treatment purposes, burns are generally categorized into the following three classifications:

First-degree burns

A first-degree burn is the least serious type of burn that you can suffer, and involves only the outermost layer of your skin, called your epidermis.

Your skin will likely be reddened and painful. It can also be swollen.

In general, if a first-degree burn does not cover a significant portion of your body, it can be treated at home.

Second-degree burns

A second-degree burn is one in which the second layer of your skin (called your hypodermis) is also burned. In this type of burn, your skin will be extremely red with a spotted or blotchy appearance, and you will probably have blisters in the area of the burn.

A second-degree burn typically causes severe pain and swelling.

If you suffer a small and localized second-degree burn - no more than a few inches in diameter - you might be able to treat it effectively at home. If the burned region is larger than this, or has occurred on your face, hands, feet, groin, buttocks, or a major joint, it is best to go to your doctor or local hospital for professional care.

Third-degree burns

A third-degree burn involves all layers of your skin, and possibly structures that are below your skin as well. Some areas of a third-degree burn are often charred black. You may experience severe pain, but if a nerve has been damaged by the burn, it is possible that you will feel little to no pain. All third-degree burns require immediate emergency medical care.

How to Treat a Minor Burn at Home

1. The first step that you should take to treat a minor burn is to hold it under cold, running water for 10 to 15 minutes. If cold, running water is not available, immerse the burn in cold water or cover it with cold compresses. Be sure not to put ice directly against the burn; direct contact with ice can cause frostbite and more damage.
2. Do not apply butter to the burn. Butter will trap heat in the damaged tissues, which can potentially cause more damage and increase your chance of developing an infection.
3. Once the burn has cooled via cold water or compress exposure, apply lotion to the area. Lotion may soothe any discomfort that you feel, and will also prevent dryness.
4. Once the burn is moisturized, cover it with a sterile gauze bandage. Just be sure to wrap the burn loosely to avoid putting too much pressure on the wound.
5. Sometimes, in order to prevent infection, your body will produce fluid-filled blisters. Do not break these blisters - they will resolve on their own. If they break on their own, you can wash the area with water and plain soap, dry it, then apply an antibiotic ointment and a loosely wrapped sterile gauze bandage. It is fine to trim off dead skin from popped blisters.
6. If needed, you can use an over-the-counter pain reliever like acetaminophen until the pain is tolerable.

How to Treat Major Burns

1. For all major burns, seek medical care as soon as possible.
2. Be sure that the cause of the burn has been eliminated, but do not remove burned clothing that has adhered to your skin.
3. Until you receive emergency medical treatment, cover the burned region with a dry, sterile bandage or a clean cloth. Use a cotton bed sheet for large areas. Do not use blankets or towels, as both have a tendency to stick to burns.
4. Do not apply ointments or try to break blisters.

Notes on Treating Chemical Burns

Use cold, running water to completely flush chemicals off your body. If the chemical is a powder, such as lime, use a brush to remove it from the skin before flushing with water.

Be sure to remove any jewelry or clothing that has been in contact with the chemical.

If there continues to be a burning sensation after washing the area with cold water, flush the area for another several minutes with cold, running water.

Wrap the burned region with a clean cloth or a dry, sterile gauze bandage.

If a chemical comes into contact with your eyes, flush your eyes with water immediately. Do not worry about finding sterile water; the most critical objective is to begin flushing as soon as possible. Flush your eyes with water for at least 20 minutes. After washing, close your eyelids and cover them with loose, moist dressings before seeking medical care with someone's assistance.

Notes on Treating Electrical Burns

All electrical burns should be evaluated by a physician for two reasons:

1. Even though the burn may appear to be a minor one, damage may have occurred deep into the underlying tissues.
2. Electrical burns can sometimes result in an irregular heart beat.

References:

• Littin, Scott C. Mayo Clinic Family Health Book. New York: HarperCollins, 2003
• Sanders, Mick J. Mosby's Paramedic Textbook. St. Louis, Missouri: Mosby-Year Book, Inc., 1994

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