Division of Student Affairs

Burns

Burns or thermal injuries can be mild to serious. This injury results from exposure to open flames or radiation or contact with hot liquids, caustic chemicals or electric current. While the seriousness of the injury depends on the severity of exposure, the type of treatments varies as well. Nevertheless, timely and proper First-Aid treatment is required to avoid complications. There are 3 degrees of burn depth and each may warrant different approach. These are the descriptions of each degree of burn injury and the basic guidelines that can be followed in the event of a burn injury.

1. First-degree Burn (Partial-thickness)
   

   Skin is the largest organ of the body that consists of two major layers, the outer layer epidermis and the inner layer, dermis. Of all types of burns, first-degree or superficial-thickness wounds reflect the least destruction because the epidermis is the only portion of the skin that is injured. this burn injury usually results from prolonged exposure to low-intensity heat such as the sun or short exposure to high-intensity heat. Signs and symptoms of first-degree burns include redness with mild swelling, pain and increased sensitivity to heat. Without other damage, this injury can be treated as minor burns and the affected areas will heal in 3-5 days without a scar.

2. Second-Degree Burn (Deep Dermal Partial-Thickness)
   

   Second-degree burns happen when the inner layer of the skin, dermis, is burned along with the whole depth of epidermis. The swelling is worse than first-degree with blister formations. Because of the exposure of nerve endings to the surface, increased pain is experienced and any stimulation such as touch or temperature changes causes more intense pain. Although some minor pigment changes may occur, these burns heal in 10-15 days. As the injury becomes even deeper they usually appear red and waxy-white without blisters but interestingly less painful due to the damage to the nerve endings. If the size of burns is within 2-3 inches in diameter, treat this as minor burn. But, if the burned areas are deeper or affecting the hands, feet, face, groin or buttocks or a major joint, get medical help immediately.

3. Third-Degree (Full-Thickness)
   

   Third degree burns are the most serious and are characterized by a hard, dry, leathery eschar or dead tissue formed from coagulated particles of the damaged dermis. A full-thickness burn involves the entire epidermal and dermal layers of the skin. There is no skin re-growth without these layers so skin grafts are required in areas larger than approximately 12-16 cm squared. Sensation is minimal or absent in these areas of injury because nerve endings have been destroyed. Healing time depends on the re-establishment of an adequate vascular bed within the injured areas and can range from weeks to months. Fat, muscle and bone may be affected by the burn injury and require treatment. In addition, difficulty inhaling and exhaling, carbon monoxide poisoning or other toxic effects may occur if smoke inhalation accompanied the burn and require an emergent care.

Guidelines for treating minor burns(including first and second degree burns about 2-3 inches in diameter):

1. Cool the burned area
   Hold the burned area under cold running water for 15 minutes or immerse the burn in cold water or cool it with cold compresses. Cooling the burn reduces swelling by carrying heat away from the skin. Don't put ice on the burn.
2. Apply some lotion
   Application of lotion, especially with aloe-vera or moisturizers to prevent drying and to promote comfort.
3. Protect the affected area with sterile bandage or dressing
   Sterile dressing protects the burned and blistered area from air and microorganisms that can potentially cause infection. A loose dressing is needed to prevent increasing the pain
4. Take an over the counter pain reliever as needed
   Over the counter medications include aspirin, ibuprofen (Advil, Motrin, others), naproxen (Aleve, Wal-proxen) or acetaminophen (Tylenol, others).
5. Change the dressing carefully and assess for signs of infection
   If signs of infection appears such as fever, excessive drainage, or non-healing wound, seek professional help immediately.
6. Don't break blisters
   Blisters protect the wound from infection. If the blisters break, wash the area with soap and water and cover with sterile dressing and change daily.
7. Avoid re-injuring or re-tanning
   If the burns are less than a year old, re-tanning or over exposure to heat may cause more extensive pigmentation changes. Use sunscreen on the area for at least a year

Guidelines for treating Major Burns: (Including severe second-degree and third degree)

CALL 911 FOR EMERGENCY CARE AT ONCE. If possible, go to the nearest emergency department to prevent complications. While waiting for professional help, follow these guidelines:

1. Don't remove burned clothing
   Make sure that the victim is not in contact with smoldering material and not being exposed to heat or fire.
2. Cover the burned area with a cool, moist, clean cloth or sterile dressing if possible.
   Covering the burned area can prevent infection and decreases pain if present.
3. Ensure airway and breathing
   If airway is blocked or breathing is inadequate or absent start performing cardiopulmonary resuscitation.