Burns

Overview, Causes, & Risk Factors

A burn is defined as any destruction of skin or body tissue resulting from heat, chemicals, radiation, or electricity. The severity of a burn depends several factors:

the amount of body surface area, also called BSA, that is injured

the depth of destruction

the location of the burn

What are the causes and risks of the injury?

Following are some of the common causes of burns:

contact with a caustic chemical

contact with a hot object, such as curling irons, cigarettes, or stoves

electricity, such as electrical outlets or defective appliances

excess exposure to sunlight

inhalation of hot gas or steam, such as the discharge from an automobile radiator

open flames, such as matches, candles, and campfires

rapid ignition of a flammable material, such as lighter fluid

scalding from hot liquids, such as coffee or boiling water

Symptoms & Signs

What are the signs and symptoms of the injury?

First-degree burns are the least severe. They affect only the outer layer of the skin. The person may experience tingling and hypersensitivity of the skin. There may be pain that is soothed by cooling measures. The wound may appear reddened, but turn white briefly when pressed. The area is dry, with little or no swelling.

Second-degree burns affect both the outer and underlying layers of skin. Symptoms include pain, redness, swelling, and blistering. The wound may have a weeping surface.

Third-degree burns cause the deepest damage. The skin is affected. Subcutaneous tissue, connective tissue, muscle, or bone may also be damaged. The surface of the burn may be white and soft, or black, charred, and leathery. The burned area has no feeling when touched. Third-degree burns usually are not painful because the nerve endings in the skin have been destroyed. In the case of burns caused by electricity, there may be wounds at entry and exit sites.

Burns that cover less than 25% of the body surface area produce a primarily local response. If more than 25% of the BSA is affected, a systemic, or whole body, response will also occur. As fluid is lost, blood pressure drops, and the person may go into shock. When this happens, it is considered a major burn injury.

The location of a burn is important. Burns around the nose, mouth, or neck may indicate the danger of airway swelling and impairment.Full-thickness burns that go all the way around a limb may lead to poor blood circulation. Burns to the eyes require immediate treatment to prevent damage to vision or blindness.

Related symptoms of a burn are as follows:

abdominal pain

cloudy, red, or watery eyes

dizziness

headaches

seizures

unconsciousness, which occurs with severe chemical exposure

visual impairments

Symptoms of an airway burn include the following:

burns to the head, face, and neck

coughing

mucus that is stained black or a dark color

shortness of breath or difficulty breathing

wheezing

Diagnosis & Tests

How is the injury recognized?

In most cases, it’s fairly easy to diagnose a burn. It can be hard to tell the difference between degrees of burn, though. For example, it may take a day or two for the burn to blister, making it a second-degree burn.

Prevention & Expectations

What can be done to prevent the injury?

Burns can often be prevented by following basic safety precautions. The following measures are recommended:

Emphasize the hazards of matches, playing with fire, and fireworks.

Follow recommendations to avoid sunburn.

Follow safety measures to avoid chemical burns.

Install smoke alarms in every bedroom.

Keep a working fire extinguisher in the home.

Know and practice fire escape routes.

Never smoke in bed.

Set water heater temperatures no higher than 120 degrees Fahrenheit.

Teach children about safety precautions at home, at school, and while traveling.

Treatment & Monitoring

What are the treatments for the injury?

First aid can often be given by the average person when someone has just been burned. It is important to contact the emergency medical system, or EMS, if the burn is extensive or severe. EMS should also be contacted if the person shows signs of shock or has burns to the airway or lungs. First aid can be divided into aid for major and minor burns.

First aid steps for minor burns are as follows:

Cover the burned area with cool water, but not ice water, for about 5 minutes.

Try to reassure and calm the person. Burns can be extremely painful and can cause a lot of anxiety.

Cover the area with a bandage after soaking it for several minutes. Use only clean cloths, and try to avoid contaminating the wound.

Over-the-counter pain medicines, such as acetaminophen or ibuprofen, may be given.

A Clostridium tetani\ bacteria.tetanus shot should be given for burns if it has been more than 10 years since the person last had one.

Very minor burns usually heal without any more treatment or follow-up with a healthcare provider. If the burn appears to be more severe, such as a second-degree or third-degree burn, or if it covers an area greater than 2 inches across, a person should receive medical attention. Burns of the hands, feet, face, major joints, or genitals should be treated as major burns. The person should see a healthcare provider.

Following are first aid steps for major burns:

If the person is on fire, have the person stop, drop, and roll. If the person is still on fire, cover the person with a wool or cotton blanket, and douse them with water if it’s available. Don’t use blankets made of synthetic materials, since these can melt.

Try not to remove burned clothing unless it comes off very easily. Make sure that all burning material is removed from the person’s skin.

Make sure the airway is open and the person is breathing. If necessary, begin CPR, or cardiopulmonary resuscitation.

If the person is breathing and has serious burns to the fingers or toes, try to separate the digits with dry, sterile nonadhesive dressings.

Elevate the burned area and protect it from further burns, pressure, or injury. Take steps to prevent shock.

What are the side effects of the treatments?

First aid treatments for burns have no significant side effects.

What happens after treatment for the injury?

If the burn is small and first-degree, it will usually heal on its own. More serious burns require major treatment. The goal is to regain motion and function in the burned area. Skin grafts and physical therapy may be needed.

Article type: xmedgeneral