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Burns
What are the classifications of burns? What causes burns?
How long does it take for burns to heal?
How are burns treated?
What do I need to know about electrical and chemical burns?
How are burns classified?
What is the significance of the amount of body area burned?
How important is the location of a burn?
What about electrical burns?
What about chemical burns?
What are the potential complications of being severely burned?
What is the prognosis of burn injury?

What causes burns?
You can get burned by heat and fire, radiation, sunlight, electricity or chemicals. There are 3 degrees of burns:
* First-degree burns are red and painful. They swell a little. They turn white when you press on the skin. The skin over the burn may peel off after 1 or 2 days.
* Thicker burns, called second-degree burns, have blisters and are painful. The skin is very red or splotchy, and it may swell a lot.
* Third-degree burns cause damage to all layers of the skin. The burned skin looks white or charred. These burns may cause little or no pain because the nerves in the skin are damaged.

How long does it take for burns to heal?
* First-degree burns usually heal in 3 to 6 days.
* Second-degree burns usually heal in 2 to 3 weeks.
* Third-degree burns usually take a very long time to heal.

How are burns treated?
The treatment depends on what kind of burn you have. If a first- or second-degree burn covers an area larger than 2 to 3 inches in diameter, or is on your face, hands, feet or genitals, you should see a doctor right away. Third-degree burns require emergency medical attention.

Do not put butter, oil, ice or ice water on burns. This can cause more damage to the skin.

First-degree burn

Soak the burn in cool water. Then treat it with a skin care product like aloe vera cream or an antibiotic ointment. To protect the burned area, you can put a dry gauze bandage over the burn. Take an over-the-counter pain reliever, such as acetaminophen (one brand name: Tylenol), ibuprofen (some brand names: Advil, Motrin) or naproxen (brand name: Aleve), to help with the pain.

Second-degree burn
Soak the burn in cool water for 15 minutes. If the burned area is small, put cool, clean, wet cloths on the burn for a few minutes every day. Then put on an antibiotic cream, or other creams or ointments prescribed by your doctor. Cover the burn with a dry nonstick dressing (for example, Telfa) held in place with gauze or tape. Check with your doctor's office to make sure you are up-to-date on tetanus shots.

Change the dressing every day. First, wash your hands with soap and water. Then gently wash the burn and put antibiotic ointment on it. If the burn area is small, a dressing may not be needed during the day. Check the burn every day for signs of infection, such as increased pain, redness, swelling or pus. If you see any of these signs, see your doctor right away. To prevent infection, avoid breaking any blisters that form.

Burned skin itches as it heals. Keep your fingernails cut short and don't scratch the burned skin. The burned area will be sensitive to sunlight for up to one year.

Third-degree burn
For third-degree burns, go to the hospital right away. Don't take off any clothing that is stuck to the burn. Don't soak the burn in water or apply any ointment. You can cover the burn with a sterile bandage or clean cloth until you receive medical assistance.

What do I need to know about electrical and chemical burns?
A person with an electrical burn (for example, from a power line) should go to the hospital right away. Electrical burns often cause serious injury inside the body. This injury may not show on the skin.

A chemical burn should be washed with large amounts of water. Take off any clothing that has the chemical on it. Don't put anything on the burned area. This might start a chemical reaction that could make the burn worse. If you don't know what to do, call 9-1-1 or your local poison control center, or see your doctor right away.

Common Causes

The first step in helping to prevent kids from being burned is to understand these common causes of burns:

* scalds, the No. 1 culprit (from steam, hot bath water, tipped-over coffee cups, hot foods, cooking fluids, etc.)
* contact with flames or hot objects (from the stove, fireplace, curling iron, etc.)
* chemical burns (from swallowing things, like drain cleaner or watch batteries, or spilling chemicals, such as bleach, onto the skin)
* electrical burns (from biting on electrical cords or sticking fingers or objects in electrical outlets, etc.)
* overexposure to the sun

Types of Burns

To distinguish a minor burn from a serious burn, the first step is to determine the degree and the extent of damage to body tissues. The three classifications of first-degree burn, second-degree burn and third-degree burn will help you determine emergency care:

First-degree burn
The least serious burns are those in which only the outer layer of skin is burned. The skin is usually red, with swelling and pain sometimes present. The outer layer of skin hasn't been burned through. Treat a first-degree burn as a minor burn unless it involves substantial portions of the hands, feet, face, groin or buttocks, or a major joint.

Second-degree burn

When the first layer of skin has been burned through and the second layer of skin (dermis) also is burned, the injury is called a second-degree burn. Blisters develop and the skin takes on an intensely reddened, splotchy appearance. Second-degree burns produce severe pain and swelling.

If the second-degree burn is no larger than 3 inches (7.5 centimeters) in diameter, treat it as a minor burn. If the burned area is larger or if the burn is on the hands, feet, face, groin or buttocks, or over a major joint, treat it as a major burn and get medical help immediately.

For minor burns, including first-degree burns and second-degree burns limited to an area no larger than 3 inches (7.5 centimeters) in diameter, take the following action:

* Cool the burn. Hold the burned area under cold running water for at least five minutes, or until the pain subsides. If this is impractical, immerse the burn in cold water or cool it with cold compresses.
Cooling the burn reduces swelling by conducting heat away from the skin. Don't put ice on the burn.

* Cover the burn with a sterile gauze bandage. Don't use fluffy cotton, which may irritate the skin. Wrap the gauze loosely to avoid putting pressure on burned skin. Bandaging keeps air off the burned skin, reduces pain and protects blistered skin.

* Take an over-the-counter pain reliever. These include aspirin, ibuprofen (Advil, Motrin, others), naproxen (Aleve) or acetaminophen (Tylenol, others). Never give aspirin to children or teenagers.

Minor burns usually heal without further treatment. They may heal with pigment changes, meaning the healed area may be a different color from the surrounding skin. Watch for signs of infection, such as increased pain, redness, fever, swelling or oozing. If infection develops, seek medical help. Avoid re-injuring or tanning if the burns are less than a year old ó doing so may cause more extensive pigmentation changes. Use sunscreen on the area for at least a year.

Caution

* Don't use ice. Putting ice directly on a burn can cause frostbite, further damaging your skin.
* Don't apply butter or ointments to the burn. This could prevent proper healing.
* Don't break blisters. Broken blisters are vulnerable to infection.

Third-degree burn
The most serious burns are painless, involve all layers of the skin and cause permanent tissue damage. Fat, muscle and even bone may be affected. Areas may be charred black or appear dry and white. Difficulty inhaling and exhaling, carbon monoxide poisoning, or other toxic effects may occur if smoke inhalation accompanies the burn.

For major burns, dial 911 or call for emergency medical assistance. Until an emergency unit arrives, follow these steps:

1. Don't remove burnt clothing. However, do make sure the victim is no longer in contact with smoldering materials or exposed to smoke or heat.
2. Don't immerse large severe burns in cold water. Doing so could cause shock.
3. Check for signs of circulation (breathing, coughing or movement). If there is no breathing or other sign of circulation, begin cardiopulmonary resuscitation (CPR).
4. Elevate the burned body part or parts. Raise above heart level, when possible.
5. Cover the area of the burn. Use a cool, moist, sterile bandage; clean, moist cloth; or moist towels.

What's the best way to protect my children from being accidentally burned?
Common complications from severe burns include the following.
* Serious breathing problems from smoke inhalation, which can take up to 24 hours to develop.
* Poisoning from inhalation of toxic gases released by burning materials such as plastic.
* Dehydration and shock due to massive fluid loss.
* Infection due to improper cleaning and dressing of injuries, which can lead to a serious bacterial infection of your blood (septicaemia).
* Thick, crusty surfaces produced by deep burns, which can become too tight and cut off blood supply to your healthy skin and tissues.
* Widespread muscle damage, which can lead to kidney failure.
* Extensive scarring, which can cause disfigurement or immobility if you're burned around your joints.

What is the prognosis of burn injury?
It can be roughly calculated by adding the patients age + percentage of body area having full thickness burns and if the total value exceeds 100, the patient's chance of survival is low.

Cold Water Treatment Of Thermal Burns

Cool burns with cold running water for 20 minutes.

Remove clothes and jewellery from the burnt area immediately.

When you burn yourself not all the damage happens at once. Because the body holds heat, the burning process can last for several minutes on up to several days or even longer in the case of serious burns. Immediate application of cold water or a cold compress is a treatment that has been found to decrease the degree and depth of a burn.

Speed is the most important single factor in burn treatment. The more quickly you cool down the burn the better your chances are of reducing its effects. Use water from a drinking fountain, sink, hose, shower or whatever water source is closest. Hold the burn under cool running water, submerge the burn in a sink full of water or place a water-soaked cloth over the burn. Add more cool water to the cloth as it absorbs the heat from the burn.

Itís also important for you to continue the water treatment for a long enough period of time. This may take 30 minutes or 3 days, depending on the burn. The first appearance of the burn can be misleading. Sometimes it doesnít look as bad as it really is until the third or fourth day. What the burn looks like then depends on what you did right after the burn and how quickly you did it. If the burn was cooled down immediately there might be almost no pain or swelling and very little change in the skinís appearance.

If the pain is still there when the injured area returns to normal body temperature, it means further cold water treatment is necessary. As long as the burned area feels warmer to the touch than the surrounding skin area, treatment should be continued.