Medical Encyclopedia

 

Medical Encyclopedia

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Burns

Contents of this page:

Illustrations

Burns
Burns
Burn, blister - close-up
Burn, blister - close-up
Burn, thermal - close-up
Burn, thermal - close-up
Airway burn
Airway burn
Skin
Skin
First degree burn
First degree burn
Second degree burn
Second degree burn
Third degree burn
Third degree burn
Minor burn - first aid - series
Minor burn - first aid - series

Alternative Names    Return to top

Second degree burn; First degree burn; Third degree burn

Definition    Return to top

There are three levels of burns:

Considerations    Return to top

Before giving first aid, evaluate how extensively burned the person is and try to determine the depth of the most serious part of the burn. Then treat the entire burn accordingly. If in doubt, treat it as a severe burn.

By giving immediate first aid before professional medical help arrives, you can help lessen the severity of the burn. Prompt medical attention to serious burns can help prevent scarring, disability, and deformity. Burns on the face, hands, feet, and genitals can be particularly serious.

Children under age 4 and adults over age 60 have a higher chance of complications and death from severe burns.

In case of a fire, you and the others there are at risk for carbon monoxide poisoning. Anyone with symptoms of headache, numbness, weakness, or chest pain should be tested.

Causes    Return to top

Burns can be caused by dry heat (like fire), wet heat (such as steam or hot liquids), radiation, friction, heated objects, the sun, electricity, or chemicals.

Thermal burns are the most common type. Thermal burns occur when hot metals, scalding liquids, steam, or flames come in contact with your skin. These are frequently the result of fires, automobile accidents, playing with matches, improperly stored gasoline, space heaters, and electrical malfunctions. Other causes include unsafe handling of firecrackers and kitchen accidents (such as a child climbing on top of a stove or grabbing a hot iron).

Burns to your airways can be caused by inhaling smoke, steam, superheated air, or toxic fumes, often in a poorly ventilated space.

Burns in children are sometimes traced to parental abuse.

Symptoms    Return to top

Symptoms of an airways burn:

First Aid    Return to top

FOR MINOR BURNS

  1. If the skin is unbroken, run cool water over the area of the burn or soak it in a cool water bath (not ice water). Keep the area submerged for at least 5 minutes. A clean, cold, wet towel will also help reduce pain.
  2. Calm and reassure the person.
  3. After flushing or soaking, cover the burn with a dry, sterile bandage or clean dressing.
  4. Protect the burn from pressure and friction.
  5. Over-the-counter ibuprofen or acetaminophen can help relieve pain and swelling. Do NOT give children under 12 aspirin. Once the skin has cooled, moisturizing lotion also can help.
  6. Minor burns will usually heal without further treatment. However, if a second-degree burn covers an area more than 2 to 3 inches in diameter, or if it is located on the hands, feet, face, groin, buttocks, or a major joint, treat the burn as a major burn.
  7. Make sure the person is up to date on tetanus immunization.

FOR MAJOR BURNS

  1. If someone is on fire, tell the person to stop, drop, and roll. Wrap the person in thick material to smother the flames (a wool or cotton coat, rug, or blanket). Douse the person with water.
  2. Call 911.
  3. Make sure that the person is no longer in contact with smoldering materials. However, do NOT remove burned clothing that is stuck to the skin.
  4. Make sure the person is breathing. If breathing has stopped, or if the person's airways are blocked, open the airways. If necessary, begin rescue breathing and CPR.
  5. Cover the burn area with a dry sterile bandage (if available) or clean cloth. A sheet will do if the burned area is large. Do NOT apply any ointments. Avoid breaking burn blisters.
  6. If fingers or toes have been burned, separate them with dry, sterile, nonadhesive dressings.
  7. Elevate the body part that is burned above the level of the heart. Protect the burn area from pressure and friction.
  8. Take steps to prevent shock. Lay the person flat, elevate the feet about 12 inches, and cover the person with a coat or blanket. However, do NOT place the person in this shock position if a head, neck, back, or leg injury is suspected or if it makes the person uncomfortable.
  9. Continue to monitor the person's vital signs until medical help arrives. This means pulse, rate of breathing, and blood pressure.

DO NOT    Return to top

When to Contact a Medical Professional    Return to top

Call 911 if:

Call a doctor if your pain is still present after 48 hours.

Call immediately if signs of infection develop. These signs include increased pain, redness, swelling, drainage or pus from the burn, swollen lymph nodes, red streaks spreading from the burn, or fever.

Also call immediately if there are signs of dehydration: thirst, dry skin, dizziness, lightheadedness, or decreased urination. Children, elderly, and anyone with a weakened immune system (for example, HIV) should be seen right away.

Prevention    Return to top

To help prevent burns:

References    Return to top

Marx JA, Hockberger RS, Walls RM, eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 5th ed. St. Louis, Mo: Mosby; 2002.

Townsend CM, ed. Sabiston Textbook of Surgery. 17th ed. Philadelphia, Pa: Elsevier; 2004.

Roberts JR, Hedges JR, eds. Clinical Procedures in Emergency Medicine. 4th ed. Philadelphia, Pa: Saunders; 2004.

Update Date: 2/19/2008

Updated by: John E. Duldner, Jr., MD, MS, Assistant Professor of Emergency Medicine, Director of Research, Department of Emergency Medicine, Akron General Medical Center and Northeastern Ohio Universities College of Medicine. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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