Alternate Names: Second degree burn; First degree burn; Third degree burn

Considerations: Before giving first aid, consider how extensively burned the victim is and try to determine the depth of the most serious part of the burn. Then treat the entire burn accordingly. Knowing how the burn occurred is helpful, since different sources cause different types of burns. If in doubt, treat it as a severe burn.

Giving immediate first aid before professional medical help is received may lessen the severity of the burn. prompt medical attention to serious burns can help prevent scarring, disability, and deformity.

If the burn does not heal normally, get medical advice. For extensive but superficial burns, keep dressings clean and dry and change them as needed. If signs of infection develop get medical help immediately. Signs of infection include increased pain, redness, swelling, drainage from the burn, swollen lymph nodes, or red streaks spreading from the burn toward the heart. Make sure the victim is up-to-date on tetanus immunization.

Victims under age 4 or over age 60 have a higher incidence of complications and, consequently, a higher death rate.

Burns on the face, hands, feet, and genitalia are most serious, because of possible loss of function.

Causes:

• Thermal burns, the most common type, are frequently the result of residential fires, automobile accidents, playing with matches, improperly stored gasoline, space heaters, electrical malfunctions, or arson.
• 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.
• Airway burns can be caused by inhaling smoke, steam, superheated air, or toxic fumes, often in a poorly ventilated space.
• Other causes include improper handling of firecrackers, scalding accidents, and kitchen accidents (such a child climbing on top of a stove or grabbing a hot iron).
• Burns in children are sometimes traced to parental abuse.

Symptoms:

• blisters
• pain (the degree of pain is not related to the severity of the burn; the most serious burns can be painless.)
• peeling skin
• red skin
• shock (watch for pale and clammy skin, weakness, bluish lips and fingernails, and decreasing alertness.)
• swelling
• white or charred skin

• charred mouth; burned lips
• burns on the head, face or neck
• difficulty breathing; coughing
• singed nose hairs or eyebrows
• dark, carbon-stained mucus

Do Not:

• DO NOT apply ointment, butter, ice, medications, fluffy cotton dressing, adhesive bandages, cream, oil spray, or any household remedy to a burn. This can interfere with proper healing.
• DO NOT allow the burn to become contaminated. Avoid breathing or coughing on the burn.
• DO NOT disturb blistered or dead skin.
• DO NOT give the victim anything by mouth, if there is a severe burn.
• DO NOT apply cold compresses and do not immerse a severe burn in cold water. This can cause shock.
• DO NOT place a pillow under the victim’s head if there is an airway burn and he or she is lying down. This can close the airway.

Call If:

• the burn is extensive or severe.
• there is a chemical or electrical burn, or if there is uncertainty about the burn’s severity.
• the victim shows signs of shock.
• the victim has an airway burn.

First Aid: 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 (not ice water) bath. Keep the area submerged for at least 5 minutes. However, if the burn occurred in a cold environment, do not apply water. A clean, cold, wet towel will also help reduce pain.

2. Calm and reassure the victim. Burns can be extremely painful.

3. After flushing or soaking for several minutes, cover the burn with a sterile bandage (if available) or clean cloth.

4. Protect the burn from pressure and friction.

5. Over-the-counter pain medications may be used to help relieve the pain; they may also help reduce inflammation and swelling.

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 occurred on the hands, feet, face, groin, buttocks, or a major joint, then treat the burn as a major burn (see below).

FOR MAJOR BURNS:
1. If someone is on fire, either douse him or her with water if it is available, wrap the victim in thick, non-synthetic material such as a wool or cotton coat, rug, or blanket to smother the flames, or lay the victim flat and roll him or her on the ground. If your clothes catch fire, STOP, DROP, and ROLL.

2. Do not remove burnt clothing (unless it comes off easily), but do ensure that the victim is not still in contact with smoldering materials.

3. Make sure the burn victim is breathing; if breathing has stopped or if the victim’s airway is blocked then open the airway and if necessary, begin rescue breathing and CPR.

4. If breathing is not a problem, cover the area of the burn with a cool, moist sterile bandage (if available) of clean cloth (do no use a blanket or towel; a sheet will do if the burned area is large). Do not apply any ointments. Avoid breaking burn blisters.

5. If fingers or toes have been burned, separate them with dry, sterile, non-adhesive dressings.

6. Elevate the burned area and protect it from pressure and friction.

7. Take steps to prevent shock. Lay the victim flat, elevate the feet about 12 inches, and cover the victim with a coat or blanket. Do not place the victim in the shock position if a head, neck, back, or leg injury is suspected or if it makes the victim uncomfortable.

8. Continue to monitor the victim’s vital signs (pulse, rate of breathing, blood pressure) until medical help arrives.

Prevention: In the U.S., about 2 million people suffer burns each year. Of these, 300,000 are burned seriously and over 6,000 are fatalities, making burns this nation’s third largest cause of accidental death.

To help prevent injuries from burns:

• Install smoke alarms in your home.
• Take time to teach children about the proper fire safety precautions, fire escapes, and the hazards of matches and fireworks.
• Know and practice fire escape routes.