One of the most familiar household accidents particularly among children is burns. Burn means more than burning feeling related to this injury. Burns is distinguished by extreme damage to the skin that leads to the damaged skin cells to deteriorate.

Based on the underlying cause and degree of damage, most individuals may heal from burn injuries without significant health outcomes. To avoid injuries and death, more extreme burns need urgent emergency medical treatment.

The treatment of burns is based on the location and extremity of the injury. Sunburns and minor scorch may typically be handled at home. Deep or widespread burns require medical attention immediately. Some patients require care at specialized burn centers and months-long follow-up care¹.

Levels of Burns

Three levels of burns are there; first, second, and third-degree. Each degree is dependent on the extremity of skin injury, with the minor being the first degree, and the most extreme being the third degree. Damage includes:

• First-degree burns consist of red, non-blistered skin
• Second-degree burns consist of blisters and skin gets thick.
• Third-degree burns consist of thickness all over the skin with a white and leathery appearance.
• Fourth-degree burns are also there. This form of burns has symptoms similar to third-degree burns and it penetrates deep into the skin, tendons, and bones.

Burns can be caused by various reasons, like:

• Scorching from hot, boiling fluids
• Chemical burns 
• Electrical burns
• Fires consist of flames from matches, candles, and lighters.
• Extreme exposure to sun²

The form of burn is not dependent on its source. For example, scalding is based on how hot the fluid is and how long it remains in touch with the skin and can cause all three burns.

Burns caused by chemicals or electrical means require emergency medical care because even though skin harm is minimal, they can impact the inside of the body.

 

Symptoms of Burn

Burn symptoms differ based on how serious the skin is damaged. The effects of the serious burn will take a day or two to develop.

• First-degree burn: Only affects the epidermis that is the outer layer of skin. It may lead to pain or redness.
• Second-degree burn: This form of burn impacts the epidermis as well as the second skin layer (dermis). Swelling and red, white, or mottled skin can be caused by it. It can produce blisters, and pain may be intense. Scarring may be caused by intense second-degree burns.
• Third-degree burn: This burn extends under the skin to the fat layer. The areas damaged can be black, brown, or white. The skin can have a leathery appearance. Nerves may be damaged by third-degree burns, producing numbness³.

 

Problems associated with burns

Third-degree burns pose the greatest risk of injuries, such as infections, loss of blood, and shock, which can also result in death as compared to first- and second-degree burns. At the same point, since bacteria may get into damaged skin, all burns carry the risk of complications.

With burns of all types, tetanus is another potential issue. Tetanus is a bacterial infection just like sepsis. It stimulates the nervous system, posing a higher risk with muscle contractions. As a general rule, to avoid this form of infection, each family member should get updated tetanus shots every 10 years.

The possibility of hypothermia and hypovolemia is also present in serious burns. Hypothermia is characterized by critically low body temperatures. Although this may sound like an unexpected consequence of a burn, an extreme loss of body heat from an injury potentially triggers the problem. Hypovolemia, or low blood volume, happens when a burn causes the body to lose too much blood⁴.

 

Burns treatment or management

Based on the cause and extremity, burn care differs. Depending on the complexity of the injuries, you have to keep all the burns clean and use appropriate bandages/dressing. It is necessary to manage the pain of the individual: insufficient management will intervene with wound treatment.

Continue to monitor injuries for any indication of infection and other long-term complications such as scarring and tightening of the skin around the muscles and joints which cause difficulty in walking.

 

• Treatments include:

Burn treatment is usually based on the kind of burn;

• Skincare products such as Aloe Vera cream or an antibiotic ointment and pain relief medicines as acetaminophen (Tylenol) are normally used to treat first-degree burns.
• Antibiotics creams or other ointments or creams recommended by the healthcare professional are used to treat second-degree burns.
• More intensive treatment is required to treat third-degree and fourth-degree burns such as: intravenous antibiotics to avoid any bacterial infection or IV fluids to restore the fluids lost during the burning of the skin. Skin grafting or using synthetic skin may also be appropriate for them⁵.
   

1. First-degree burns: Pour cool water over the burn injury. Ice should not be applied. Aloe Vera gel is applied over sunburns. Antibiotics are used for thermal burns and these burns are covered with gauze. For these type of burn, you can also use over the counter pain killers.
2. Second-degree burns: Second-degree burns are usually treated the same way as first degree burns. A better antibiotic cream that consists of silver, like silver sulfadiazine, could be recommended by your healthcare professional to kill bacteria. Pain and inflammation can be minimized by alleviating the burned area.
3. Third-degree burns:  Burns of the third degree may be lethal and frequently involve grafts of the skin. Skin grafts cover infected tissue with a healthy portion of skin from another portion of the uninjured part of the patient's body. The region from where the skin graft is obtained normally recovers on its own. A temporary source of the graft may come from a deceased donor or a human-made (artificial) source if the patient does not have sufficient skin for a graft at the time of burn, but they will gradually need to be replaced by the patient’s skin. Treatment often requires additional fluids (usually supplied intravenously, through an IV) to maintain blood pressure and avoid shock and dehydration⁶.

 

First-aid for minor burn

• Stop burning. For at least 5 minutes, cool the burn with flowing cool (not cold water). Do not over-cool the person! Stop the cooling procedure if the person begins to shiver.
• Remove jewelry and clothes from the damaged area immediately.
• Over-the-counter pain killers such as acetaminophen or ibuprofen must be administered to reduce pain.
• Applying Aloe Vera products is calming and a safe option for burn regions without blisters. A topical antimicrobial, i.e. Bacitracin or Triple Antibiotic Ointment, and a bandage or Band-Aid gauze cover can be used for burn regions with blisters.
• A sterile gauze bandage or a clean piece of cloth covers the burn area. Cover the burn area lightly to avoid any pressure on the damaged tissue.

Seek medical treatment if the patient encounters the following:

• A recurrent fever that is not alleviated by medicine
• Redness that can reach beyond the burn's boundary
• A pain that is not managed by acetaminophen or ibuprofen
• Please ensure that if the patient seems to be dehydrated, then the patient needs to drink plenty of fluids in order to stay hydrated⁷.

 

References:

1. Burns: Types, Treatments, and More. [Internet]. [Cited 2020 December 1st]; Available https://www.healthline.com/health/burns/
2. Burns: Types, Treatments, and More. [Internet]. [Cited 2020 December 1st]; Available https://www.healthline.com/health/burns#firstdegree-burn/
3. Burns. [Internet]. [Cited 2020 December 1st]; Available https://www.mayoclinic.org/diseases-conditions/burns/symptoms-causes/syc-20370539/
4. Burns: Types, Treatments, and More. [Internet]. [Cited 2020 December 1st]; Available https://www.healthline.com/health/burns#complications/
    
5. Burns. [Internet]. [Cited 2020 December 1st]; Available https://www.webmd.com/pain-management/guide/pain-caused-by-burns#1/
6. Burns: Management and Treatment. [Internet]. [Cited 2020 December 1st]; Available https://my.clevelandclinic.org/health/diseases/12063-burns/management-and-treatment/
7. Emergency Care for Burns. [Internet]. [Cited 2020 December 1^st]; Available http://brc.iaff.org/phone/emergency-care-for-burns.html/

 

 

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