Burns & Scalds

Burn injuries can be classified by their type and depth. The size of burns is expressed as a percentage of total body area.

Types of burn

Scald – caused by a hot liquid
Friction – caused by rough surfaces, e.g: carpet
Radiation/sunburn
Electrical – will have an entry burn and an exit burn
Chemical
Dry – touching hot objects, e.g: a cooker.

Depths of burn

Superficial (1st degree) – this is when only the top layer of skin has been damaged. These are the most minor burns. Often the only sign is a reddening of the skin. Minor sunburn falls into this category of burns.

Partial thickness (2nd degree) – these burns cause blisters in the skin due to the damaged tissue releasing fluid.

Full thickness (3rd degree) – this is the most serious type of burn. In a full thickness burn, every layer of the skin has been affected and the underlying bone, muscle or fat may have also been damaged.

Assessment of burn size

Correctly estimating the size of the burn is important. Burn area is measured as a percentage of total body surface area.

There are two techniques which can be used:

Palm of hand: roughly speaking, the palm of the victim’s hand will be approximately 1% of their body surface area
Rule of nines (see image)

Burns in the region of 10% of body area are serious and may produce severe shock.

First aid for a minor burn

Step 1: Immediately run the burn under cold running water for a minimum of 10 minutes. If running cold water is not available then improvise! You can use other non-toxic liquids such as drinks. Your aim is to cool the burn.

Step 2: Expose the affected area and if possible remove anything that could be constricted (watches, jewellery etc.). Do not remove clothing sticking to the burn, instead cool through the clothing.

Step 3: After cooling the burn, cover with a non-fluffy dressing/covering. If you have access to a first aid kit, use a non-fluffy sterile dressing. If not then improvise with whatever is available (plastic bag, kitchen clingfilm, teatowel etc.). Be careful not to constrict the burn!

Step 4: Seek medical advice for anything except the most minor of burns. Call an ambulance if serious or if the burn is near the face/neck.

What not to do

Do not try to remove clothing sticking to a burn, instead cool through the clothing
Do not apply toothpaste/butter/creams to a burn. Running water is the most effective cooling method.
- Exception: “Aftersun” lotion is useful for sunburn
Do not burst any blisters
Do not stop cooling before 10 minutes is up!

Chemical burns

There are a wide variety of chemicals and substances which can cause chemical burns. These can range from household chemicals such as bleach, cleaning products, and pesticides to strong industrial chemicals used in the workplace. Chemical burns can be incredibly serious as the chemical will keep damaging the skin and tissue until it is removed.

Step 1: Check for any dangers to yourself. The chemicals that caused the casualty’s injuries could also pose a danger to you. Try to establish what caused the burn and how safe the chemicals are. If you are in an enclosed area, move the casualty outside or open windows to prevent the build-up of fumes. Wear disposable gloves.

Step 2: Cool the burn with copious running water for at least 15 – 20 minutes. Ensure that you do not come into contact with the water used to cool the burn as it may contain the harmful chemical.

Step 3: If any clothing has come into contact with the chemical, it should be removed providing it isn’t sticking to the burn. Try to identify the chemical involved and its container.

Step 4: Cover the burn with a sterile, non-fluffy first aid dressing. If no dressing is available, then improvise. Good items to use include cling film and plastic bags.

If the burn is serious, the casualty shows signs of shock or the casualty becomes drowsy/loses consciousness then call an emergency ambulance immediately. If a large chemical spill has occurred then also ensure the fire brigade and police have also been informed.

If you become exposed to the chemical involved then you should seek medical advice immediately.

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