Last Updated October 11th, 2019
What is a burn?
The injury of a part of the body when it is exposed to a fire is called a burn. Burns are very common in today’s world, what with the number of flammable substances around. Moreover, once a person gets a burn, the doctor must keep a weather eye on it to ensure that it does not lead to an infection that cannot be managed. Burns can be restricted to the surface of the skin or may go deeper. Burns are classified into different types depending on their severity. They can be classified as first, second, and third degree burns.
What is a first-degree burn?
A first-degree burn causes very little damage and affects only the outermost layer of the skin. The person will have symptoms such as redness of skin and minor inflammation and swelling. As the burn heals, there will be a slight peeling of the skin. First-degree burns usually heal within 7 to 10 days. Usually first-degree burns will resolve with home care. They will heal the sooner they receive care for them.
What is a second-degree burn?
A second-degree burn affects not just the outermost layers of the skin but beyond that. It causes the skin to blister and become red and sore. The blisters may sometimes pop leading to wetness around it. With time, thick, soft fibrinous exudate tissue will start to cover the wound.
What is a third-degree burn?
Third-degree burns are the most severe kind of burns after fourth-degree burns. The burn moves slowly through the skin and affects several layers of it. Third-degree burns may not cause as much pain as some people believe only because of excessive nerve damage. They cause symptoms such as:
- Waxy and white skin color
- Blisters that do not develop
- Charred skin
- Raised texture of skin
- Dark brown color in the area of the burn
Treatment of Burns
The treatment of burns is determined by the extent (degree) of the burn. The treatment methods and urgency for first, second, and third degree burns are all different.
Treatment of first-degree burns
Hospitalization is not required for a first-degree burn. These burns are treated at home and heal fast if proper care is taken. Some of the things that you must do are:
- Hold the burnt area under cool running water for 15 to 20 minutes and dress it up after that.
- Treat the area with creams such as aloe vera or antibiotic ointments
- Apply lidocaine (an anesthetic)
- Take over-the-counter pain medications such as acetaminophen
Treatment of second-degree burns
Depending on how bad the blisters are, the longer the burns will take to heal. With increase in severity and surface area of the burn, skin grafting may be required. This means that for a larger surface area burn that affects your face, hands, groin, feet, or buttocks you must seek immediate medical care. You must consult a doctor.
The emergency first aid that you can do for a second-degree burn includes the following:
- Cool the burn by keeping it under running water
- Remove rings and other jewelry from the burn area before it starts to swell, making it difficult to remove them later.
- Apply aloe vera cream and an antibiotic ointment once the wound has cooled.
- Take medications such as ibuprofen and acetaminophen for the pain.
- Bandage the skin with sterile gauze. The bandage will help reduce pain, stop air from reaching the burn, and protect the skin that has been blistered.
Treatment of third-degree and severe burns
Ultrasound mist therapy
Ultrasound mist therapy may be used to clean and stimulate the tissue.
Fluids for rehydration
Pain and anxiety medication
A healing burn can lead to a lot of pain. This means that pain medications such as morphine must be administered, especially when removing the dressing from the wound. Sometimes anti-anxiety medications may also be necessary to manage patient distress. This is because the burn may cause anxiety in the patient.
Ointments and burn creams
If your burns are not severe, you will not be transferred to a burn care center. Certain ointments such as bacitracin and silver sulfadiazine will be applied on the burn area. These ointments and creams will help close the wound and largely reduce the risk of infection.
Antibiotics may be injected intravenously if you develop an infection.
A tetanus shot may also be recommended to fight tetanus infection, if there is any.
Physical and occupational therapy for a burn
In some cases, the burn area is very large and may cover a number of joints. Physical therapy is recommended in such cases to ensure that the skin over the joints remains flexible. If muscles are affected, a separate set of exercises may be recommended. These could improve the strength of muscles and their coordination.
Sometimes daily activities at work may be a problem. In such cases, occupational therapy helps the patient cope with the difficulties introduced by the burn. The patient can learn how best to adjust at his workplace so that he continue to work in his present condition.
Surgical and other procedures of treatment
Insertion of tube into windpipe
In severe burn cases, your throat may swell and shut. This means that the air supply will be cut to your lungs. The doctor will then insert a pipe into your throat so that normal breathing can continue.
Easing blood flow around a wound
If a scab goes completely around a limb, it can stop blood circulation. If it goes around the chest, it can cause breathing difficulties. Sometimes the doctor will have to cut the scab to provide relief.
Skin grafting is done to replace the scarred skin with healthy skin. The skin that is used is from other parts of the patient’s body or from a donor. It could be used from other animals such as pigs as well.
Plastic surgery or reconstruction is done to reduce the effect of scarring and also to restore the flexibility of joints.
How is burn pain managed?
Burn pain is difficult to manage because it can be intense and last for a short period of time or in some cases it could last a very long time. In addition to this, the pain when the dressing is removed is also quite intense and will require proper management. With severe burns, treatments that are more aggressive are necessary.
Opioids such as morphine are used and given intravenously to the patient. The non-pharmacological approaches to pain include the use of recreational equipment such as TV and radio. Though hypnosis is sometimes used for the management of pain in burn victims, a study showed that its use is quite limited still.
Sedatives are also used sometimes. Examples of sedatives used are midazolam and propofol. They also help reduce anxiety in addition to helping the patient sleep. Dexmedetomidine is also used at times to prevent the occurrence of delirium.
Several complications can arise if a burn is not treated well. There is a risk of infections, blood loss, and shock mostly in third degree burns. The risk of infections comes from the fact that the skin is broken. This makes it easier for the bacteria to make their way beneath the skin and travel into the bloodstream.
One such bacterial infection is tetanus. The bacteria responsible for tetanus travel through the nervous system affecting the contraction of muscles in your body. You must receive a tetanus shot every 10 years to make sure that you never have this bacterial infection.
Severe burns also lead to hypothermia and hypovolemia. Hypothermia is a medical condition in which the body temperature dips to dangerously low levels. This happens because of the loss of heat because of a burn injury. The loss of blood due to a burn leads to a condition in which the body’s blood levels are reduced. This is called hypovolemia.
Home Remedies that actually do not work for a burn
Many home remedies that are traditionally believed to work for a burn may not actually work. They are the result of speculations. They are not explained by science and have no evidence to support their use. Some of these remedies are:
Bread and butter sounds good; burn and butter not so much. Do not use this daily breakfast item on your burns. It could do you more harm than gain. There is no evidence to prove that butter helps. In fact it may contain bacteria that may enter the open wound and cause infection if applied on a burn.
Eggs are another breakfast item that is best reserved for your tummy. Avoid using eggs on a burn for quite the same reason as butter. Uncooked eggs will contain bacteria that are very harmful and can cause an infection.
Coconut oil is healthy. However, should you use it on a wound? The simple answer is no. The reason is that there is no evidence to support it. In addition, it might actually cause the burn to become more severe.
There is a belief that lavender oil helps to treat a burn. However, there is no serious evidence to show that this is true. In the absence of evidence, it is better not to use essential oils, especially when there is a burn and you cannot say how the burnt area will react to it. There could also be an allergy when it comes to essential oils, which can cause further irritation in the burn area
This is a very popularly recommended remedy, which is actually very bad for your body. Contrary to popular belief, using ice on a burn does not help. It can actually cause more damage to the nerves than is already there. It can also cause irritation on the skin and a cold burn if used.
Treat the burn the right way
When you treat a burn the right way, you end up saving a life and the quality of life for those who survive. The important thing is to understand the severity of the burn before you administer any kind of first aid. Some burns such as third and fourth degree burns will require that you contact emergency care immediately and rush the patient to the hospital. Specialized care would be necessary at the hospital and even surgical procedures may be required.
It is also necessary to avoid certain home remedies for burns that are born of the speculative mind and have no scientific basis. Some of these are the use of eggs, butter, coconut oil etc. to treat burns. These will actually do more harm than good. In some cases, they might increase the severity of the burn and in others they may lead to bacterial infections.
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