Burn Care

What are the different kinds of burns?

A burn can be categorized in three different categories. They are:

• First Degree
  Burn only affects the outer layer of skin (epidermis) and induces swelling and redness. It requires little treatment and subsides without permanent damage. A sunburn is a good example of a first degree burn.
• Second Degree
  Burn affects the epidermis and second layer of skin (dermis). Burn will be reddish in color, swollen, and skin may be peeling from the burn area. If it is not treated properly the burn can become third degree from decreased blood flow and swelling.
• Third Degree
  The outer layer, second layer, and hypodermis are severely damaged. Skin may become charred or turn a translucent white color and the victim may go into shock. Due to the structural damage it will be very slow to heal and susceptible to permanent scarring.

What can cause a burn?

• Thermal Agents:
  – Flames
  – Hot Liquids
  – The Sun
  – Steam
  – Radiation
• Chemicals:
  – Acids
  – Fluids
  – Other Corrosives
• Electricity:
  – Becoming part of an electrical circuit (while grounded)
  – Lightning

What is the first thing I should do if someone I know gets burned?

The first thing you should do is to STOP THE BURNING PROCESS. This should be done in the following way:

• Sunburn/Radiant Heat Burn
  Move patient to a cool place out of the sun or away from the heat source.
• Electrical Burn
  Turn off electricity. Do not touch patient until the electricity is turned off, as you may also get burn/electrocuted.
• Chemical Burn
  Immediately flush with water for 10-15 minutes
• Patient Is On Fire
  Have patient cover up face and STOP, DROP, and ROLL.

What other treatment should be applied to a burn?

The important thing to remember when dealing with burn injuries is that you should never underestimate the seriousness of a burn. You should seek medical help if any doubt exists with regard to the seriousness of a burn.

Cool the burn immediately with cool water to reduce the skin temperature and stop the burning process, numb the pain, and prevent or reduce swelling. Do not use ice on burns as it may decrease the blood supply to the area and may actually make the burn worse.

• Remove burned clothing, metal from belt buckles, etc as these things can continue to burn if they retain heat. Disposable diapers will especially retain heat. Loosen or remove tight clothing, jewelry, or boots before swelling occurs. If burn is over 30% of the total body surface area you may have swelling in an area remote from the burn due to fluid shifts, so remove everything that might constrict.
• After cooling the burn with water, cover the burn with a clean dressing to the burn area. If you don’t have a dressing, cover the burn with a clean t-shirt (never a towel as the fiber can stick in the wound and be painful to remove) or plastic wrap.
• People are usually more comfortable if exposed nerve endings are covered, and also it is important to keep the burn victim warm.
• Get Medical Help! Never underestimate the seriousness of a burn!
• For serious burns don’t give anything to the victim to eat or drink prior to seeking medical attention.
• Elevate burns to the extremities to reduce swelling.

For a person who is burnt around the head there is a danger of an airway injury, as such they must be brought to the hospital immediately if there are singed nasal hairs, burned face, or burns around the mouth. In this case always keep the head elevated.

The harsh vibrating sound heard during respiration in cases of obstruction of the air passages, also known as “stridor” is a potentially fatal sign related with burn victims.

Burn prevention

Newborns

• Install smoke alarms in or near bedrooms, check monthly, and change batteries twice a year.
• Never microwave bottles–it heats unevenly.
• Never leave children unattended while food is being prepared.
• Never store anything flammable on stovetop.
• Never eat or drink hot foods/liquids while holding/carrying an infant.
• Test all warm liquids/foods before feeding.
• Coil/use short electrical cords, do not allow them to dangle.
• Do not use tablecloths.
• Always keep cooking utensils handles turned to back of stove.
• Keep highchairs/chairs/playpens away from stoves and counters.
• Walkers are dangerous, remove wheels or do not use.
• Use safety plugs in all unused outlets.
• Limit time in sun–babies burn easily, use sunscreen (at least 30 SPF).
• Only use cool mist vaporizers, keep them a safe distance from crib.
• Allow three feet between a space heater and anything flammable.
• Keep candles, potpourri, matches, cigarettes, etc., out of reach.
• Run cool water first for tub, then warm until desired temperature.
• Test tub water with wrist, elbow, or special thermometer.
• Face child away from faucet and towards opposite end of tub.
• Set water heater temperature at 120 degrees F.
• Store chemicals/cleaners in original containers and out of reach or locked up.
• Keep baby equipment out of direct sunlight, metal/plastic parts can cause burns.
• Always dress your baby in non-flammable sleepwear.

Toddlers (1-3 years)

• Never leave children unattended in kitchen while food is cooking.
• Never allow a child to stand on chair near the stove while you are cooking.
• Never leave hot iron unattended on ironing board.
• Never store snacks on/above stove, children may try to get them.
• Never leave cigarettes, matches, lighters, etc., in reach of children.
• Never store flammable items on stovetop.
• Never allow electrical appliances in or near bathtub.
• Never leave a child alone in the house.
• Install functioning smoke alarms in/near bedrooms, check monthly, change batteries twice/year.
• Establish a three-foot “No Zone” around all hot appliances: stove, fireplace, barbecue, heaters, etc.
• Do not allow young children to pour or handles hot liquids or food.
• Do no tallow children to play with pots and pans, they cannot tell when they are hot or not.
• Do not use tablecloths; children can pull hot foods, candles, potpourri, etc. onto them.
• Always have shoes on your child when outside; hot sidewalks/sand, cigarettes, campfires, etc. can cause burns.
• Store chemicals/cleaners in original containers and out of reach or locked up. Never store in pop bottlers or other “drink type containers”.
• Install safety plugs in all unused outlets.
• Use button/knob covers for stove.
• Always keep cooking utensil handles turned to the back to stove, use back burners to cook.
• Coil/use short electrical cords, do not allow them to dangle.
• Keep water heater temperature at 120 degrees F.
• Run cool tub first, then add warm until desired temperature.
• Monitor while taking a bath. Do not leave alone.
• Always use sunscreen, (at least 30 SPF) when outside, even on cloudy days.
• Use safety decals on bottom of tub, to prevent falls.
• Do not keep flammable liquids in your home.
• Use only cool mist vaporizers, keep safe distance from bed/crib.
• Use space heaters with auto shut off for accidental tip over.
• Always dress in non-flammable sleepwear.

Preschool-age child (3-5 years)

• Continue adequate supervision.
• Discourage game playing, (hid and seek, tag, etc.) around heat/fire sources: (stoves, heaters, barbecues, fireplaces, etc.)
• Keep matches and lighters out of reach, purchase only child resistant lighters.
• If you smoke, never leave lit cigarettes unattended.
• Begin to educate your child on fire safety, escape routes, and the “stop, drop, and roll” technique.
• Practice/reinforce these with your child, often.
• Do not give hot foods/liquids to your child, allow them to cool.
• Do not carry hot foods/liquids and your child at the same time.
• Do not attempt to carry hot foods/liquids with toddlers underfoot.
• Do not use tablecloths, too easily pulled off.
• Keep fire extinguishers in your home, check the pressure often.
• Be a good role model, children mimic adults.
• Never allow children to handle fireworks.
• Use only flame-retardant/noncombustible costumes for Halloween.
• Teach children that matches/lighters are tools for adults, and when they are older you will show them how to use them properly.
• Always dress in non-flammable sleepwear.

Grade school children

• Teach your child how to call 911 and what to say.
• Instruct your child on using matches and lighters safely and responsibly.
• Begin to instruct your child on safe cooking methods:
  • Wear short or close fitting sleeves to avoid catching on fire.
  • Turn pot handles to back.
  • If grease fire starts: cover the pan, turn off burners, do not try to move pan.
  • Never put water on grease fire.
  • Lift lids away from you, to allow steam to escape.
  • Use oven mitts to move pans/lift lids.
  • No ‘playing around’ while cooking.
• Place microwave at level safe for your child to use.
• Teach microwave safety:
  • Use move mitts to remove items, containers get hot.
  • Stir food before eating, center is hot.
  • Allow popcorn bags to cool a little before opening, then do so away from you.
• Instruct children about coiling cords or using short ones, and the “no dangle” rule.
• Teach children not to ‘warm up’ by or near fireplaces, heaters, or fires.
• Teach your child electrical safety:
  • Do not climb on electrical poles or towers.
  • Do not climb over fences that surround electrical substations.
  • Do not fly kites near electric power lines.
  • Do not attempt to retrieve kite if caught in power lines.
  • Do not climb trees near power lines.
• Teach your child proper use of extension cords: do not overload, do not run under carpets, run behind furniture, etc.
• Use only flame-retardant/noncombustible costumes for Halloween.
• Be a good role model.
• Involve children in planning and practicing safety and fire drills.
• Always dress in non-flammable sleepwear.

Teens

• Allow lawnmower engines to cool before refueling.
• Work on cars outdoors only, gasoline vapors may ignite.
• Never open radiator cap if car overheats, allow to cool.
• Use caution with hair dryers and long hair, hair can be pulled into motor and catch fire.
• Use caution with curling irons.
• Avoid too much sun–use adequate sunscreen and/or clothing.
• Use caution when using hobby glues/finishes, vapors can ignite or cause loss of consciousness.
• Inquire about fire/safety issues for any new job.
• Do not use fireworks.
• Use matches/lighters with caution.
• Never throw aerosol cans in a fire, they can explode.
• Never ignite vapors from aerosol cans, they can explode.
• Never use gasoline to state a fire.
• Never smoke while refueling a car.
• Never smoke while using an aerosol can (hairspray, paint, etc.)
• Always use ashtrays for cigarettes/matches.
• Do not wear loose clothing around open flames.
• No ‘fooling around/fighting’ while cooking.
• Learn what to do when smoke alarm goes off:
  • Yell FIRE! Warn anyone that may be home.
  • Follow pre-planned escape route/s.
  • Do not try to save anything (CDs, jewelry, pets, etc.) except yourself.
  • If you see smoke, keep low, crawl, take short breaths or use wet cloth over nose/mouth.
  • Feel doors, if hot, DO NOT OPEN, find alternate route.
  • Do not re-enter until told to do so by an adult.

I just started babysitting. What should I know to prevent any burns to the children?

• Know contact #’s.
• Ask about escape plan.
• Never leave child alone.
• Don’t smoke.
• Ask about cooking privileges.
• Never carry hot foods/liquids and child at the same time.
• No loose/large sleeves while cooking.
• Never leave child alone in the kitchen.
• Do not allow child under foot while cooking.
• If bathing child, gather all supplies prior to bath.
• Run cold water first, then add warm.
• Test water with wrist/thermometer.
• If you need to leave bathroom, take child with you.

Things to do around the house to protect the family

Electrical outlets/cords

• Do not overload outlets/cords
• Keep safety plugs in unused outlets
• Only one heat-producing appliances (toaster, coffee maker, etc.) per outlet
• Do not run cords under carpets/rugs
• Do not use frayed/broken cords
• Keep cords out of high traffic areas
• Run cords behind furniture

Fireplace/wood burning stove

• Always use a screen
• Small fire only
• No paper or trash, sparks can fly
• Have chimney inspected/cleaned yearly
• Burn only dry, seasoned hardwood
• Remove ashes in metal container, store outside
• Never leave children alone with fire

Smoke alarms

• Test monthly
• Never paint
• Clean frequently
• Install outside all bedrooms
• Install on each level, including basement
• Change batteries twice a year
• Install special units for visual/hearing impaired
• “Chirping” indicates low battery
• Never ‘borrow’ batteries from smoke detectors

Space heaters

• Allow three feet from anything flammable, including walls
• Use only recommended fuel
• Cool before refilling
• Refill in vented area
• Turn off before leaving/going to bed
• Do not use extension cord
• Use electric heater with auto shut off, for accidental tip overs

Kitchens

• Never leave food cooking on stove unsupervised
• Never leave young children alone in the kitchen
• Turn all panhandles to back of stove
• Have fire extinguisher near by, not over stove
• Coil/use short cords on appliances
• Never store flammable items on stove
• Never store snacks on/above stove
• Do not plug appliances into stovetop outlet, cords could catch fire
• Wear short or rolled, tight fitting sleeves while cooking
• Always have a lid handy, in case of grease fires
• Use only rubber-backed area rugs in kitchen
• Fasten oven door so child will not use as step
• Do not use area rugs near stove
• Cook on rear burners

Microwaves

• Never use metal or aluminum foil.
• Do not use glass/ceramic with metal trims, can cause lip burns and/or sparks.
• If fire occurs, unplug, do not open door.
• Never place eggs in shell in microwave.
• Use oven mitts to remove food.
• Never let young children (under 7) remove hot food.
• Use caution when heating jelly donuts, jelly becomes extremely hot.
• Never run when empty.
• Open microwave popcorn bag away from face.
• Always stir food before serving, there may be hot spots.
• Always check food temperature before giving to young children.
• Use only microwave safe containers.

Bathrooms

• Bath time is not playtime
• Water temperature: no more than 120 degrees.
• Do not leave child alone.
• Run cold water first for tub, then warm.
• Check with thermometer/wrist, prior to tub.
• Face child away from faucet.
• Have clearly marked Hot/Cold faucets.
• Do not leave personal appliances with Ground Fault Circuit Interrupter (GFI), will disconnect if dropped in water.
• Never use space heater in bathroom.
• Keep chemicals (cleaners, hair dyes, etc.) in original containers and out of reach.
• Dry hands before touching electrical appliances.
• Install slide-bolt latch on upper, outside bathroom door, to keep toddlers out and safe.

Miscellaneous

• Burn candles in appropriate containers only.
• Set Water Heater temperature at no more than 120 degrees.
• Do not flush toilets or run other water sources, while shower is in use.
• Wet contents of ashtrays before disposing.
• Never store gasoline in your home.
• Always store chemicals in the original containers, keep out of reach of children.
• Never use gasoline as a cleaner or remover.
• Never prime a carburetor with gasoline.
• Keep baby equipment out of direct sunlight.
• Have furnace and chimney inspected/cleaned yearly.
• Use Cool mist vaporizers only and keep safe distance from bed/crib.
• Use charcoal lighter fluid to soak charcoal, never re-soak after lighting.
• Never use gasoline for charcoal.
• Have water source nearby with any open burning.
• Never allow children around an open fire.
• Purchase only non-flammable sleep wear.
• Wear shoes/sandals outside: cigarettes, sand, pavement, asphalt, tar, etc. can call cause burns.
• Never carry gasoline in your trunk.
• Seat belt buckles get hot, can cause contact burn.
• Overnight guest should be made aware of fire exit plan.