burns%20-%20initial%20management
BURNS - INITIAL MANAGEMENT
Thermal burns are burns due to external heat sources that raises skin and tissue temperature causing tissue cell death or charring. Flame is the most common type of burn. Inhalation injury is found in 30% of victims of major flame burns.
Chemical burns are due to strong acids, alkalis, detergents or solvents coming into contact with the skin. Tissues are damaged by protein coagulation or liquefaction rather than hyperthermic activity.
Electrical burns are due to electrical current or lightning coming in contact with the body.
First degree burns or superficial burns appears similar to sunburn that is painful, dry, swollen, erythematous without blisters and involves only the epidermis.
Second degree burns or partial-thickness burns has appearance of moist blebs, formation of vesicle and blister; underlying tissue is mottled pink and white with good capillary refill; this involves the entire epidermis and a variable portion of the dermal layer.
Third degree burns or full-thickness burns appears dry, leathery eschar, mixed white waxy, khaki, mahogany and soot stained. It involves the entire epidermis and dermis, leaving no residual epidermis cells, may include fat, subcutaneous tissue, fascia, muscle and bone.

Parental Education

  • Advice parents on home wound care
    • Clean burn at home at least twice daily with soap & water to remove left over creams from previous application, & change dressings at least once daily
    • Apply topical antibiotics & give oral pain medications
  • The aim of preventive education is continuing reduction in the number of serious burn injuries
  • Educate parents on how to prevent fires
    • Use smoke detectors
    • Discourage cigarette smoking
    • Control of hot water thermostat
    • Learn to use fire, matches, lighter to prevent injury
  • Educate parents & caregivers in preventive burn injury measures
    • Roll, not run, if clothing catches fire, or wrap in blanket
    • Practice escape procedures during a fire incident
    • Crawl beneath smoke if caught indoors during a fire
    • Use flame retardant clothing & toys
  • Educate parents & caregivers on emergency treatments prior to seeking medical consult
    • Thermal burns
      • Cooling burn injuries with cold water or cold compress, avoid ice or ice water especially for large burns because it will cause hypothermia
      • Leave burn blisters intact
      • Do not apply any ointment, oil or spray to the burned area
    • Chemical burns
      • Irrigate affected skin or eyes with tap water
      • If chemical is in powder form, wipe off the powder from affected skin
      • Remove contaminated clothing
      • Cover burn area loosely with dry, clean cloth
    • Electrical burns
      • Unplug the device that caused the burn injury; do not touch the child in contact with the electric current until you turn off the circuit breaker
      • Determine if the child is breathing & initiate cardiopulmonary resuscitation (CPR) if necessary
      • Cover the burned area with sterile gauze bandage or clean bed sheet & keep the child warm
      • Do not give the child anything to eat or drink
  • Advise close follow-up
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