How to Treat a Burn
Estimated reading time: 6 minutes
Accidents can happen at any time and quite often the longer term consequences of an accident are entirely dependent on the initial action taken to treat any wounds or injury. In this blog we will take a look at burns, what types of burn there are, their “grading” and how to treat them.
Table of contents
What types of burns are there?
Burns can be caused in several ways such as:
- Thermal burns caused by either hot or cold sources. These can be flames, friction, hot metals, scalding liquids and steam or ice and other chilling materials, for example.
- Radiation burns caused by exposure to radiation sources such as ultra-violet rays from the sun
- Chemical burns caused by exposure to acids or alkalis
- Electrical burns caused by exposure to both AC and DC electrical currents.
Structure of the skin
The skin is made up of three main layers:
- Epidermis. This is the very outer layer made up of the outer Stratum Corneum layer, the Keratinocytes layer and the basal layer.
- Dermis. This is the middle layer which contains things like the blood vessels, sweat glands and the nerve endings
- Subcutis. This is the deepest layer and contains collagen and fat cells.
Burns are classified in three grades:
- Superficial burns, traditionally known as “1st degree”, only affect the epidermis. Typically, these would be red and painful but with no blistering. An example of this would be sunburn.
- Partial thickness burns, traditionally known as “2nd degree”, are those that penetrate into the dermis. The skin would be red, painful, potentially swollen and blistered.
- Full thickness burns are those which were traditionally known as “3rd degree” or “4th degree” burns. These penetrate all the layers of the skin. Typically these leave the area white or charred with no sensation at all because the nerve cells have been destroyed. Deeper burns which go on to affect muscles, tendons and bones are included in this category as they penetrate fully through the skin and beyond.
How to treat a burn
Quick action is really important when treating burns to prevent them from getting worse. The first thing to do is to remove the source of the burn immediately, but without putting yourself at risk. You many need to help the person to ‘stop, drop and roll’ if their clothing is alight.
If electricity is involved, make sure it’s turned off before touching the casualty. Remember that higher voltages have the ability to arc through the air and potentially electrocute others.
Remove any jewellery or tight clothing, but only if the item is not stuck to the burn itself. Removal of jewellery or tight clothing is important because, if the area swells it can become constricted and cause further issues.
Cool the burn with cool, ambient or lukewarm water (not cold) for at least 20 minutes (no maximum time limit). This increases to 40+ minutes if the burn has been caused by a chemical. If the chemical was in powder form when it caused the burn, ensure that the powder is brushed off before cooling with water. The last thing that you want to do is create a chemical paste.
Note that cooling the burn will only be of benefit if it’s started within 3 hours of the burn occurring. Never use ice or iced water to treat a burn as this can cause further damage and remember to warm the patient while you cool the burn. Cooling someone’s skin will also lead them to cool rapidly, potentially leading to hypothermia. This is especially important in infants and children as they have a lower thermal mass in comparison to their surface area.
After you’ve cooled a burn
Once the burn has been cooled, gently cover it with a layer of polyvinyl chloride film (clingfilm), but only on burns away from the face. Any facial burns should be covered with a proprietary facial burns water gel dressing. Note that any burns dressing shouldn’t be allowed to dry out as this will likely cause complications later. Instead, keep hold of any spare cooling agent found in the packet of the dressing for application to the dressing once it starts to dry out.
Clingfilm on burns
Applying a layer of clingfilm, or facial burns water gel dressing, will help to protect the burn from infection. It will also reduce any moisture evaporation from the skin, and hence the heat loss and pain. The cooling effect of the water or facial burns water gel dressing will also act as pain relief and will decrease the swelling (inflammatory reaction) associated with the injury.
Do not wrap clingfilm around the burnt area. Instead, it should be layered onto the wound, ideally only one or two layers thick (i.e., where the clingfilm overlaps). Wrapping the clingfilm around the burnt area may have a tourniquet effect as the swelling continues. If the burns are to the fingers/thumbs, consider placing sheets of clingfilm between the fingers to prevent them from adhesion to the adjacent digit.
The good thing about clingfilm is that it does not stick to the burn. This makes it easy to remove once professional medical assistance has been sought. Any pain can be treated with paracetamol or ibuprofen.
Once the basic treatment has taken place, for more serious burns, contact 111 for advice or take the injured party to the hospital for professional treatment. These would include;
- Burns to the hands, face, feet or genitals
- Burns that surround a limb or the torso
- Any full thickness burns
- Partial thickness burns (e.g., blisters) that are bigger than a 50 pence piece
- Superficial burns that are bigger than 5 of the patients closed hands. (i.e., the area they can cover with the flat of their hand)
- Any size of burns of mixed thicknesses
At Chris Garland training we offer several first aid courses. These are designed to give you the skills you need to deal with most basic injuries requiring first aid. If you are not sure which is most appropriate for you, please do contact us. We’re happy to work with you to understand your needs and advise you on which of our courses best suits your needs.