According to the CDC, over 1 million people a year are reported to have burns that require medical attention. These burns can come from a lot of different factors, from thermal burns like exposure to a heat source, or from chemicals.
With the rioting and looting going on in America today, the Molotov Cocktail is seeing a come back and understanding how to care for a burn patient might be important.
Let’ s first examine the 3 classifications of burns.
1st Degree Burns
1st degree burns are the least severe and are usually seen as a reddening of the skin like you might see with a bad sunburn. 1st degree burns aren’t life threatening, but can be painful as I’m sure you’ve probably experienced. While this burn is not immediately dangerous, repeated over exposure to 1st degree sunburns can cause serious skin cancers. So, make sure to protect yourself and loved ones when outdoors.
This burn is also known as a “Superficial” burn because only the top layer or, “Superficial” layer of skin is damaged and affected.
2nd Degree Burns
The easiest way to tell a 1st from a 2nd degree burn is to look for blistering. The blistering is the body’s attempt to protect itself by flooding the area with water to help cushion the wound from further injury.
DON’T POP THE BLISTERS. This is strongly discouraged by modern medicine so leave them alone. By popping the blisters we would be reducing the amount of protection to the wound and opening up an entry point for infection since the skin is compromised. The blisters might look ugly but popping them doesn’t do anything positive for the casualty.
This type of burn is also known as a “Partial Thickness” burn because multiple layers of the skin have been damaged.
3rd Degree Burns
Also known as “Full Thickness” burns, is the worst classification of this type of injury. It’s identified by looking for charring, white or blackened tissue like you’d see on chicken skin that’s been on the BBQ for too long. It’s called a “Full Thickness” burn because all layers of the skin have been severely damaged.
With damage this bad, there is unlikely to be any pain at center of the burn because the nerves have been destroyed, but the surrounding areas where the nerves are still intact will be extremely painful.
Why Burns are Bad
1st and 2nd degree burns are not especially dangerous because it’s only the top layers of skin being damaged. The skin is able to repair itself and get rid of the damaged tissue which is why you see a sun burn peel. The dead skin is falling away, and bright new skin underneath is coming to the surface.
3rd degree burns, however, will require expert medical attention for the casualty to make a full recovery. Full Thickness burns damage all layers of the skin and the tissue underneath and can cause serious complications.
The skin is the first and primary way the human body keeps out bacteria, and when damaged, the open wound is more susceptible to infection. This is why even small burns should be treated like a laceration or abrasion. Make sure you are keeping the burn clean and changing the bandage frequently to help prevent infection from taking over.
Since thermal burns are caused by exposure to a heat source, there is a loss of water at the wound site. The water in your body is essentially being cooked out. Burn victims can become severely dehydrated so make sure to encourage an increased consumption of water to combat the loss of fluid.
This is a burn that wraps completely around the appendage or torso of the casualty.
When exposed to high temperatures, the skin contracts, or tightens, and loses its elasticity. Almost like it turns to leather. This is bad because as the swelling sets in under the skin, the skin doesn't stretch to accommodate the increase of fluid. The pressure builds until blood flow is compromised to the point where the casualty's own skin acts like a tourniquet.
If the burn is around the torso, or trunk, of the casualty they might not be able to take a deep breath because the skin is so tight and rigid. This can severely limit their ability to take in enough oxygen and could lead to death if left untreated by a surgeon.
Burns to the face are especially dangerous. Not only is it potentially disfiguring long term, but facial burns can mean that the casualty has an inhalation injury, badly damaging the tissue to a structure that’s essential for survival, the airway.
A key component to emergency trauma is managing the casualty’s airway. If they can’t breath in oxygen they die, and since their airway has been burned, swelling and damage can be life threatening.
Inspect the casualty’s face closely for signs of damage. Look for singed eyebrows, or facial hair, then look to see if there’s any blistering around the nose and mouth. This might indicate a serious injury and they need to be seen by doctors immediately.
Burns to the Hands and Feet
Burns to the hands, feet, or any joint, can have bad long-term effects. Small scars are not usually a problem, but large scars like you might expect with a burn, can severely restrict the movement of joints.
This is seen most often with burns to the hands. Hands are incredibly complex structures capable of very intricate and delicate movements. But, if there’s an excess of scar tissue, each joint is locked into position and joint articulation is lost, either partially, or completely. The hand is essentially frozen by scar tissue and becomes unusable.
Now that we understand thermal burns and what makes them dangerous, next week I’ll go into how to treat a burn in an emergency/first aid setting and some considerations for chemical/electrical burns.
You can purchase North American Rescue burn dressings here.