Contact with hot drinks, food, fats and cooking oils was the most common cause of thermal injuries however explosions, chemical burns, contact with fire, smoke or flames and exposure to light and radiations can also cause burns. All burns require immediate first aid treatment. Burns can lead to functional, aesthetic and psychological effects. If there is significant skin loss there is risk of infection.
A burn is a skin lesion which sometimes affects underlying tissue. There are four types:
The severity of a skin3 depends on three main criteria: depth of burn, extent over the body and location on the body.
There are three levels of burns:4
It can be difficult to tell the difference between partial and full-thickness burns. The depth of a burn is not critical in the initial treatment of burns. An assessment of the extent of the burn is more important initially.
The extent of burn is estimated as a percentage of total body surface area.
Burns to some areas such as the face, hands, feet and perineum are taken particularly seriously.
Other factors to be considered include the person’s age (children under 5 or adults over 60) and coexisting chronic diseases (eg heart failure, respiratory failure, diabetes).
Remove the person from danger and further injury. Hold the burn under cold running water for 20 minutes. If necessary, prevent heat loss by covering unburnt areas.
Burnt clothing should only be removed if it does not stick to the burn. Do not remove clothing that is stuck to the burn as this carried a risk of skin detachment. Any chemicals, such as acids and alkalis, must be washed off with running water for at least 20 minutes. A cool shower is ideal.
Superficial burns required pain relief, dressings and regular review to make sure they don’t become infected.
A major burn is defined as a burn of any depth that involves more than 20% of the total body surface area for an adult (and more than 10% of total body surface area for a child).
Major burns are a medical emergency and require urgent treatment. Immediately apply cold water to all affected areas and then cal triple zero (000) for an ambulance. A cool or lukewarm shower is ideal.
Partial thickness burns will require a non adherent dressing to promote healing and reduce the risk of infection. If the body is not able to heal the injury by itself, skin grafts may be needed.
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