Burns are something that you can come across in many different areas. It might be a temperature burn where someone has touched something very hot or very cold, it could be flames, steam, or even sunburn or chemical burns.
Types of Burn
There are different levels of burns. The least serious are superficial burns, where solely the outer layers of skin have been burnt. Then there are partial-thickness burns. This is where it is a deeper burn and can normally be identified by blistering. Sometimes even something like a severe heat or sunburn can be at level. The most serious are full-thickness burns, which is where the burn has gone through the layers of the skin. In some cases, these actually cause the patient the least amount of pain. This may sound weird, however, if the burn is so bad that it actually destroys the nerve endings around the area, then the patient will not feel pain. Remember, you can also get a mixture of levels of burn, so you might have a full-thickness burn in the middle and then as it goes out to superficial around the outside.
Problems with Burns
Big problems arise with any burns where clothing or any material such as a normal dressing sticks onto the burn. This is a major problem because when pulled off, the burnt skin will come with it. NEVER pull off anything which has stuck to the burn! Burns are painful enough anyway, and this will just cause the patient even more pain.
Another big problem relating to burns is infections. You may think that the burn will kill any harmful pathogens, which may be true, however, this is not where the infection control problems arise. You are actually prone to infection straight after a burn, especially as more and more layers of skin are destroyed. Since our skin acts as a barrier to any harmful pathogens, after removing the skin via the burn, the pathogen can now get in. Should the burn be worse than a superficial burn, blistering may occur. NEVER pop these blisters as the body will remove the liquid by itself. Also, in popping the blisters, you are breaking a barrier of entry, meaning you have then created a way for harmful pathogens to enter the body. Another way of providing suitable infection control is to always wear gloves.
Initial Assessments
The first thing you need to do is to have a look at the area and find out what the cause of the burn was. Also, see how old the patient is. If they are very young or very old, the skin will be much thinner, therefore more prone to a more severe burn. The location of the burn is also important. It may well be on an area of the body which could present a major problem. An example of this may be around the respiratory system as it can affect someone’s breathing. Then assess the size of the burn. This is typically called the Rule of Nines. The body is then divided up, so roughly speaking, the size of their hand will be 1% surface area. The head is 9%, the front of the body is 18%, the back of the body is 18%, legs are 18% each and arms are 9% each. This allows you to give a rough estimate as to the body coverage of the burn. This will be useful for the Emergency Services as they will be given an idea of how serious the burn is.
First Aid Treatment
The rule for burns is to run it under cold, clean, running water for at least 20 minutes. The idea of this is to cool the burn. Whilst this rule used to be 10 minutes, it is now 20 minutes. This makes sure that the skin is fully cooled. You should always use running water when possible because otherwise, the limited pool of water will warm up and then it will not cool the burn further. It might well be that you are in a situation where you haven’t got access to running water. That is where the burns kits come in. They come in all sorts of cases and sizes. They are commonly in kitchens or areas where burns are high risk, such as factories. Inside there are different types of dressing that you may need. Some of the dressings you find are a gel-based dressing. The gel on them aids with the cooling down of the burn. As well as this, they will not stick to the burn.
If you are in a situation without any First Aid kits, you can use cling film if it is available. Look at this page for the proper administration of cling film in relation to burns.
Inside the Burns Kit
There are many useful things inside of a Burns Kit, such as sachets of gel and also burn dressings. Burn dressings come in different shapes and sizes. For example, you can get them to cover the face, which has gaps in it for breathing. Before use, check the expiry date on it as it will not work as effectively after the expiration date has passed. Once you lay the special dressing onto the skin, you can then pour spare gel on top to keep it cool. There will also be some bandages – these are NOT for the affected skin. They should only be used to hold any dressings, pads or clingfilm in place. There will be a pair of scissors for cutting away clothing. As earlier, you would not peel off the clothing away from the burn itself, but you might cut the clothes around the affected area. If you do this, check that the remaining clothing will not tug on the affected area during movement. Other things in a Burns Kit can include a spray or liquid which you can apply directly to the burn to help cooling.
It is a good idea to make sure there is a Burns Kit in your workplace, in kitchens and places like that. Finally, if you work in remote areas, you need to start thinking about how could you cool burns off should they occur.
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