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BURNS AND SCALDS
Burns are injuries that result from dry heat like fire, flame, a piece of hot metal, the sun, contact with wire carrying high tension electric current or by lighting or friction. Scalds are caused by moist heat due to boiling water, steam, oil, hot tar, etc.
Chemical burns are caused by strong acids (sulphuric acid, nitric acid) or by strong Alkalies (caustic soda, caustic potash, quick lime or strong ammonia)
A Nuclear burn is caused by the instantaneous flash of intense heat given off by a nuclear explosion. It is capable of causing superficial burns on the exposed skin of person several miles away.
Radiation burns are caused by over-exposure to X-ray of Radiation Therapy.
This casualty is to be referred to hospital immediately.
Degrees of burns
The degree of burns indicate the degree of damage to the tissues. There are three degrees of burns.
First Degree: when the skin is only reddened.
Second Degree : When there are blisters on the skin. And there is destruction of deeper tissues and charring.
Third Degree : The danger from burns depends on the area of the burns rather than the degree. Superficial burns over a large area of the body are more dangerous than the complete charring of a part of the limb. It must be noted that in the same person, different parts of the body may show different degree of burns.
The first two degrees are seen in scalds also.
When the chemical fall on skin or cloth worn by the person any of the three degrees of burn may be produced. When swallowed, the chemicals if strong, will damage the tissues with which they come into contact while swallowing viz, lips, tongue, throat, food passages, stomach. There may be damage to the skin around the mouth.
Note : The severity of a burn depends upon both the area it covers and its depth.
Helping a person whose clothes have caught fire
The first aider should know how to deal with a person whose clothes have caught fire.
Put out the flames by whatever means available. Most of the causes of burns occur in homes where water is readily available to quench the flames water also cools the burnt area causing less damage to occur.
Do not allow the person to run about. This only fans the fire and makes the flame spread.
Hold a rug, blanket, coat or table cover in front of you, while approaching a man whose clothing have caught fire.
Lay him down quickly on the ground and wrap tightly with any thick piece of cloth, rug or coat. Smother the flame by gentle pats over the covering but do not roll the casualty.
If the clothes in front of the body have caught fire, lay him on his back and vice versa, till suitable material is brought to smother the flame.
Results of burns : Immediate and Later
Immediate - 1. Intense pain
Later - 1. There may be infection in the damaged area
Immediate - 2. Shock
Later - 2. After healing, it will leave Scars causing disfigurement and / or restriction of movements.
Management of serious burns and scalds
Immediate attention that is required in serious burns are :
Keep the casualty quiet and reassure him.
Wrap him in clean cloth.
Do not remove adhering particles of charred clothing.
Cover burnt area with sterile or clean dressing and bandages. In case of burns covering a large part of the body, it is sufficient to cover the area with a clean sheet or towel.
Keep him warm but do not overheat him.
If the hands are involved, keep them above the level of the victim's heart.
Keep burnt feet or legs elevated.
If victim's face is burnt, sit up or prop him up and keep/under continuous observation for breathing difficulty. If respiration problems develop, an open airway must be maintained.
Do not immerse the extensive burnt area or apply ice water over it because cold may intensify the shock reaction. However a cold pack may be applied to the face or to the hands or feet.
Shift the casualty to the nearest hospital, if he is fit to be moved.
If you cannot take him to hospital, wait for the doctor to arrive.
Do not open blisters.
Keep him wrapped up in clean cloth.
Treat for shock.
Remove quickly from the body anything of a constricting nature like rings, bangles, belts and boots. If this is not done early, it would be difficult to remove them later as the limb begins to swell.
If medical help or trained ambulance personnel cannot reach the scene for an hour or more and the victim is conscious and not vomiting, give him a weak solution of salt and soda at home and enroute; (one level teaspoonful of salt and half level teaspoonful of baking soda to each glass of water, neither hot nor cold). Allow the casualty to sip slowly. Discontinue fluid if vomiting occurs. Do not apply ointment of any form, or grease or other home remedy.
Management of chemical burns
Wash off the chemical with a large quantity of water by using a shower or hose if available as quickly as possible. This flooding with water will wash away most of the irritant.
Cut out contaminated clothing.
Do not touch the burnt area with bare fingers.
Treat as for burns.
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