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burns

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Different types of burns

Alternative Names 
first-degree burn, second-degree burn, third-degree burn

Definition
A burn is defined as any destruction of skin or body tissue resulting from heat, chemicals, or electricity. The severity of a burn depends on how much tissue is affected, and how deep the burn is. Burn severity can range from first-degree to third-degree.

What are the signs and symptoms of the injury? 
First-degree burns are the least severe. They affect only the outer layer of the skin, causing pain, redness, and swelling.

Second-degree burns affect both the outer and underlying layers of skin. Symptoms include pain, redness, swelling, and blistering.

Third-degree burns cause the deepest damage. The surface of the burn may be white and soft, or black, charred, and leathery. The burned area has no feeling when touched. Third-degree burns are not usually painful because the nerve endings in the skin have been destroyed.

Symptoms of an airway burn include: What are the causes and risks of the injury? 
. Thermal burns are often the result of accidental fires. These fires can be caused by playing with matches, improper use of a space heater, or electrical malfunctions. Automobile accidents are a common cause of burns. Even the sun can cause burns in the form of sunburn.

What can be done to prevent the injury? 
There are many ways to help prevent burns:
  • Install smoke alarms in each and every bedroom.
  • Know and practice fire escape routes. Families should plan what to do in case of a fire, and where to meet afterwards. It's important to teach children about safety precautions at home, at school, and while travelling. These include fire escapes, the hazards of matches, and playing with fire and fireworks.
  • Never smoke in bed. A person can fall asleep while smoking, and the cigarette can set the mattress on fire.
  • Take precautions in the sun. This means wearing proper clothing, avoiding sun exposure during peak sun hours, and using sunscreen to prevent sunburns. Too much exposure to the sun can make skin cancers more likely. It can also cause first-degree burns, and even some very mild second-degree burns, that are very painful.
How is the injury recognised? 
In most cases, it's fairly easy to diagnose a burn. It can be hard to tell the difference between degrees of burn, though. For example, it may take a day or two for the burn to blister, making it a second-degree burn.

What are the treatments for the injury? 
First aid can often be given by the average person when someone has just been burned. It is important to call for emergency help if the burn is extensive or severe, if the person shows signs of shock, or if the person has burns to the airway or lungs. First aid can be divided into aid for major and minor burns.

First aid steps for minor burns are:
  • Cover the burned area with cool water, but not ice water, for about 5 minutes.
  • Try to reassure and calm the person. Burns can be extremely painful and cause a lot of anxiety.
  • Cover the area with a bandage after soaking it for several minutes. Use only clean cloths, and try to avoid contaminating the wound.
  • Over-the counter analgesics, such as paracetamol or ibuprofen, may be given.
  • Very minor burns usually heal without any more treatment or follow-up with a doctor. If the burn appears to be more severe (second-degree or third-degree) or covers an area greater than two inches across, a person should receive medical attention. Burns in very sensitive areas, such as the hands, feet, face, major joints, or genitals, should be treated as major burns, and the person should see a doctor.
  • A tetanus Injection should be given for burns if it has been more than 10 years since the person last had one.
First aid steps for major burns are:
  • If the person is on fire, have the person stop, drop, and roll. If the person is still on fire, cover the person with a wool or cotton blanket, and douse them with water if it's available. Don't use blankets made of synthetic materials, since these can melt.
  • Try not to remove burned clothing unless it comes off very easily. Make sure that all burning material is removed from the person's skin.
  • Make sure the airway is open, the person is breathing, and he or she has proper circulation (ABCs). If necessary, begin CPR, or cardiopulmonary resuscitation.
  • If the person is not breathing, remember that this is the most important aspect. CPR should be performed. If another person can help, have that person place cool, moist bandages over the burn areas while the first person continues to perform CPR. Do not break any blisters.
  • If the person is breathing and has serious burns to the fingers or toes, try to separate the digits with dry, sterile non-adhesive dressings.
  • Elevate the burned area and protect it from further burns, pressure, or injury. Take steps to prevent shock.
What are the side effects of the treatments? 
With most burns, the most common side effect is pain. This can be lessened by removing any burning material from the skin, and keeping the area clean and moist.

The second most common side effect is infection. It's important to avoid contaminating the area with dirt or dirty cloths, and to keep from breaking any blisters.

What happens after treatment for the injury? 
If the burn is small and first-degree, it will usually heal on its own. More serious burns to hands, feet, face, genitals, major joints, or large areas, require major treatment. This goal is to regain motion and function in the burned area. Skin grafts may be needed.

Author: James Broomfield, MD
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Contributors
Potential conflict of interest information for reviewers available on request
 


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