First aid steps for burns caused by heat and electric shock

Posted by MSc Le Thi Thanh Huong - Resuscitation Doctor - Emergency Medicine - Emergency Department - Vinmec Central Park International General Hospital

Burns are injuries caused when the body is exposed to heat, electricity or chemicals. Accordingly, depending on the cause of the burn and the extent of the wound, doctors have different first aid, treatment and treatment methods.

Thermal burns are usually caused when the body comes into contact with a hot surface, hot liquid, heat, or fire. In this case, we should only use cool water and a clean cloth to cover the wound. However, you should not use ice, as it will make the burn worse.
1.1. First aid steps for minor burn injuries To ensure the safety of themselves and the victim, first aiders need to follow the principles of first aid for burns as follows:
Observe around, ensure the environment safety or take the victim to a safe place. Bring a bag or first aid kit. Wear personal protective equipment (Gloves, safety glasses), if you are giving first aid to others. Use cold water to cool the burn (if cold water is not available, normal cool water, but not ice) for at least 10 minutes. Leave the burn under cold running water until the pain is gone. Cover the burn with a clean bandage/gauze. For example: When you have a burn from boiling water, you can leave the burn under cool running water for 10 minutes (don't let the water spray too hard, just let the water run in a stream).

1.2. First aid steps for major burn injuries Look around, ensure a safe environment, or get the victim to a safe place. If the burn is caused by fire or extensive burns, call 911 (call 911 or the nearest emergency unit where you have a phone number). When calling an ambulance, you need to provide clear information about: Location of the victim (room number, house number, street, ward, district...), number of victims (estimated), victim's situation, fire situation or accident, request or ask for further assistance (when needed). Accordingly, you need to pay attention to providing a phone number and keep the phone constantly so that emergency personnel can contact you when needed. If the victim or the victim's clothing is on fire, instruct the victim to put out the fire by stopping, lying down, and rolling on the ground. Then use a blanket dipped in water and cover the victim. When the fire is out, remove the blanket, carefully remove jewelry and clothing on the victim, but do not try to remove anything that has stuck to the victim's skin. For large burn areas, use cold water to cool for a minimum of 10 minutes. After cooling the burn, cover the wound with a clean, dry dressing/gauze. Use a clean, dry blanket to cover the victim. Check the patient for signs of shock. After that, it is necessary to quickly bring the patient to the hospital so that doctors can examine, evaluate and treat the disease early.

Electricity can cause burns on the outside and inside of the body, damaging various organs.

You can see signs of damage on the skin of the electrical current entering the body is not great but can still cause severe damage to other organs in the body. Therefore, it is not possible to rely on external traces to assess the severity of electrical burns. Electric shock can cause apnea, arrhythmia, death, or cardiac arrest.

If an electric shock accident is caused by a high voltage current (For example, a broken high voltage wire), immediately notify the authorities and call 911. Accordingly, do not enter the accident area or attempt to Move the power cord until the power is definitely off. Because electricity can pass from the victim's body to you. Besides, you should also pay attention to absolutely do not touch the victim's body until the power is completely cut off. In case you are familiar with electrical appliances, disconnect the power and quickly approach the victim.
2.1. First aid steps for victims of electric shock Look around, make sure the environment is safe, or take the victim to a safe place. Bring a bag or first aid kit. Wear personal protective equipment (Gloves, safety glasses), if you are giving first aid to others. Call 911 or the nearest emergency department where you have a phone number. When the power is off and in a safe area, approach the victim, check the victim by: Lay calls to see if the victim responds (open eyes, blinks, grimaces, groans, moves limbs. ...). If the casualty is not responding, check to see if the victim is breathing (by observing if the victim's chest and abdomen move up and down for 10 seconds). If there is no response, support CPR (cardiopulmonary resuscitation) right away.
Then, quickly take the patient to the medical center to be diagnosed by the doctor and give an appropriate treatment plan.

Respiratory support. Cardiovascular stabilization. Fluid resuscitation: using electrolyte solutions Estimate the amount of fluid to be infused based on the area of ​​burned skin, according to the following formula:
In the first 24 hours: 4 ml Lactate ringer/kg/% burn area + basic needs . Rate of infusion: 50% of total volume in the first 8 hours, 25% of the total volume in the next 8 hours, 25% of the total volume in the last 8 hours. Monitor fluid response by monitoring blood pressure, CVP, and urine flow (maintain urine output 0.5-1mL/hr, or 30-50mL/hr).

In addition, patients need to control pain with drugs: Paracetamol, Methadone, Morphin... and take care of burn wounds, avoiding potentially dangerous complications.