Principles of first aid for burns

The article was professionally consulted by Specialist Doctor II Tran Van Trong - Specialist in Pediatric Surgery, Plastic Surgery - Aesthetics - Department of General Surgery - Vinmec Danang International Hospital.

Burn is a very common injury, anyone can get it with just a small mistake. There are many causes of burns, such as heat burns, fire burns, electricity, chemicals, etc. Depending on the type of burn agent and the extent of the burn, we have ways to handle it difference.

There are 4 main groups of causes of burns, including:
Thermal burns: There are two main types:
Dry burns: due to fire burns, metal burns, motorcycle pot burns or spark burns. Wet burns: due to grease burns, boiling water burns, steam burns, hot food burns. Chemical burns: include:
Acid burns: acids that can cause burns such as nitric acid (HNO3), sulfuric acid (H2SO4), hydrochloric acid (HCL),... Basic burns: such as KOH, NaOH, Ca(OH)2. In which slaked lime is a type of burn due to both heat and basicity. Electrical burns: burns caused by an electrical current running through the body. Electrical burns are usually caused by lightning or electric shock, burns from domestic or industrial electricity.
Burns caused by physical rays: this is a rare type of burn in daily life, it is usually caused by ultraviolet rays, infrared rays, X-rays, radioactive rays such as gamma, beta.
When burned, the first part of the human body that is affected is the skin. Human skin is inherently extremely fragile and sensitive, so it is easily damaged by any external agents. Burns can affect the skin, muscle layers, bones and blood vessels, disrupt the function of the damaged area, change the structure, and even lead to death or lifelong disability.

The depth of the burn is classified into 3 degrees. The higher the degree, the more damage caused by the burn. Specifically, the degrees of burns include:
I: Superficial burns:
At this level, the skin damaged by the burn will only be in the outermost layer of skin, causing this area of ​​​​the skin to become red and painful. Burning due to irritation of nerve endings. Wounds caused by this type of burn will heal completely after only 3 days.
Second degree: Partial burns of the skin:
The part of the skin damaged by the burn is the epidermis and part of the dermis. Second-degree burns form vesicles that, when broken, reveal a pink and painful surface. If the burn is kept clean and free of infection, it should heal on its own in about 1-4 weeks without needing any treatment. Burns that heal on their own will not leave scars or have scars but are not significant. In addition, after the burn heals, the skin may remain red for a longer period of time. In case, second-degree burns become infected, causing the lower skin layer to be destroyed and second-degree burns turn severe to third-degree burns.
Grade III: Burns of all layers of skin:
All layers of skin will be severely damaged, including pores and sweat glands. The burn will be pale white or gray, dry but not painful, besides, nerve endings are destroyed. In case the victim has a very severe burn of all layers of the skin, the subcutaneous fat layer is at high risk of being destroyed and the muscle is exposed. Third-degree burns are very susceptible to infection, so it takes a long time for the burn to heal, but the burn can leave a scar.
Since the depth of burns depends on the concentration of the chemical or the temperature, the length of time that the heat or the chemical is applied to the skin, the depth of the burn is sometimes uneven. Human skin tends to retain heat, when burned, the outer layer of clothing is burned into charcoal when it is attached to the damaged skin, which will make the wound worse. Therefore, when you have just received a burn, you should immediately pour plenty of water continuously on the burn to reduce the depth of the damaged skin.

Each location of the burn has great significance for the life and recovery of the victim, such as:
Burns in the eyes can cause blindness Burns in the face cause edema that compresses the airways , prone to facial deformities and bad scarring Burns to the hands or joints can lead to stiffness, reduced or lost function. Burns in the back area, the area near the anogenital or the anal area have a high risk of infection, and the recovery time is very long. If inhaled smoke or heat can burn the respiratory tract, leading to respiratory edema, causing congestion, respiratory failure and very easy pneumonia.

If the burn is not given timely and proper first aid, it can cause serious health consequences, leaving extremely unfortunate consequences for the victim later. Therefore, whether the victim has a minor or severe burn, first aid is essential. Because many cases did not give first aid in time or mishandled the burn, it left unfortunate consequences.
The general rule when giving first aid for burns is to separate the victim from the source of the burn, then drain the water directly into the burn as soon as possible, continuously for 20-30 minutes to reduce the surface temperature of the skin. and help reduce the depth of the burn. However, absolutely do not use ice, only use ordinary cold water such as tap water, well water. Then, use gauze or a cotton towel soaked in water to cover the burn to relieve pain.
Depending on the condition of the burn, you can buy burn medicine at home or take the victim to the nearest medical facility for treatment. Note, when burns appear scalds, do not arbitrarily puncture them
In addition to the general rule, each cause of burns will have a different first aid rule:
Electrical burns: immediately disconnect the power supply or try to remove the victim from the power source. If the heart stops beating, it is necessary to give artificial respiration with chest compressions on the spot and then take the victim to the emergency room.
Chemical burns: immediately remove clothing, wash the burn repeatedly with water to dilute the concentration of the chemical. If the victim has an acid burn, the wound should be washed with water containing bicarbonate. If the burn is caused by an alkaline substance, wash it with water mixed with lemon or vinegar. If you have an eye burn caused by any chemical, only wash your eyes with clean water, soak your eyes in water for about 20 minutes, then cover your eyes with a thin cloth and take the victim to the nearest medical facility. .
Burns caused by fire: when the victim's clothes are on fire, it is necessary to pour water or cover the victim with a blanket to extinguish the source of the fire. In the case of a severe burn, absolutely do not remove the clothing that has been attached to the burn to avoid the injured skin peeling off, causing more pain and increasing the severity of the wound. You should cover the burned area with a medical bandage or clean cloth to prevent infection, and then take the victim to the hospital for treatment.

Do not immerse the burn in ice cold water, because the burned skin area when cold will cause the body temperature to drop, leading to blood vessel constriction, muscle contraction, making the burn more serious. This is probably the most common first aid mistake that many people make when it comes to burns.
Do not apply unscientific methods such as applying fish sauce, squeezing water or bananas on burns. This only makes the burn more susceptible to infection and more difficult to treat.
Do not apply toothpaste on the burned area g. Toothpaste does not soothe burns as people think, it contains a mild alkaline substance, when applied to the burned skin, it makes the victim feel more painful. Only use toothpaste for acid burns: after you have diluted the acid concentration on the skin by soaking in water, you can apply toothpaste to the burned skin to neutralize the residual acid on the skin. then rinse with water.
Do not pop the blisters to avoid the risk of bacterial infection entering.

Reference source: Mayoclimiv.org