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FIRST AID: BURNS AND SCALDS

Burns and scalds are damage to the skin caused by heat. Both are treated in the same way.

A burn is caused by dry heat – by an iron or fire, for example. A scald is caused by something wet,
such as hot water or steam.

Burns can be very painful and may cause:

 red or peeling skin

 blisters
 swelling
 white or charred skin

Types of Burns
There are four main types of burn, which tend to have a different appearance and different
symptoms:

 superficial epidermal burn – where the epidermis is damaged; your skin will be red, slightly
swollen and painful, but not blistered
 superficial dermal burn – where the epidermis and part of the dermis are damaged; your skin
will be pale pink and painful, and there may be small blisters
 deep dermal or partial thickness burn – where the epidermis and the dermis are damaged: this
type of burn makes your skin turn red and blotchy; your skin may be dry or moist, and become
swollen and blistered, and it may be very painful or painless
 full thickness burn – where all three layers of skin (the epidermis, dermis and subcutis) are
damaged; the skin is often burnt away and the tissue underneath may appear pale or blackened,
while the remaining skin will be dry and white, brown or black with no blisters, and the texture
of the skin may also be leathery or waxy
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Causes

Burns tend to be caused by a variety of environmental factors:

 The majority of burns are called flame burnssince they're caused by fire. Contact with flame can
cause direct injury to the skin and tissue.

 A wound to the skin caused by a hot liquid is called a scald. The thicker the liquid and the longer
its contact with the skin, the greater the scald.

 Damage to the skin caused by a hot object is called a contact burn. In such instances, the burn is
usually confined to the part of skin that touched the hot object. Examples are burns from
cigarettes, irons, or cooking appliances.

 Sunburn involves damage to the skin caused by ultraviolet (UV) rays, which are emitted from the
sun.

 Electrical burns are caused by currents of electricity. These burns are usually very deep and may
cause severe damage to the skin and its underlying tissue.

 Contact with flammable gases or liquids may cause chemical burns. Inhaling hot gases could
damage the upper airways, making it difficult to breathe.

Treatment and Emergency Care

First aid for burns

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 Stop the burning process as soon as possible. This may mean removing the person from the area,
dousing flames with water, or smothering flames with a blanket. Do not put yourself at risk of
getting burnt as well.
 Remove any clothing or jewellery near the burnt area of skin, including babies' nappies. But do
not try to remove anything that's stuck to the burnt skin, as this could cause more damage.
 Cool the burn with cool or lukewarm running water for 20 minutes as soon as possible after
the injury. Never use ice, iced water, or any creams or greasy substances like butter.
 Keep yourself or the person warm. Use a blanket or layers of clothing, but avoid putting them
on the injured area. Keeping warm will prevent hypothermia, where a person's body temperature
drops below 35C (95F). This is a risk if you're cooling a large burnt area, particularly in
young children and elderly people.
 Cover the burn with cling film. Put the cling film in a layer over the burn, rather than wrapping
it around a limb. A clean clear plastic bag can be used for burns on your hand.
 Treat the pain from a burn with paracetamol or ibuprofen. Always check the manufacturer's
instructions when using over-the-counter medication. Children under 16 years of age should not
be given aspirin.
 Sit upright as much as possible if the face or eyes are burnt. Avoid lying down for as long as
possible, as this will help reduce swelling.

When to go to hospital

Once you have taken these steps, you'll need to decide whether further medical treatment is
necessary.

Go to a hospital accident and emergency (A&E)department for:

 large or deep burns bigger than the affected person's hand
 burns of any size that cause white or charred skin
 burns on the face, hands, arms, feet, legs or genitals that cause blisters
 all chemical and electrical burns

Also get medical help straight away if the person with the burn:
 has other injuries that need treating
 is going into shock – signs include cold, clammy skin, sweating, rapid, shallow breathing, and
weakness or dizziness
 is pregnant
 is over the age of 60
 is under the age of 5
 has a medical condition, such as heart, lung or liver disease, or diabetes
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 has a weakened immune system (the body's defence system) – for example, because of HIV or
AIDS, or because they're having chemotherapy for cancer

If someone has breathed in smoke or fumes, they should also seek medical attention.

Some symptoms may be delayed, and can include:

 coughing
 a sore throat
 difficulty breathing
 singed nasal hair
 facial burns

Electrical burns

Electrical burns may not look serious, but they can be very damaging. Someone who has an
electrical burn should seek immediate medical attention at an A&E department.

If the person has been injured by a low-voltage source (up to 220 to 240 volts) such as a domestic
electricity supply, safely switch off the power supply or remove the person from the electrical
source using a material that doesn't conduct electricity, such as a wooden stick or a wooden chair.

Do not approach a person who's connected to a high-voltage source (1,000 volts or more).

Acid and chemical burns

Acid and chemical burns can be very damaging and require immediate medical attention at an
A&E department.

If possible, find out what chemical caused the burn and tell the healthcare professionals at A&E.

If you're helping someone else, put on appropriate protective clothing and then:
 remove any contaminated clothing on the person
 if the chemical is dry, brush it off their skin
 use running water to remove any traces of the chemical from the burnt area

Sunburn

In cases of sunburn, follow the advice below:

 If you notice any signs of sunburn, such as hot, red and painful skin, move into the shade or
preferably inside.
 Take a cool bath or shower to cool down the burnt area of skin.
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 Apply aftersun lotion to the affected area to moisturise, cool and soothe it. Don't use greasy or oily
products.
 If you have any pain, paracetamol or ibuprofen should help relieve it. Always read the
manufacturer's instructions and do not give aspirin to children under the age of 16.
 Stay hydrated by drinking plenty of water.
 Watch out for signs of heat exhaustion or heatstroke, where the temperature inside your body rises
to 37 to 40C (98.6 to 104F) or above. Symptoms include dizziness, a rapid pulse or vomiting.

If a person with heat exhaustion is taken to a cool place quickly, given water to drink and has their
clothing loosened, they should start to feel better within half an hour.

If they don't, they could develop heatstroke. This is a medical emergency and you'll need to call
999 for an ambulance

Preventing burns and scalds

In the kitchen
 it's best to keep your toddler out of the kitchen, well away from kettles, saucepans and hot oven
doors – you could put a safety gate across the doorway to stop them getting in
 use a kettle with a short or curly cord to stop it hanging over the edge of the work surface,
where it could be grabbed
 when cooking, use the rings at the back of the cooker and turn saucepan handles towards the
back so your child can't grab them

In the bathroom
 never leave a child under five alone in the bath, even for a moment
 fit a thermostatic mixing valve to your bath's hot tap to control the temperature
 put cold water into the bath first, then add the hot water – use your elbow to test the temperature
of the water before you put your baby or toddler in the bath

Throughout the home

 put your iron, hair straighteners or curling tongs out of reach while they cool down after you've
finished using them
 fit fireguards to all fires and heaters
 keep matches, lighters and lit candles out of young children's sight and reach

Hot drinks
 keep hot drinks well away from young children – a hot drink can still scald 20 minutes after it
was made
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 put hot drinks down before you hold your baby
 after warming a bottle of milk, shake the bottle well and test the temperature of the milk by
placing a few drops on the inside of your wrist before feeding – it should feel lukewarm, not
hot
 don't let your child drink a hot drink through a straw

Preventing sunburn
 encourage your child to play in the shade – under trees, for example – especially between 11am
and 3pm, when the sun is at its strongest
 keep babies under the age of six months out of direct sunlight, especially around midday
 cover your child up in loose, baggy cotton clothes, such as an oversized T-shirt with sleeves
 get your child to wear a floppy hat with a wide brim that shades their face and neck
 cover exposed parts of your child's skin with sunscreen, even on cloudy or overcast days –
use a sunscreen that has a sun protection factor (SPF) of 15 or above and is effective against
UVA and UVB
 reapply sunscreen often throughout the day – even water-resistant sunscreens should be
reapplied after you come out of the water

References:
https://medbroadcast.com/condition/getcondition/burns
https://www.nhs.uk/conditions/burns-and-scalds/treatment/
https://www.nhsinform.scot/illnesses-and-conditions/injuries/skin-injuries/burns-and-
scalds#preventing-burns-and-scalds