International Journal of Health Sciences and Research

www.ijhsr.org ISSN: 2249-9571

Review Article

Burns: First Aid

Singh Kuldeep1, Punia Sudhanshu2, Singh Bhupender3, D. Pramod2,
Singh Bikramjit2
1
HOD, 2Resident, 3Assistant Professor,
Burns and Plastic Surgery, PGIMS, Rohtak, Haryana, India.
Corresponding Author: Dr. Sudhanshu Punia

ABSTRACT

Burns are common occurrence and often the patient is rushed to a nearby medical practitioner or
hospital for first aid. Some patients may receive first aid from their relatives or friends in correct or
incorrect manner. Most of the time the first respondents in case of burns are family members, friends,
by standers. Properly instituted first aid reduces the morbidity and even mortality in burn patients.
Many simple interventions can make a great difference in the course of burns and improve patient
outcome.
This article is aimed to educate primary health care providers, accident and emergency departments,
paramedicals and even the general public so that treatment for burn patients can start early.

Key Words: First aid, Burns, What to do, Immediate treatments

INTRODUCTION lamps for illumination or cooking and

Burns are common occurrence and accidentally get burnt by it.
often the patient is rushed to a nearby 3. Electrical injuries occur due to
medical practitioner or hospital for first aid. inadvertent coming in contact with the
Some patients may receive first aid from electrical cables, most patients are not
their relatives or friends in correct or electrical workers hence, do not have
incorrect manner. Therefore it is imperative any protective devices for the same.
that the public is made aware of the proper 4. Chemical burns, mostly in factory
first aid as it does limit further burn workers and as in a case of vitriolage.
morbidity. As many of our patients come
from a rural background, so are initially Administration of First Aid:
treated by home remedies, some of which Most of the time the first
include ink, ash, mud, turmeric and even respondents in case of burns are family
cow-dung. Use of peacock feathers is also members, friends, by standers. They have to
rampant. The scientific base of these be made aware about the proper
treatments has eluded the authors and has no administration of first aid, along with, not to
place in first aid or treatment. injure themselves while saving the patient.
Most common type of burns in which
properly administered first aid is useful are - Thermal burns:
1. Scalds in the pediatric population, One must always try to put out the
2. Thermal burns in farmers and daily fire first. The stop and drop policy should be
wage workers, who still utilize kerosene followed. Prevent the victim from running
which would only fan the flames and make

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 Singh, Kuldeep et al. Burns: First Aid

them burn faster. The victim should be Rings, bracelets, bangles, watches,
instructed to lie down on the floor jewelry or other tight items should be
immediately with the burning side removed from the burnt parts. This is to be
uppermost. As the flames always burn done quickly and gently, before the swelling
upwards, lying flat prevents the fire from develops in the burnt part. Then removal
going around the body. Rolling should be becomes difficult, painful and it might even
avoided as it would burn the previously result in loss of the digit.
unburnt areas and may result in other Ointments, creams, lotions, powders,
injuries. [1] grease, ghee, gentian violet, calamine lotion,
To stop the victim from burning he/ toothpastes, butter, 'local doctor'
she may be doused with water or covered formulations etc., should not be applied over
with a heavy cotton cloth. Use of synthetic the burn wound. They make the formal
textiles should be avoided, as that would assessment of the nature, depth and extent
ignite and stick to the victim and do more of the burn wound difficult. Moreover,
harm. Once the fire is extinguished the eventual removal of such substances might
garment should promptly be removed, as it also be difficult and painful to the patient.
tends to trap heat. If water is not available Furthermore, the potential of these
any clean, packaged drink can be used eg. applicants contaminating the wound always
Milk. [2] exists and so, should be avoided. Mud, dirt,
Water, which is being used to douse sand should not be applied either for
the patient should be cool (around 15°C) dousing the flames or afterwards. [2]
and not too cold, running and should be For transport, the burnt part should
used for at least 10 minutes. This should be be covered in a clean dry sheet/ cloth. This
applied as soon as possible after injury. [3] prevents soiling of the wound, reduces pain
This can be continued longer till the pain caused by the air draft and reduces
eases. But, care must be taken to prevent infection. Plasticized polyvinyl-chloride
development of hypothermia, especially in (PVC) film available as a food-wrap is a
children and the elderly. [4] Application of a good alternative to cover the burned areas.
clean towel dampened with cool tap water Being pliable, it molds to the contours of the
should be done afterwards as it helps in wound and forms an impermeable, non-
reducing pain. [5] adherent barrier. Its application and removal
In addition to improved healing, cold is easy and painless. Moreover, being
water also has an excellent analgesic effect. transparent, it also permits inspection of the
Modulation of pain related inflammatory wound. [7]
mediators may be one mechanism by which Inhalation injury:
properly administered first aid influences If there is a lot of smoke, as in a case
healing afterwards. [5] Use of ice, very cold of fire in an enclosed space, the nose and
water is to be avoided as it may cause mouth should be covered with a wet cloth
further injury to the already injured tissues, and the victim should be removed from
and if used in large quantities hypothermia those premises by dragging along the floor,
may also occur. Hence, early appropriate if possible, as smoke tends to rise upwards
first aid to partial thickness burn wounds and collect towards the ceiling.
has been shown in an experimental animal Such patients are critical; oxygen
model to be associated with earlier healing should be administered immediately, if
and eventually less scarring. [3,6] The use of possible and must be rushed to the nearest
raw eggs and flour has also been mentioned. medical facility. These patients may also
The proponents of raw eggs claim that the need intubation and ventilatory support.
proteins in the egg form a layer over the Electrical burns:
burnt skin and prevent contamination. The electric current can injure in
several ways – current its self, flame burns,

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 Singh, Kuldeep et al. Burns: First Aid

arc burns, fall resulting in other injuries. [8] Common points in first aid irrespective of
These types of burns tend to injure deeper type
structures more than overlying skin. The  Stop the burning process, ie. remove the
injury to deeper structures manifests later as offending agent.
necrosis of tissue. When attending to such a  Be careful not to injure yourself.
patient make sure the source of current is  Cool the burn area.
off, check that it is off and then help the  Elevate the burn area.
patient. Avoid using water to douse flames  Jewelry, including bracelets, rings and
at the site of injury as the current can flow necklaces should be removed.
up to the rescuer also. Use a dry wooden  Do not try and remove adherent burnt
stick/ pole/ wooden chair to remove the clothing.
victim from the site. Edema (swelling) sets
 In hot liquid burns (scalds) all wet
in faster in these injuries so limb elevation
clothes are to be removed.
should be done immediately and
 Wrapping the burn wounds with a clean
maintained. Immediate cardiopulmonary
cloth is sufficient during transfer to the
resuscitation may be needed for such
nearest emergency department.
patient; hence, the patient should be rushed
to a tertiary center.
After the first medical attention, the
Chemical burns:
following information must be provided to
In case of chemical burn, which
the nearest burn unit/ medical facility before
could be alkali or acid burn, first and
transfer:
foremost reaction should be to remove all
1. Age of the patient
clothing, ornaments immediately and
2. Gender
rigorous washing continuing for prolonged
3. The place and means of injury
time. The time period could be up to an hour
4. Burning agent
or two. Chemical burns tend to be common
5. Time of injury
in factory workers, laborers or as in a case
6. Width and depth of the burn including
of vitriol age. Acid burns cause less damage
involved body area
than alkali, which penetrates deeply by
7. Associated injuries
liquifactive necrosis. [9] Common acid burns
8. Co-morbidities if any
are due to sulphuric/ hydrochloric/ nitric
9. General medical status of the patient and
acid. Washing with running water is to be
any medical interventions performed
continued till the pH is neutralized as shown
by litmus paper test. If eyes are involved, as
CONCLUSION
in facial burns, the eyes should continuously
This article is aimed at health care
irrigated with Ringer Lactate/ normal saline
providers, especially those who offer their
in the hospital and the patient should be
services at the primary level, accident and
reviewed by an ophthalmologist along with
emergency departments, paramedicals and
a burns specialist.
even the general public, as proper and
In a few cases, solid particles of
timely institution of first aid in burns can
sodium, potassium, calcium may be present,
significantly reduce the subsequent
these should be brushed off or picked off, as
morbidity and even mortality.
these particles react with water, which, can
cause further damage. Once all the particles
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How to cite this article: Kuldeep S, Sudhanshu P, Bhupender S et al. Burns: first aid. Int J Health
Sci Res. 2017; 7(8):434-437.

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