Burns First Aid Treatment

Almost every person comes across burns during his/her lifetime. The commonest cause of burn is thermal burn and then come other types of burns such as radiation, electrical and chemical burn. Before we get into the deep core of the topic, we must understand the simple classification in which burns are divided.

Depending whether the germinal layer of the skin is intact or destroyed, burns can be simply divided into: Partial thickness and Full thickness burns. Partial thickness burns are superficial in depth, painful, underlying germinal layer is intact and healing may be complete. Alternatively, full thickness burns are deep in depth, destroy the underlying germinal layer and the sensation is absent. They form scars and contractures. Knowing these basics about burns are essential for burns first aid treatment.

It must be known that burns are the most silent but the most lethal accidents a person faces. Therefore, the immediate burns first aid treatment should be known to everyone: Firstly, it is required to stop the process right away. This can be done by removing the patient from the source area of the burn. Then the overlying clothing is removed because this may have retained the heat from the incident hence aggravating the burn more.

After removing the clothing, a stream of continual cool water should be run on the burn area of the patient. This prevents continued damage by providing cooling effect on the burns. After this, the burn area should be calculated. If the burn area is greater than 15% in adults and 10% in children, urgent admission in a tertiary care hospital is recommended. Thereafter, the treatment of burns is a three step procedure:

1.      Managing the local condition: Here, the aim is to prevent infection and promote healing. This can be done by applying simple non-adherent dressings on the wound which may be changed every 2 – 3 days. It is recommended to use paraffin impregnated gauze pieces and application of sulfasalazine ointment on the burn area to prevent infection. When there is an involvement of hands, it is recommended to apply sulfadiazine cream and seal the hands with polythene bag. Localized but complicated burns like inhalational burns may be subsequently treated in-hospital.

2.      General treatment: In general treatment, the first thing to take care of is the pain management. In-hospital intravenous opiates are administered because partial thickness burns are of real agony to the patient. Fluid replacement is a mandatory part of the burns first aid treatment and the amount of fluid replacement depends on the total area burnt. “Rule of nines” is a famous formula to calculate the total burnt area where specified percentages have been allotted for different body parts:

-          Head and Neck 9 %

-          Each arm 9%

-          Each leg 2 x 9 = 18%

-          Front of the trunk 2 x 9 = 18%

-          Back of the trunk 2 x 9 = 18%

-          Perineum 1%

Parkland’s Formula is subsequently used to calculate fluid to be given in first 24 hours:

Fluid (ml): 4 ml x weight (kg) x % burnt area.

The amount of resultant fluid should be divided into two parts: the first half to be given in 8 hours and the other half to be given in 16 hours.

Once this first aid treatment is commenced, the final step is of reconstruction and rehabilitation. This stage is solely of the attending physicians and surgeons and opinions are made considering the severity of the burns.

The first aid treatment mentioned above should be known to the local population so that in the absence of hospital services, patients can be managed adequately till he/she reaches the hospital.