Unconsciousness

BURNS

What are Burns?
A burn is a type of injury to skin, or other tissues, caused by heat, electricity, chemicals, friction, or radiation. Most burns are due to heat from hot liquids, solids, or fire. Burns are one of the most common household injuries, especially among children. Burns are characterized by severe skin damage that causes the affected skin cells to die.

Burn levels
There are three primary types of burns: first-, second-, and third-degree. Each degree is based on the severity of damage to the skin, with first-degree being the most minor and third-degree being the most severe. Damage includes:
1st-degree burn
A first-degree burn is burns that affect only the superficial skin layers; it involves only the outer layer of skin. It is the least serious type. It may cause:

• No blistered skin
• Redness
• Swelling
• Pain

You can usually treat a first-degree burn as a minor burn. If it involves much of the hands, feet, face, groin, buttocks or a major joint, seek emergency medical attention.
Second-degree burns:
A second-degree burn is when the injury extends into some of the underlying skin layer. It is more serious. It may cause:

• Blisters and some thickening of the skin
• Red, white or splotchy skin
• Swelling
• Pain

If the second-degree burn is no larger than 3 inches (7.6 centimeters) in diameter, treat it as a minor burn. If the burned area is larger or covers the hands, feet, face, groin, buttocks or a major joint, treat it as a major burn and get medical help immediately.  
Third-degree burns:
The most serious burns involve all layers of the skin and underlying fat. These are burns that destroy the skin and expose raw or charred flesh. Muscle and even bone may be affected. Burned areas may be charred black or white. The person may experience:

• Widespread thickness with a white, leathery appearance
• Difficulty breathing
• Carbon monoxide poisoning
• Other toxic effects, if smoke inhalation also occurred

Fourth-degree burns:
There are also fourth-degree burns. This type of burn includes all of the symptoms of a third-degree burn and also extends beyond the skin into tendons and bones.

Causes of Burns
Burns have a variety of causes, including:

• Scalding from hot, boiling liquids
• Chemical burns
• Electrical burns
• Fires, including flames from matches, candles, and lighters
• Excessive sun exposure

The type of burn is not based on the cause of it. Scalding, for example, can cause all three burns, depending on how hot the liquid is and how long it stays in contact with the skin.
Chemical and electrical burns warrant immediate medical attention because they can affect the inside of the body, even if skin damage is minor.

First aid and Treatments for Burns:
For minor burns:

• Cool the burn to help soothe the pain. Hold the burned area under cool (not cold) running water for 10 to 15 minutes or until the pain eases. Or apply a clean towel dampened with cool tap water.
• Remove rings or other tight items from the burned area. Try to do this quickly and gently, before the area swells.
• Don't break small blisters (no bigger than your little fingernail). If blisters break, gently clean the area with mild soap and water, apply an antibiotic ointment, and cover it with a nonstick gauze bandage.
• Apply moisturizer or aloe vera lotion or gel, which may provide relief in some cases.
•  If needed, take an over-the-counter pain reliever, such as ibuprofen (Advil, Motrin IB, others), naproxen sodium (Aleve) or acetaminophen (Tylenol, others).
• Consider a tetanus shot. Make sure that your tetanus booster is up to date. Doctors recommend people get a tetanus shot at least every 10 years.

See your doctor if you develop large blisters. Large blisters are best removed, as they rarely will remain intact on their own. Also seek medical help if the burn covers a large area of the body or if you notice signs of infection, such as oozing from the wound and increased pain, redness and swelling.
Major burns:
Major burns are always serious, take the person to a health center at once. If it is impossible to get medical help immediately, take these actions:

• Wrap the person in thick material; such as a wool or cotton coat, rug, or blanket. This helps put out the flames.
• Pour water on the person.
• Protect the burned person from further harm. If you can do so safely, make sure the person you're helping is not in contact with smoldering materials or exposed to smoke or heat.
• But don't remove burned clothing stuck to the skin.
• Check for signs of circulation. Look for breathing, coughing or movement. Begin CPR if needed.
• Remove jewelry, belts and other restrictive items, especially from around burned areas and the neck. Burned areas swell rapidly.
• Don't immerse large severe burns in cold water. Doing so could cause a serious loss of body heat (hypothermia) or a drop in blood pressure and decreased blood flow (shock).
• Elevate the burned area. Raise the wound above heart level, if possible.
• Cover the area of the burn. Use a cool, moist, bandage or a clean cloth.

Complications
Compared with first- and second-degree burns, third-degree burns carry the most risk for complications, such as infections, blood loss, and shock, which is often what could lead to death. At the same time, all burns carry the risk of infections because bacteria can enter broken skin.
Tetanus is another possible complication with burns of all levels. Like sepsis, tetanus is a bacterial infection. It affects the nervous system, eventually leading to problems with muscle contractions. As a rule of thumb, every member of your household should receive updated tetanus shots every 10 years to prevent this type of infection.
Severe burns also carry the risk of hypothermia and hypovolemia. Dangerously low body temperatures characterize hypothermia. While this may seem like an unexpected complication of a burn, the condition is actually prompted by excessive loss of body heat from an injury. Hypovolemia, or low blood volume, occurs when your body loses too much blood from a burn.

Prevention of burns
The obvious best way to fight burns is to prevent them from happening. Certain jobs put you at a greater risk for burns, but the fact is that most burns happen at home. Infants and young children are the most vulnerable to burns. Preventive measures you can take at home include:

• Keep children out of the kitchen while cooking.
• Keep chemicals in closed containers and keep them away from children.
• Turn pot handles toward the back of the stove so children cannot reach them.
• Place a fire extinguisher in or near the kitchen.
• Test smoke detectors once a month.
• Replace smoke detectors every 10 years.
• Keep water heater temperature under 120 degrees Fahrenheit.
• Measure bath water temperature before use.
• Lock up matches and lighters out of reach .
• Install electrical outlet covers.
• Check and discard electrical cords with exposed wires.
• Keep chemicals out of reach, and wear gloves during chemical use.
• Wear sunscreen every day, and avoid peak sunlight.
• Ensure all smoking products are stubbed out completely.
• Clean out dryer lint traps regularly.

It’s also important to have a fire escape plan and to practice it with your family once a month. In the event of a fire, make sure to crawl underneath smoke. This will minimize the risk of passing out and becoming trapped in a fire.

Outlook for burns
When properly and quickly treated, the outlook for first- and second-degree burns is good. These burns rarely scar but can result in a change in pigment of the skin that was burned. The key is to minimize further damage and infection. Extensive damage from severe second-degree and third-degree burns can lead to problems in deep skin tissues, bones, and organs. Patients may require:

• Surgery
• physical therapy
• Rehabilitation
• Lifelong assisted care

It’s important to gain adequate physical treatment for burns, but don’t forget to find help for your emotional needs. There are support groups available for people who have experienced severe burns, as well as certified counselors. Go online or talk to your doctor to find support groups in your area.