What is a burn?

A burn involves the destruction of skin cells, and sometimes the underlying structures of muscle, fascia and bone. it occurs when these structures absorb more heat than their capacity to dissipate it.

Children and older adults, by virtue of their thinner skin, sustain severe burns at lower temperatures and in less time than an adult. Exposure for just three seconds to water which is 140°F (the temperature of the average home's hot water as it comes from the tap) can result in a full thickness or third degree burn, which would require hospitalization and skin grafts. An adult would have to be exposed to the same temperature for up to five seconds to sustain the same burn. At a higher temperature, the time required to obtain a serious burn can be reduced to a fraction of a second.

Most people think of burns in terms of degrees: first, second and third degree burns. The medical profession often categorizes burns in terms of thickness — full thickness and partial thickness.

First Degree Burn: Superficial

Cause: Sunburn, scald, flash flame.
Surface Appearance: Dry, no blisters
Color: Pink
Pain Level: Painful
Healing Time: 2-5 Days with peeling, no scarring, may discolor

Second Degree Burn: Partial Thickness

Cause: Contact with hot liquids or solids, flash flame, chemical
Surface Appearance: Moist blisters
Color: Pink to cherry red
Pain Level: Painful
Healing Time: Superficial: 5-21 days, no grafting. Deep: no infection, 21-35 days; if infected, converts to full thickness.

Third Degree Burn: Full Thickness

Cause: Contact with hot liquids or solids, flame, chemical, electrical
Surface Appearance: Dry and leathery until removed. Charred blood vessels visible under skin.
Color: Mixed white, waxy, pearly, or dark khaki, mahogany. Charred
Pain Level: No pain, nerve endings are dead
Healing Time: Large areas may need months with skin grafting. Small areas may heal with grafting within weeks.

WHAT ARE APPROPRIATE FIRST AID RESPONSES? Remember: a quick response can help lessen the extent of injury.
  • Stop the burning process (remove the source of heat}.
    If clothes are on fire, “STOP, DROP and ROLL."
    if clothes get soaked with a hot liquid, remove clothing.
    If liquid chemical spills on skin, rinse with tepid water.
    If powder chemical spills on skin, brush off, and then rinse with tepid water.
    Remove any clothes that have been contaminated by a chemical immediately.
  • Remove belts, all jewelry, and all tight clothing, especially from around the person’s neck. Burned areas will swell immediately.
  • Cover burns with clean, dry dressing, bandage or sheet.
  • Keep person warm with a blanket.
  • Seek medical attention immediately.
NEVER
  1. Pour cold water on a burn.
  2. Pack burned area with ice.
  3. Apply butter or ointment immediately
Doing any of the above can make iniuries worse.
 

SPECIAL CONSIDERATIONS

MINOR BURN INJURIES: Cool burn with cool water. Antimicrobial ointment may be applied with a bandage after the wound is cooled.

Consult with physician for additional treatment, particularly if skin breaks or pain does not subside. ELECTRICAL INJURIES: DO NOT TOUCH the person who is in contact with electricity. YOU WILL BE INJURED. Disconnect the source of power or call for for assistance, then begin first aid. Primary concern is airway, breathing, circulation, and cervical spine immobilization, then assess for additional injuries. CHEMICAL INJURIES: Remove clothing before flushing with water. Check for contact lenses, which should be removed before irrigation. Use caution not to flush chemical on parts of body that are not contaminated. Read the container label for information or consult with Poison Control Center before administering first aid for specific chemical reactions.
"A burn injury may be one while painful, poses no risk to the patient’s life and will heal with no cosmetic deformity or impairment. Unfortunately; burn injuries can also be the most serious forms of injury that a patient experiences, places their life at great risk and causes long term impairment and disability. Recognizing burn injuries and the importance of initial intervention are critical to a successful outcome."

Richard L. Gameiii, MD.
Loyola University Burn Center