How to Treat Burns?

Burns are classified according to severity, with first degree burns the most superficial and third degree burns the most severe. First degree burns often result from brief exposure to a flame or a hot liquid. Burns from excessive exposure to the sun or a sunlamp are usually first degree, but can be second degree in severity.

The skin at the site of a first degree burn is dry, bright red, warm, and painful to touch. Second degree burns involve deeper layers of skin which in this instance exhibit blisters or a raw, moist surface. These burns may also result from contact with hot liquids or from flash explosions. Third degree burns involve the subcutan­eous layers and they may be caused by flames or contact with a very hot object. Skin that has suffered a third degree burn appears pearly white or charred. The surface is dry initially, but later begins to ooze. Unlike milder burns, third degree burns are not painful or tender.

Treatment Tips for Burns

The best immediate treatment for a burn is the application of cold. Such applications reduce the pain, swelling, and redness, and may even cut down the extent of the damage. Cold packs, ice, or submerging the burned area in tap water no warmer than 77 degrees (F) are all effective. Except in cases of sunburn, towels soaked in ice water may be used. The burn should then be cleaned gently with soap and water. First degree burns should require little if any treatment beyond this, although creams or ointments such as vaseline may be soothing.

Burn blisters should generally be left alone and protected with gauze dressings. If these blisters are large or painful, they may be opened and drained, by cleansing the skin, sterilizing a needle with alcohol, and puncturing the blister at its edge. Breaks in the skin can then be coated with a thin layer of an antibiotic or iodine ointment. A Band-Aid or gauze dressing may be applied loosely. Small blisters on the feet can be protected with tape and cushioned with foam rubber or moleskin.

Ruptured blisters or areas of raw, oozing skin should be gently cleansed with soap and water or soaks (see Formulary). An anti­biotic ointment may then be applied, but only in a very thin layer, since thick layers will not allow fluid accumulating in the skin to escape. A loose gauze cover can be applied to protect the wound. The layer of ointment on the wound will prevent the gauze from sticking to the wound. An alternate method is to apply a thin layer of the ointment or' sterile petrolatum (petroleum jelly) directly to the gauze before the dressing is laid on the burn.

Medical care should be sought for all third degree burns, and for any second degree" burns that cover more than very small areas. First degree burns over large areas, or that are particularly painful or swollen, will also require the help of a physician. Any signs of secondary infection, including increasing tenderness, swelling, redness, heat, or drainage of pus, should be checked by a physi­cian. Always be sure that tetanus immunizations are current, even for relatively minor wounds.