Burns
Burns are tissue injured caused by the contact with heat, flame, chemicals, electricity.
It is a type of coagulative necrosis.
Its effects are not limited to brunt area but can cause serious systemic effects.
Types of burn
1. Thermal burns:
Scald: spilling of hot liquid
Flame burns
2. Electrical:
They are more deeper and harmful.
3.Chemical:
It is common in children
Classification of burn
According to depth of burn:
1. Superficial burns- involves only the upper layer of skin.
Formally known as 1st degree burn.
Red looking, no blistering
Painful
fast healing usually within 10days
Without leaving scar
2. Superficial partial thickness( 2nd degree):
Involves epidermis and papillary dermis.
Redness with clear blister
Blanches with pressure.
Very painful
Wound heals in 2-3 weeks
3 Deep partial thickness (2nd degree):
Involves reticular dermis.
May leave scar
Pain and discomfort
Healing time 3-8 weeks
4 Full thickness (3rd degree):
Extends into skins dermis and beyond hair follicles, nerves, sweat glands, muscles and bones.
May never recover if badly burned
Skin is white leathery, black
Painless
Needs skin grafting
B. According to extent of burn injury
First degree:
Superficial burn
Pink red discolored area with slight edema.
Pain persist up to 48 hours relieve by cooling.
Epidermis peels off within 5 days
No scar
Healing takes place spontaneously within 10 days
2. Second degree:
Affects epidermis and dermis
Pain, blister, oozing of fluid
Red splotch skin
3. Third degree burn:
Destruction of skin, fat muscle and bone
No blanching with pressure
Not painful
Discoloration vary from waxy white to brown.
Leathery which must be removed
Granulation tissue develops
Grafting is required
Grafting done only after wound debridement
First aid management of burn:
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Remove victim from source.
Ask victim to lie down and roll.
Avoid running
Extinguish fire by running water for 10 min.
Remove jewelleries.
If major burn: look for CAB, take vitals
Call for emergency help.
Don’t remove the clothes if stuck
Don’t touch the wound
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Don’t apply lotion, oil on burn
Do not give victim to eat or drink unless reach to hospital.
Cover with clean clothes
If electricity burn: switch off as soon as possible.
Do not touch casualty
Assess the level of consciousness and other injuries
If chemical burns like: sulfuric acid, sodium hypochlorite, hydrofluoric acid get victim
out of it as soon as possible
Do not try to neutralize burn
Flood the injured part with water for 20min
Chemicals like dry lime, phenols elemental metals should not be irrigated
Brush off prior to irrigation
Refer to hospital
Poison
Is any substance (solid, liquid, gas) that even in small amount can cause damage or interferes
with bodies function.
Poisoning is a state caused by introduction of harmful substances.
Children under 5 are common victim
May occur as acute exposure or chronic exposure to poison
Causes of poisoning
Accidental poisoning: due to contaminated food, water, fungi, berries, sleeping pills.
Suicidal: intentional taking of poison
Homicidal poisoning
First aid Management for Poisoning
Ensure safety:
 Assess the casualties circulation, airway and breathing, check for pulse.
 If inhalation poisoning provide open ventilation and move from poisoning gas.
 If victim is breathing but unconscious, put in recovery position.
 Identify the source of poisoning Look for empty bottles and keep it .
 Find out time, type and amount of poisoning.
 Change the clothes if poison spills and flush the skin.
 If on the eye gently flush the eye with cool water for 20 minutes.
 If food poisoning: Encourage to take rest and avoid solid food for 24 hours
 If symptom persists take to hospital
 If the person vomits turn head to side
 If non- corrosive poisoning: induce vomiting
 If corrosive poisoning: do not induce vomiting.
 Change the clothes that is contaminated with poison.
 Refer to hospital