I have recently had a little run of accidently burning myself…. Once on the grill and once on the iron. I can hear you saying perhaps you shouldn’t cook, and definitely don’t iron!!
“Prevention is the best first aid after all!”
But in all seriousness, it made me think of the many patients that I have seen over the years that have not applied appropriate first aid to a burn and then ended up with painful blistering and sometimes infection. It also made me think of one Patient in particular that DID apply the correct first aid to his large burn on his hand. We were worried that it would require specialised wound care and rehab because it was on his hand and due to wearing a coat the skin had prolonged contact with the boiling water. But when he turned up for his dressing change the next morning we were amazed to see that there was minimal blistering and no loss of skin. Whilst it still needed protecting and dressing, he did not need hospital care. This all came down to the first aid that he had applied in those first 20 minutes.
In a recent video I discussed the WHY of burn first aid as I find that many people don’t apply appropriate first aid even though they technically know what to do. You can find that video on my FB page https://www.facebook.com/head2toefirstaid/
This blog however, is dedicated to the WHAT of burn first aid. What should burn first aid look like?
Firstly, let’s review the types of things that can burn…
Thermal (hot and cold): my daughter has been burnt when she went on a plastic slide on a hot day, I also once had an elderly Patient that fell on a very hot day and as she couldn’t get up quickly ended up with a burn on her hip!
Electricity: it is worth mentioning that electricity burns should always get assessed as they often are worse than they appear on the surface
Radiation: this includes the good old sun… so don’t forget to slip, slop slap and slide into the shade!
The next step is to use your knowledge of what can cause a burn to actively try and prevent them. Prevention is a whole other blog in itself but think of bath water temperature, where you place your hot drink, how you position your saucepan handles, where you keep your cleaning chemicals…. More information can be found on burn prevention here http://www.kidsafensw.org/imagesDB/wysiwyg/BurnInjuryPrevention2013_2.pdf
Although you may have done all that you can do to prevent a burn happening, they can still occur and you will need to know what to do. The important steps of burn first aid is:
• To cool the area immediately with cool running water for at least 20 mins (30 mins if it is a bitumen burn).
• Elevate the area if possible (e.g. on a limb) to reduce swelling
• Cover the area with a non-stick dressing. A great temporary measure that will allow you to safely cover the area while waiting for medical assessment is good old gladwrap. Sealing the burn from air will help to reduce the pain as nerve endings will not be exposed.
The initial first aid used for a burn can really change the outcome and the recovery time…
There are a few points to add to the above… Remember ice can burn so cool running water NOT ice is what is best to stop the burning process. Hydrogels should only be used if water is NOT available. Remove tight clothing and jewellery before swelling occurs, however DO NOT peel of stuck clothing. DO NOT pop blisters.
An important part of first aid is knowing when to seek help. Sometimes it is obvious and if the burn is significant/severe or involves the airway you need to call 000 and apply the above first aid whilst waiting for the ambulance. However, if the burn is not significant or severe then a good way to decide if you need to seek medical help is to think of the following:
- Is it the size of a 20c piece or bigger? If so you need to seek medical help.
- Is it on a functional area (face, over a joint, hands or feet)? Then you need to seek medical help to minimise scarring and ensure the function of the area is not compromised.
- Is there a blister? If so then the right dressing by a Dr or nurse straight away will minimise the infection risk and ensure the area heals quickly.
- Is the person very young, old or ill? If so they will be more affected by the burn and should seek medical help.
- Remember if you are unsure about whether the burn needs to be assessed then it probably does, so follow your gut.
The initial first aid used for a burn can really change the outcome and the recovery time so please, please take the time needed to properly cool a burn down and seek the appropriate medical help based on the severity, symptoms and location of the burn. Stay safe and remember that ironing can be dangerous as I found out this week!