BURNS

General Information

DEFINITION--Injury to the skin, and sometimes other organs, from contact with heat, radiation, electricity or chemicals.

BODY PARTS INVOLVED--Skin; underlying tissue and respiratory system (sometimes).

SEX OR AGE MOST AFFECTED--Both sexes; all ages. The risk of damage is greatest with infants and young children.

SIGNS & SYMPTOMS--

Burns are of 3 types:

• 1st-degree burns are limited to the upper skin layer. They produce redness, tenderness, pain, swelling and slight fever.
• 2nd-degree burns affect deeper skin layers. Symptoms are more severe and include blisters.
• 3rd-degree burns involve all skin layers. Skin is white (appears cooked), and there may be no pain in the initial stages.

CAUSES

• Rise in skin temperature from heat sources, such as fire, steam or electricity.
• Tissue injury caused by chemicals or radiation, including sunlight.
• Lightning strikes can cause internal burns with minimal external signs.

RISK INCREASES WITH

• Stress, carelessness, smoking in bed or excess alcohol consumption, all of which make accidents more likely.
• Occupations involving exposure to heat or radiation, such as firefighting, police work or defense-factory work.
• Faulty wiring.
• Hot water heaters set too high.

HOW TO PREVENT

• Wear sun-screen lotions outdoors.
• Fireproof your home. Install smoke alarms, plan emergency exits and have regular fire drills.
• Wear protective gear and observe safety precautions around heat or radiation.
• Don't touch uncovered electric wires.
• Teach children safety rules for matches, fires, electrical outlets and cords.
• If you have small children, put safety caps on unused outlets. Discard frayed cords.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory blood and urine tests, and studies of kidney and liver function (severe burns).

APPROPRIATE HEALTH CARE

• Self-care for most 1st-degree burns.
• Doctor's treatment for more severe burns.
• Hospitalization for all large 3rd-degree burns and some 2nd-degree burns. Special burn centers exist for the worst cases.
• Surgery to graft skin over 3rd-degree burns (see Skin Graft in Surgery section).

POSSIBLE COMPLICATIONS--Infection at the burn site; pneumonia; shock due to loss of fluids and electrolytes (severe burns); permanent scars; vision impairment, if eyes are injured; tetanus and other infections.

PROBABLE OUTCOME--Most persons recover if the extent of burns (including 3rd-degree burns) is limited to 50% of the body surface. For less-severe burns, skin usually repairs itself in 1 to 3 weeks.

How To Treat

GENERAL MEASURES----For severe burns see Emergency First Aid section. For less-severe burns:

• Apply non-prescription body lotion to cool 1st-degree burns.
• Immerse small 2nd- or 3rd-degree burn areas in cold water for 10 minutes to reduce pain and swelling.
• Keep the burn area clean. Soak in a tub or use lukewarm compresses once a day. You may add 2 tablespoons of powdered detergent to the tub to help soak off crusting areas. Use plain water for compresses.
• Prop the burn area higher than the rest of the body, if possible.
• You may use dressings on the burn.

MEDICATION--

• To treat minor burns, you may use non-prescription antibiotic ointments, topical anesthetics and aspirin.
• To treat severe burns, your doctor may prescribe pain relievers, antibiotics and tetanus booster shots.

ACTIVITY--Depends on location and extent of the burn. Getting a burn patient up and moving as soon as possible after treatment begins is an important part of the recovery

DIET--No special diet for minor burns. More severe burns require intravenous feeding.

Call Your Doctor If

• You or a family member has been burned. This can be an emergency.
• An infant has a burn, even if it seems minor.
• The following occur during treatment: No healing in 6 days; chills and fever; increased pain, redness, swelling or pus in the burn area.