Burns and Scalds

Burns and scalds, a type of burn caused by wet heat, are potentially fatal injuries. They can cause life-threatening shock through serious fluid loss and, if around the face and neck, can restrict breathing.

What are the risks from burns?

In burns, fluid is lost in three main ways:

• Blistering
• Swelling around the injury
• Directly from the injury

While the fluid loss may not be visible as liquid lying around the casualty it is nevertheless lost from the blood as a straw-coloured substance known as plasma. Severe burns therefore can and often do prove to be fatal.

The second risk from burns is infection. The damaged tissue provides little or no resistance to infection and serious problems may arise some time after the initial injury. The risk of infection increases with the size and depth of the burn, and the casualty will probably suffer from shock as well.

Causes of burns

Dry heat This is the most common type of burn and includes burns caused by hot objects such as exhausts or by cigarettes or lighters.

Wet heat Also known as a scald, wet heat usually refers to hot water or steam but it can also include other hot liquids such as oil or fat.

Friction When two objects rub together very quickly friction generates heat, causing another kind of dry burn.

Chemical burns Industrial and household chemicals can cause serious burns.

Electrical burns These can be caused by the everyday low-voltage currents found in switches, wires and appliances around the home or from the high-voltage cables scattered around the countryside in the form of power lines, railway tracks and so forth. In rarer cases electrical burns can be caused by lightning strikes.

Radiation burns While this may sound dramatic, most of us have suffered some degree of radiation burn at some point in our lives - more commonly referred to as sunburn.

Depth of the burn

Burns are classified into three types:

Superficial burns only involve the outer layer of skin and, although often extremely painful, are generally not life­threatening unless a very large surface area of the body is covered. The burnt area is very sore and is usually red and possibly a little swollen. If good first aid treatment is applied and the area burnt is not extensive, then further medical treatment is unlikely to be needed.

Partial thickness burns include the top layers of skin and involve blistering. They are characterised by red, raw­looking skin with blisters that weep clear fluid, and pain. The risk of shock is high with partial thickness burns and any burn of this type needs medical attention. Partial thickness burns covering a substantial percentage of the body can kill.

Full thickness burns involve damage to all the layers of skin, usually including the nerve endings and other underlying tissues and organs. Characterised by charred tissue often surrounded by white waxy areas of dead skin with damaged nerves, full thickness burns will always need emergency medical attention and in the long term will often require plastic surgery.

Area of the body burn

Generally, the larger the area of the body burned, the more serious the burn. Any burn to the face or neck needs urgent medical attention. As a general principle, if the casualty has other injuries, appears to be in a great deal of pain, is showing signs and symptoms of shock, is having difficulty breathing, or you have other reasons to suspect that his or her condition is more serious, then call an ambulance whatever the extent or depth of the burn.

How do you tell how severe a burn is?

Many burns are minor and can be safely treated at home or with help from a local doctor or pharmacist.

However the size and depth of the burn will tell you if it needs urgent medical treatment.

How to Treat Burns and Scalds