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"Don't touch that, honey, it's hot".

Burns can result from heat, chemicals, electricity or radiation.

The likelihood of radiation burns, however, is limited to a small section of the population.  Limited in its occurrence, as it is, it will not be discussed in this section, but, deferred to Basic Life Support .

When dealing with any burn, the primary objective should be to remove the "burning" action, without causing any additional injury to either the patient or the first aide provider.  If the burn is a superficial burn (first degree and some second degree burns,) this can be accomplished by immersing the burn in cool or cold water.  If the burn is a deeper burn (some second degree and third degree burns,) where blisters have formed and broken, or deeper layers of the skin are affected and  the burn site is oozing a clear fluid, then we need to shift our focus to infection control, and it is suggested that the burn site be covered with a clean (sterile, if possible) dry dressing.  Weather it's a superficial or deep burn, the first aide provider should never cover the burn with any salve or ointment, this will only serve to "keep the heat in," and our primary objective should be to remove the heat.  Here's a simple rule for the treatment of burns:  If the burn site is dry (superficial) - get it wet (water.)  If the burn site is wet (oozing) - keep it dry (dry dressing.)

Chemical burns can be caused by dry or liquid chemicals and need to be removed from the skin as quickly as possible.  As discussed in the previous section, DO NOT FORGET about, or disregard your own personal safety.  If the substance that is on the patient's skin is "burning" the patient and you get the same substance on your skin, IT WILL BURN YOU.  If the substance is dry or powdery,  it needs to be brushed off the skin as completely as possible, then flushed from the skin with copious amounts of water.  If the substance is a liquid then it needs to be immediately flushed from the skin with copious amounts of water.  Having the patient in a bathtub or shower would supply the required amounts of water in order to accomplish this goal.  The only chemical that CAN NOT be flushed from the skin with water, because it reacts violently with water, producing even more heat, is phosphorous.   The occurrence of burns as a result of phosphorous is mostly limited to the industrial sector and most likely would not be the concern of a "first aider."

If the burn is the result of contact with electricity, the first aiders immediate concern should be to ascertain that the source of electricity has been disconnected. Once assured, the external burn site should be treated like any other burn.  The amount of damage done by the electricity, however, may not be immediately apparent.  Electrical burns differ from others in-as-much-as there are two sites with which to be concerned.  There will be an "entrance" wound and an "exit" wound.  It is not important to be able to distinguish between the two, but rather just to be aware that there ARE two.  Each of those two sites may appear minor in severity, but it is not the external wound that is of concern.  From the position of the entrance and exit wounds we can surmise what pathway the electricity traveled through the body and may be able to insinuate which organs may have been affected by the flow of energy through the body, and it is the heat of the electricity and the effect of that heat (kind of a "cooking" action) on the internal organs and delicate internal tissue that is of concern.  No matter how minor the electrical burn may appear, the victim should be evaluated by a doctor, in an emergency department, immediately.

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Copyright 2002-2012 by Emergency Medical Ed All rights reserved.
Last updated: 04/13/13.