Alexei Volkov
Burns can be extremely dangerous and require immediate medical attention. In the event of a burn, it is important to act quickly to prevent further injury. First aid for burns typically involves cooling the burn with running water, removing any jewellery or clothing near the burnt area, and covering the burn with cling film or a plastic bag in the case of hand burns. If the burn is severe or fails to heal within three weeks, it may be necessary to refer to a plastic surgery unit for further treatment. Additionally, individuals with weakened immune systems or those who have inhaled smoke or fumes should seek medical attention at a hospital.
| Characteristics | Values |
|---|---|
| Soot Presence | Whether the burning plastic produces soot. The generation of soot during combustion demonstrates incomplete burning, which occurs frequently in plastics containing high carbon content and various additives. |
| Odor | The smell produced when the plastic burns. The aroma emitted from burning plastic can help identify the specific type of polymer used. |
| Material Drips | Whether the plastic drips during combustion. Thermoplastics drip during combustion because they become pliable when exposed to heat. Thermosets maintain their form and do not drip when exposed to flame. |
| Smoke Characteristics | The type and amount of smoke emitted. |
| Additives | The presence of additives like flame retardants modifies how materials behave when burned. |
| Burn Test | A burn test can help identify the type of plastic. However, advanced methods like spectral analysis are needed for conclusive results. |
| Healing Time | Burns that fail to heal within three weeks should be referred to a plastic surgery unit for review. |
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What You'll Learn
Burns that fail to heal within three weeks
Second-degree burns affect the epidermis (the outer layer of skin) and the dermis (the second layer). They cause skin discoloration, with colours ranging from deep red to dark brown, and a shiny, moist appearance. Blisters, pain or discomfort, and layers of skin peeling away are also common. The healing process for second-degree burns involves three stages: react, repair, and remodel. During the first stage, the body activates its immune system, causing inflammation, swelling, and skin discolouration. In the second stage, cells work together to remove damaged tissue and make room for new skin and tissue growth. Finally, in the remodel stage, the body creates a scar by closing any gaps in the tissue with collagen.
Third-degree burns damage both layers of the skin and can even affect deeper layers, such as underlying fat, muscles, tendons, and bones. The injured skin may turn white, black, or grey, and it may feel dry and leathery. These burns often result in heavy scarring and require proper medical care. Treatment for third-degree burns includes debridement, or the removal of dead tissue, followed by skin grafting or other forms of surgical reconstruction. Skin grafts involve removing injured skin and replacing it with healthy skin from another part of the body, known as the donor site. Meshed grafts, which create a mesh pattern that can cover larger areas, are often used for larger wounds or less functional and cosmetic areas.
If a burn has not healed within three weeks, it is important to seek medical attention to prevent further complications and ensure proper treatment and care.
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Acid and chemical burns
If you or someone else is experiencing an acid or chemical burn, it is crucial to take immediate action. Start by calling for emergency medical assistance and wearing gloves to protect yourself from the chemical. Remove any clothing or items contaminated by the chemical, being careful not to spread it to other areas. If the burn is on the skin, carefully brush off any dry chemicals and immediately flush the affected area with cool or lukewarm running water for an extended period, typically about an hour. Do not apply any creams or other substances to the burn, as this can interfere with treatment.
The management and treatment of acid and chemical burns in a hospital setting involve prompt and constant water irrigation to neutralise the chemical and stop its tissue-destructive effects. This initial irrigation is crucial, as chemical burns continue to damage tissue until the chemical is neutralised. After neutralisation, the burn is managed similarly to a thermal burn, addressing any specific complications associated with the type of chemical involved. For example, hydrofluoric acid exposure can lead to severe pain, low calcium levels, and raised potassium levels, requiring treatment with calcium gluconate to neutralise the acid and stabilise the patient's calcium levels.
The identification of the specific chemical involved in the burn is essential for guiding treatment. Different chemicals have distinct combustion properties and behaviours when burned, and advanced techniques such as infrared spectroscopy or pyrolysis-gas chromatography may be necessary for accurate identification. Additionally, the odour emitted during combustion can be a diagnostic tool for identifying the type of polymer involved. A thorough understanding of the chemical involved guides the medical team in addressing the specific secondary effects and clinical presentations associated with that particular substance.
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Electrical burns
The management of electrical burns involves immediate disconnection from the power source, adherence to ATLS protocols, and referral to burn centres. Treatment includes specialised fluid resuscitation, cardiac monitoring, and potential fasciotomies for high-voltage injuries. It is important to note that the outward appearance of an electrical burn may not reflect the true extent of the injury, as internal tissues or organs may be more severely affected.
In terms of first aid, it is crucial to ensure the electrical source is turned off. For electrical burns on the hands, arms, legs, or feet, the affected limb should be raised above heart level. Keep checking the victim's breathing and pulse rate and cover them with warm, dry clothes or blankets. If there are any odd sensations, pains, or feelings, even in areas remote from the burn, urgent evaluation is necessary.
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Inhaling smoke or fumes
The health risks associated with inhaling plastic fumes vary depending on several factors, including the type of plastic, the method of burning, and the length of exposure. Certain groups, such as children, the elderly, and individuals with pre-existing respiratory or immune conditions, are more susceptible to adverse effects. Additionally, occupational exposure is a significant concern for workers in industries involving plastic manufacturing or recycling, underscoring the necessity of stringent safety protocols.
To mitigate the risks associated with inhaling plastic fumes, it is crucial to prevent exposure and implement safety measures. The use of personal protective equipment (PPE), such as N95 masks and respirators, can significantly reduce the risk of inhaling harmful fumes. Proper ventilation and air circulation are also essential, as they help dissipate the fumes and reduce their concentration in the air. Opening windows and doors, using fans, and investing in air cleaners are effective ways to improve ventilation and air quality.
In the event of accidental exposure to plastic fumes, it is important to monitor for any symptoms and seek medical advice if necessary. While short-term exposure may result in minor irritation, prolonged or frequent exposure can lead to more severe respiratory issues and even cause extensive damage to vital organs, including the heart and lungs. Therefore, it is always advisable to minimize exposure to plastic fumes and prioritize prevention and safety measures to protect your health.
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Applying appropriate first aid
When a burn occurs, it is important to act quickly and calmly. Here are the steps to follow for applying appropriate first aid to burns:
Remove the Person from the Source of the Burn
Firstly, it is crucial to remove the affected person from the source of the burn to prevent further injury. If the person is connected to a high-voltage source (1000 volts or more), do not approach them. Call for emergency services immediately.
Remove Clothing and Jewellery
Remove any clothing, nappies, or jewellery near the burnt area of the skin. Do not try to remove anything that is stuck to the burnt skin, as this could cause more harm. If clothing is melted onto the skin, do not disturb it, but ensure you start cooling the burn immediately.
Cool the Burn
Cool the burn with running cool or lukewarm tap water for at least 20 minutes as soon as possible after the injury. Cooling can be beneficial for up to three hours after the injury, so start as soon as possible. Do not use ice, iced water, or any creams or greasy substances like butter or oily products.
Keep the Person Warm
While cooling the burn, it is important to keep the person warm to prevent hypothermia, especially in young children and the elderly. Use blankets or layers of clothing, but avoid covering the injured area. If a child starts shivering, stop the cooling process.
Cover the Burn
Cover the cooled burn with cling film, laying it over the wound rather than wrapping it, especially if the burn is on a limb. A clean, clear plastic bag can be used for burns on the hands to maintain mobility. If cling film is not available, use a clean, non-fluffy cloth or a non-sticky, sterile dressing. Avoid wet dressings, as they can cause heat loss during transfer to the hospital.
Treat Pain
Treat the pain from the burn with over-the-counter medications such as paracetamol or ibuprofen. Do not give aspirin to children under the age of 16.
Seek Medical Attention
For serious burns, call emergency services or seek immediate medical attention at a hospital. Burns that require urgent medical attention include electrical burns, acid and chemical burns, and burns where the person has inhaled smoke or fumes. Additionally, if the burn fails to heal within three weeks, refer to a plastic surgery unit for further review and treatment.
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Frequently asked questions
Remove any clothing or jewellery near the burnt area of skin. Cool the burn with cool or lukewarm running water for 20 minutes as soon as possible after the injury. Cover the burn with cling film. Treat the pain from a burn with paracetamol or ibuprofen.
You should go to the hospital if you have a weakened immune system, have breathed in smoke or fumes, or have been injured by electricity or chemicals.
If your clothing catches fire, extinguish the flames using water or the 'drop and roll' method.
Burns that fail to heal within three weeks should be referred to a plastic surgery unit for review.
