First Aid for Burns and Scalds

Burns are due to dry heat (including friction), whereas scalds are due to wet heat (like steam). Burns and scalds must be treated promptly and carefully to limit the effects of the injury and to prevent possible long-term scarring.

Assessing a burn or scald

You will have to assess the depth and extent of the injury.

Depth:

• Superficial (1st degree wound): The skin is red and tender and may be swollen. This type of burn or scald is very painful.
• 2nd degree burn or scald: The skin is blistered and raw. The burn/scald is painful. Extensive burns/scalds of this type can be fatal.
• 3rd degree burn or scald: The skin is burnt away and damage extends into the muscle and fat layers. There is a pale, waxy look to the area and there may even be charred skin. There is little to no pain associated with this type of injury because nerve endings have been damaged.

Extent:

When assessing the size of a burn 1% is equal to the size of the casualty’s hand.

When to expect burns/scalds to the mouth and throat:

• The face has been burnt.
• There is soot around the nose or mouth.
• The history of the incident suggests that the casualty inhaled hot fumes or smoke.
• The casualty's voice starts to become hoarse.

Burns to the mouth and throat will rapidly start to swell, for this reason it is very important to treat the burns as an emergency, because swelling could restrict breathing.

• Dial emergency services
• Loosen any tight clothing.

Serious burns and scalds

• Dial emergency services immediately.
• Gently flood the affected area with cold water (or any other non-flammable liquid like milk or beer).
• Remove any clothing not sticking to the wound.
• Cover the wound with non-fluffy material like a pillowcase.
• Wrap the area in cling wrap (discard the first two turns from the roll).
• Do not waste time to secure the ends of coverings in place.
• Continue to apply cold, not ice, water over the area.
• Wrap the casualty in a blanket and take care not to cool the casualty down too much.
• Treat the casualty for shock.
• Do not put the casualty in a bath filled with cold water; this will cause the casualty's core temperature to drop too quickly and hypothermia could set in.
• Do not apply lotions or butter etc. to the wound. This does not cool the wound down and can cause severe infections.
• Do not completely enclose limbs in cling wrap because as swelling starts, the coverings could restrict blood flow.
• Do not use adhesive tape to keep coverings in place.
• Hands and feet can be put into clean plastic bags instead of cling wrap.

Minor burns and scalds

• Hold the affected area under cool running water for at least 15 minutes. Do not use ice.
• Remove any jewellery from the affected area before swelling starts.
• Do not put lotions or butter on the burn or scald. Once again, this doesn't cool the area and can cause infection.
• Do not burst blisters. Cover blisters or raw areas with sterile dressing or a plaster.
• If the area becomes infected, seek medical advice.
• Do not use adhesive tape to hold dressing in place.

Electrocution

Do not attempt to help an electrocuted casualty if it poses any danger to your well-being. Ensure that the current is switched off before touching the casualty. If it is not possible to switch the current off, use a broom or any non-conductive material to knock the source of electricity away from the casualty. Remember, water conducts electricity…

Treatment:

• Ensure that the casualty's airway is open, that the casualty is breathing and that there is a carotid pulse. Act accordingly.
• Treat any burns as described above.
• Phone emergency services.

Fire

When someone's clothes are on fire, the action you take will be vital to their well-being. Your main concern, of course, is to extinguish the flames.

What to do:

• Lay the casualty down so that the flames are on top.
• Douse the flames with a non-flammable liquid like milk or water. Or
• Wrap the casualty tightly in a blanket, rug or coat. Wool is especially effective because it is non-flammable. Do not use nylon, polyester or any other manmade fabrics).
• Lay the casualty down on the ground.
• Flames need oxygen to burn and the blanket etc. will starve the flame of oxygen, causing it to die.
• Do not allow the casualty to run around.
• Do not beat at the flames.
• If you do the above, the flames will 'jump'; they will spread, causing further burns.

Treatment:

• Treat the burns as described above.
• Phone emergency services.
• Treat the casualty for shock.