First+Aid,+Burns

=Burns= (Return to First Aid)

Burns
The most common system of classifying burns categorizes them as first-, second-, or third-degree. Sometimes this is extended to include a fourth or even up to a sixth degree, but most burns are first- to third-degree, with the higher-degree burns typically being used to classify burns postmortem. (//Usually burnsarefirst degree burns, second degree burns, or third degree burns. Third degree burns are wors than second and so on. Usually a person that gets a burn so bad that it is fourth, fifth, or sixth degree is already dead or will be within hours if not any second//.)

The following are brief descriptions of these classes: __First-degree burns__ are usually limited to redness (erythema), a white plaque and minor pain at the site of injury. These burns only involve the epidermis. (//Basically these burns usually leave white marks on your skin and redness//.)

__Second-degree burns__ manifest as erythema with superficial blistering of the skin, and can involve more or less pain depending on the level of nerve involvement. Second-degree burns involve the superficial (papillary) dermis and may also involve the deep (reticular) dermis layer. (//These burns show blisters//.)

__Third-degree burns__ occur when the epidermis is lost with damage to the hypodermis and possibly muscle underneath. Burn victims will exhibit charring and extensive damage of the dermis, and sometimes hard eschar will be present. Third-degree burns result in scarring and victims will also exhibit the loss of skin hair and keratin. These burns may require hospitalization. (//This is where the skin and just the skin chars. The Burn usually looks black and hurt a LOT. These burns usually heal with ugly scars over the whole surface that was burned//.)

__Fourth-degree burns__ damage muscle, tendon, and ligament tissue, thus result in charring and catastrophic damage of the hypodermis. In some instances the hypodermis tissue may be partially or completely burned away as well as this may result in a condition called compartment syndrome, which threatens both the life and the limb and the patient. Grafting is required if the burn does not prove to be fatal.

__Fifth-degree burns__ result in hypodermis being burnt off, leaving blackened muscle, tendon, and ligament. Fat, nerves, veins, and arteries have been destroyed and the burn area is paralyzed as a result. Amputation or grafting is required if the burn does not prove to be fatal, depending on the amount of bone envolvement.

__Sixth-degree burns__ leaving blackened bone and damaging marrow tissue, these burns will definitely require amputation.

Burns may be caused by a wide variety of substances and external sources such as exposure to chemicals, friction, electricity, radiation, and extreme temperatures, both hot and cold.
 * __Causes of burns__**

Most __chemicals__ (but not all) that can cause moderate to severe chemical burns are strong acids or bases. Chemical burns are usually caused by caustic chemical compounds, such as sodium hydroxide, silver nitrate, and more serious compounds (such as sulfuric acid and Nitric acid). Hydrofluoric acid can cause damage down to the bone and its burns are sometimes not immediately evident.

__Electrical burns__ are generally caused by an exogenous electric shock, such as being struck by lightning or defibrillated or cardioverted without a conductive gel. The internal injuries sustained may be disproportionate to the size of the burns seen, and the extent of the damage is not always obvious. Such injuries may lead to cardiac arrhythmias, cardiac arrest, and unexpected falls with resultant fractures. (//These burns usually come from being severly electrocuted and electric burns are tricky//.)

__Radiation burns__ may be caused by protracted and overexposure to UV light (as from the sun), tanning booths, radiation therapy (as patients who are undergoing cancer therapy), sunlamps, and X-rays. By far the most common burn associated with radiation is sun exposure, specifically two wavelengths of light UVA, and UVB, the latter being the more dangerous of the two. Tanning booths also emit these wavelengths and may cause similar damage to the skin such as irritation, redness, swelling, and inflammation. More severe cases of sun burn result in what is known as sun poisoning. (//Sun burn CAN cause 1st-2nd degree burns and causes a lot of cancer. Itching, redness, and peeling skin mean you have been burned too much. Use sunscreen and clothing or you will get to practice first aid on yourself//.)

__Scalding__ Scalding is a specific type of burning that is caused by hot liquids or gases. They most commonly occur in the home from exposure to high temperature tap water. Steam is a common gas that causes scalds. The injury is usually regional and usually does not cause death. More damage can be caused if hot liquids enter an orifice. However, deaths have occurred in more unusual circumstances, such as when people have accidentally broken a steam pipe. The demographics that are of the highest risk to suffering from scalding are young children, with their delicate skin, and the elderly over 65 years of age. (//Really hot water and hot gasses such as steam from a cooking pot or a pipe cause burns called scalding which hurt very badly as far as burns go//.)

__Cold burn__ A cold burn (see frostbite) is a kind of burn which arises when the skin is in contact with a low-temperature body. They can be caused by prolonged contact with moderately cold bodies (snow and cold air for instance) or brief contact with very cold bodies such as dry ice, liquid helium, liquid nitrogen, liquid discharged from an upside-down gas duster, or other refrigerants. In such a case, the heat transfers from the skin and organs to the external cold body. The effects are very similar to that of a burn caused by extreme heat. The remedy is also the same. For a minor cold burn, it is advisable to keep the injured organ under a flow of water of comfortable temperature. This will allow heat to transfer slowly from the water to the organs. (//Frostbite happens wherever ice-temperature cold is present, especially in conjunction with water or other liquids because they firther lower your body's temperature//.)

A local anesthetic is usually sufficient in managing pain of minor first-degree and second-degree burns; also Aloe vera sap can be used to heal the burn area. However, systemic anti-inflammatory drugs such as naproxen may be effective in mitigating pain and swelling. Additionally, topical antibiotics such as Mycitracin are useful in preventing infection to the damaged area. Lidocaine can be administered to the spot of injury and will generally negate most of the pain. Regardless of the cause, the first step in managing a person with a burn is to stop the burning process at the source. For instance, with dry powder burns, the powder should be brushed off first. With other burns, such as those caused by exposure to chemicals, the affected area should be rinsed thoroughly with a large amount of clean water to remove the caustic agent and any foreign bodies. Cold water should not be applied to a person with extensive burns, however, as it may compromise the burn victim's temperature status.
 * __First Aid__**:

__Small burns__: 1. Clean off the burned area and runn comfortable-temperature water over the burn. (You do this to get the heat out of the deeper layers of the skin. It is important because the victim may still be burning inside until you get that heat out.) 2. Once the heat is off put antibiotic on burns that are cut or open in any way. Let blisters and redness heal naturally. Make sure the heat is out of the burn before you apply antibiotic creams because the creams, bandaids, etc retain heat trapping it inside the burn. (Aloe vera is your best friend if you have it.)

__Large Burns__: This is one situation you do ot want to be in unless the burns are 1st-2nd degree but the best you can do is here. This is for large 1st-3rd burns 1. Get rid of anything that may continue burning the victim. 2. try to cool the burned area with comfortable temperature water for a long period because the burn is probably deep in addition to being large. 3. Try to keep open wounds especially from third degree burns away from infection but do not put anibiotics on yet. 4. Make the victim comfortable until an emergency vehicle arrives.

__Fatal Burns__: This is for fourth degree and higher burns. Pray you never see one but here you might actually save a life if you think on your feet. 1. If there is a great loss of blood anywhere stop it. Be careful putting pressure on burns that might crack open more. Light pressure if you think this might happen. 2. The burn victim probably has lung trouble from smoke if it was from a fire. Make sure their lungs are working. 3. Try to make them comfortable and lower their temperature but bear in mind that you should never use ice and try not to infect open dmaged wounds. (//Generally you need to stabilize them and make sure they do not choke or bleed to death until help arrives. They will probably be screaming and it will break your heart not to be able to do anything but keeping them stable and reducing infection is the BEST thing you can do until help arrives. There is little you can do//.) (//As a further note: though rarely burns that are really bad but are just on a limb such as a charred arm can be better isolated. If you get a full-body burn you might have to be creative. Remember to be in charge though and if someone more qualified is around you help them//.)

If the patient was involved in a fire accident, then it must be assumed that he or she has sustained inhalation injury until proven otherwise, and treatment should be managed accordingly. At this stage of management, it is also critical to assess the airway status. Any hint of burn injury to the lungs (e.g. through smoke inhalation) is considered a medical emergency.

To help ease the suffering of a burn victim, they may be placed in a special burn recovery bed which evenly distributes body weight and helps to prevent painful pressure points and bed sores. Survival and outcome of severe burn injuries is remarkably improved if the patient is treated in a specialized burn center/unit rather than a hospital. Serious burns, especially if they cover large areas of the body, can result in death.

Once the burning process has been stopped, the patient should be volume resuscitated according to the Parkland formula, since such injuries can disturb a person's osmotic balance. This formula dictates the amount of Lactated Ringer's solution to deliver in the first twenty four hours after time of injury. This formula excludes first and most second degree burns. Half of the fluid should be given in the first eight hours post injury and the rest in the subsequent sixteen hours. The formula is a guide only and infusions must be tailored to the urine output and central venous pressure. Inadequate fluid resuscitation causes renal failure and death. Hyperbaric oxygenation has been shown to be a useful adjunct to traditional treatments. (//This is mostly stuff you won't have unless you are a proffesional medic. Just remember the lungs. They can be tricky//.)

http://en.wikipedia.org/wiki/Burn
 * Also for good pictures of some burns see this Wiki Page**:

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