Burns

Who doesn’t love a BBQ or candle lit room? However, burns are a common presentation to the Emergency department.

First aid for burns is often misunderstood and getting it right can make all the difference to the outcome.

  1. All burns need to be cooled as soon as possible. This is at least 20 minutes of cold, running water which can be effective up to 3 hours after the burn has occurred. The burn can extend after the initial contact so this step is vital. Never use ice or cold packs as it is the continuous flow of water that actually helps prevent the skin damage. Similarly if an irritant chemical contacts the skin, irrigation with water is needed, often for much longer times periods.
  2. Try and remove jewellery or tight clothing as the area will swell
  3. Once cooling has been done try to keep the affected area irrigated to reduce swelling
  4. Covering the burn with clean cling film may help to reduce pain before getting to hospital, it is the damaged nerve endings contact with air that often cause much of the pain. Do not put any creams, ointments, honey or butters on the burns

 

In general burns should be assessed by a medical practitioner in order to make sure the correct treatment is initiated. There are some situations where doctors may be more concerned than others and the patient may need urgent transfer for specialist care. For example, electrical or chemical burns, burns to the face or burns with high amounts of thermal energy.

Blistering of a burn is a sign that it is not superficial as the deeper layers of skin are separated, these will all need medical attention.  Burns affecting the hands, feet, joints of the arms or legs and genitalia also need urgent expert assessment.  When you are seen in the Emergency department you may also require a tetanus booster as a burn can put you at risk of tetanus infection. Most burn injuries also require follow up with the GP or burns clinic, as they can often look worse after 2-3 days and require specialist dressings.  It is important that a healthcare practitioner keeps a close eye on the healing process so they can refer to a burns expert if necessary.

As well as the burn itself, smoke exposure can be very harmful.  This can happen with both enclosed fires and with prolonged exposure such as in bushfires or industrial fires.

The lining of the airway itself can be burnt which may be suggested by singed facial hair or blackening around the mouth and nose.

There are also several poisonous gases in smoke including cyanide and carbon monoxide.

Carbon monoxide is colourless and odourless so cannot easily be detected. That is why smoke AND carbon monoxide detectors should be in every home.  Poisoning may be subtle with symptoms such as mild confusion, headache, fatigue, vomiting. In more serious cases this can progress to coma and even death.

 

If you are unsure what to do about a minor burn or concerned about smoke inhalation and you need to speak to a doctor, download the My Emergency Dr app for an urgent consultation with a qualified specialist emergency doctor 24 hours a day, seven days a week.

Categories:

John Greenfield