03Nebosh -First Aid Tips for Burns and Electrical Shock

Burns can result from dry heat (fire), moist heat (steam, hot liquids), electricity, chemicals or radiation (including sunlight). Treatment for burns depends on:
• The depth of the burn (whether it is first, second or third-degree)
• How much area of the body is affected
• The location of the burn
First-degree burns affect only the outer layer of skin. The skin area appears dry, red and mildly swollen. A first-degree burn is painful and sensitive to the touch. Mild sunburn and brief contact with a heat source (e.g., a hot iron) are examples of first-degree burns. First-degree burns should feel better within a day or two. They should heal in about a week if there are no complications.
Second-degree burns affect the lower layers of the skin as well as the outer skin. They are painful and swollen and show redness and blisters. The skin also develops a weepy, watery surface. Examples of second-degree burns are severe sunburn, burns caused by hot liquids and a flash from gasoline. Self-Care Procedures can be used to treat many second-degree burns, depending on where the burns are and how much area is affected.
Third-degree burns affect the outer and deeper skin layers as well as any underlying tissue and organs. They appear black and white and charred. The skin is swollen and underlying tissue is often exposed. The pain felt with third-degree burns may be less than with first- or second-degree burns or none at all because nerve endings may be destroyed. Pain may be felt around the margin of the affected area, however. Third-degree burns usually result from electric shocks, burning clothes, severe gasoline fires, etc. They always require emergency treatment. They may result in hospitalization and sometimes require skin grafts.
Questions to Ask

1) Is the burn a third-degree burn (Is there absence of pain, the presence of charred, black and white skin and exposure of tissue under the skin)
If answer is YES – Seek emergency care

If answer is NO – Go to next question

2) Is the burn a second-degree burn and on the face, hands, feet, genitals or on any joint (elbow, knee, shoulder, etc.)If answer is YES – Seek emergency care

If answer is NO – Go to next question
3) Is the burn a second-degree burn (Has it affected more than the outer skin layer, and does it show signs of extensive blistering (i.e., covers more than three inches in diameter of the skin)
If answer is YES – Seek a Doctor

If answer is NO – Go to next question

4) Does the burn occur in an infant or a young child

If answer is YES – Seek a Doctor

If answer is NO – Provide Self Care

Self-Care Procedures for Burns:
First-Degree Burns:
•Cool the area right away. Place the affected area in a container of cold water or under cold running water. Do this for at least five to 10 minutes or until the pain is relieved. This will also reduce the amount of skin damage. (If the affected area is dirty, gently wash it with soapy water first.)
•Do not apply ice or cold water for too long a time. This may result in complete numbness leading to frostbite.
•Keep the area uncovered and elevated, if possible. Apply a dry dressing if necessary.
•Do not use butter or other ointments (e.g., Vaseline).
•Avoid using local anesthetic sprays and creams. They can slow healing and may lead to allergic reactions in some people.
•Call your doctor if after two days you show signs of infection (fever of 101 degrees Fahrenheit or higher, chills and increased redness, swelling or pus in the infected area) or if the affected area is still painful.
•Take aspirin, acetaminophen, ibuprofen or naproxen sodium to relieve pain.
Note: Do not give aspirin or any medication containing salicylates to anyone 19 years of age or younger, unless directed by a physician, due to its association with Reye’s syndrome, a potentially fatal condition.
Second-Degree Burns:
(that are not extensive and are less than three inches in diameter)
•Immerse the affected area in cold (not ice) water until the pain subsides.
•Dip clean cloths in cold water, wring them out and apply them over and over again to the burned area for as long as an hour. Blot the area dry. Do not rub.
•Do not break any blisters that have formed.
•Avoid applying antiseptic sprays, ointments, creams. Once dried, dress the area with a single layer of loose gauze that does not stick to the skin. Hold in place with bandage tape that is placed well away from the burned area.
•Change the dressing the next day and every two days after that.
•Prop the burn area higher than the rest of the body, if possible.
•Call your doctor if there are signs of infection (e.g., fever of 101 degrees Fahrenheit or higher, chills and increased redness and swelling or pus in the affected area) or if the burn shows no sign of improvement after two days.
Chemical Burns:
Flush the burned area with plenty of running cold water to remove traces of the chemical. Apply either a commercial burn ointment, a thick layer of honey, petroleum jelly, or a thick paste of baking soda and water to the burned area. Cover with a loose protective bandage.
Note: If the chemical burn involves the eye, immediately flush the eye with plenty of running water, cover the eye with a sterile pad to keep the lid still and contact immediate medical help.
Electric Shock Burns:
Someone who has sustained an electrical shock can be in extremely critical state. Do not touch the victim if he is still touching the electrical equipment which caused the shock. The rescuer should disconnect the attachment plug from the socket or disconnect the main house electrical switch, if possible. If not possible, separate the victim from the source of the contact by means of a long, dry stick, a dry rope or a long length of dry cloth. Be sure that your hands are dry and that you are standing on a dry surface.

Once you’ve removed the person from the source of the contact, check to see if he is breathing. If not, begin mouth-to-mouth resuscitation immediately. If there is someone else available, have them call for resuscitation help from the fire department, ambulance, or police. Continue mouth-to-mouth breathing until the ambulance arrives. A second person may initiate CPR if necessary.

Electrical burns are difficult to detect. A person who has received a severe electrical shock may have badly burned underlying tissue, thought the surface skin shows little evidence. Get the victim prompt medical attention. Unattended electrical burns can lead to serious complications.

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