Tag: managing burn injuries

Wounds are skin breakages caused by injury. Complications in relation to wounds include bleeding and infection.

Types of Wounds

• incision – a cut, such as one made with a knife
• laceration – pulled off skin
• abrasion – wound caused by friction
• contusion – a.k.a. bruising
• puncture wound – wound caused by a pointy object eg. nail

First Aid for Traumatic Wounds

There are 3 concepts required in providing immediate care for traumatic wounds:

1. control the bleeding
2. clean the wound
3. protect the wound

1. Control the Bleeding

• Step 1: wear gloves to protect self from casualty’s blood
• Step 2: control the bleeding
• Step 3: assess for shock & if suspected, provide first aid for shock
• Step 4: call 112 for assistance

2. Clean The Wound

• Step 5: once the bleeding is under control, irrigate the wound with running water
• Step 6: remove gross debris

3. Protect The Wound

• Step 7: cover wound with a clean cloth or sterile dressing if available
• Step 8: seek medical advice as required

NOTE: DO NOT remove any foreign objects embedded in wounds! Such objects need to be removed in a hospital setting, with adequate pain relief. If foreign object is embedded, apply bandaging to hold it in place until casualty arrives at the hospital.

First Aid for Particular Types of Wounds

Fracture site wounds

If there is a visible fracture at the injury site, or a fracture is suspected, do not apply a lot of pressure to stop the bleeding since this would cause a lot of pain, as well as create further problems with the fracture. In such case you can still irrigate the wound by running water.

Thoracic Wounds

When dealing with thoracic wounds, do not apply too much pressure to stop the bleeding. Additionally, leave the chest wound uncovered. You may clean the area surrounding the wound, but there is no need to irrigate the wound with running water.

Abdominal Wounds

If an injury to the abdomen causes the intestines to be pushed out of the abdomen, do not attempt to push them back inside the casualty, as this may cause serious damage. Instead, use a moist sterile cloth and cover the intestines, or else leave the intestines uncovered and wait for the ambulance to arrive.

Burns

Burns occur when the body is exposed to thermal, chemical, or electrical energy which leads to skin loss and damage to the underlying tissue. Complications arising from burns include tissue damage, fluid loss, heat loss, and infection.

Types of Burns

• thermal burns – flames, hot objects, flash burns, radiation, hot liquids, and steam burns
• chemical/corrosive burns
• electrical burns – caused by electric conduction which usually causes 2 wounds: a small entry wound and a larger wound at the earthing area; electrical burns can easily cause a cardiac arrest!

The severity of an injury caused by a burn depends on factors such as the site of injury, the depth and extent of injury, the cause, as well as the casualty’s age, prior health status and additional injuries.

Burn Depth

1. Superficial Burn

In a superficial burn, the burn affects only the epidermis of the skin. Signs of a superficial burn include:

• pain
• redness
• blanches with pressure
• absent oedema

2. Partial Burn

In a partial burn, the burn affects both the epidermis and the dermis. In such burns, blisters may appear, which are fluid-filled located between the epidermis and the dermis. NEVER burst a blister unless in a hospital setting! Signs of a partial burn include:

• pain
• blisters
• moisture

3. Full Burn

In a full burn, the burn uncovers the structure of the affected area – structures such as muscles and bones. Nerves are usually burned in these types of burns, which causes the casualty to experience no pain sensation. Signs of a full burn include:

• uncovered structures
• discolouration
• dryness
• absent pain

Measuring the Extent of a Burn

• Method #1: The Palmar Method
• Method #2: The Rule of 9’s

Managing Burn Injuries

In burn injuries the main aims are to:

• reduce pain
• reduce the burning process
• protect the injury

1. cool burn down with running water
2. remove ALL burnt clothing
3. cover burned area with a moist dressing and keep it wet so it doesn’t stick to the burnt area
4. if a moist dressing is not available, cover the area with plastic film
5. seek medical attention

• DO NOT use any creams to treat burns.
• DO NOT use ice to calm down the burning sensation as ice can cause a burn too.
• DO NOT remove any clothing that is seemingly stuck to the burnt area.

First Aid for Other Types of Burns

Electrocution burn

Whilst an electrocuted casualty may not experience a cardiac arrest immediately, it is still possible after some time. Thus, if the casualty complains of chest pain and dyspnoea, get ready to resuscitate as a cardiac arrest may become quite possible.

Liquid chemical burn

If a casualty experiences a liquid chemical burn, flood burned area with water.

Dry Powder Chemical Burn

In the case of dry powder chemical burns, brush dry powder off, making sure it is still safe for you, and then flood with water.

NOTE: Inhaling hot or chemical fumes causes burns within the airway and the lungs. Thus, a casualty experiencing inhalation in such cases should go to the hospital for treatment as soon as possible.

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