Burns and electrical injuries

Shelley Westwood, RN, BSN

Burns

A burn is an injury caused by fire, heat, chemicals, radiation, or electricity.

Burns are traumatic in that they can cause extreme pain, permanent disfigurement, psychological problems, and even death.

Types of Burns

Thermal - caused by house fires, car accidents, scalding water, irons, sunburn, etc.

Chemical - caused by contact with acids or alkaline. Contact includes ingesting, inhalation, and injection.

Electrical - caused by faulty electrical wiring, chewing on electrical cords, high-voltage power lines, and the rare occurrence of lightening strikes.

First-Degree Burns

First-degree burns:

▫ Superficial burns

▫ Most mild burn

▫ Damages only the epidermis

Symptoms:

▫ Hot, red, dry skin

▫ Mild Swelling

▫ Pain

Causes:

▫ Sunburn

▫ Brief contact with hot objects, steam, or weak acids

Superficial Burn

Example: Sunburn

Second-Degree Burns

Second-degree burns:

▫ Partial-thickness burns

▫ Effects the epidermis and the dermis

Symptoms:

▫ Blister or vesicle

▫ Skin appears wet and mottled

▫ Swelling

Causes:

▫ Boiling liquid and fire

▫ Extreme sunburn

▫ Artificial radiation

Partial-Thickness Burn

Risk of secondary infection

is greater

Example: Severe Scalding

Third-Degree Burns

Third-degree burns:

▫ Full-thickness burns

▫ Affects the epidermis, dermis, the tissue beneath the skin, and possibly the muscles and bones

▫ Nerve endings are destroyed

Symptoms:

▫ White or charred skin

Causes:

▫ Fire and flames

▫ Extended contact with hot objects

▫ Exposure to electricity

▫ Immersion in a boiling substance

Full-Thickness Burns

Risk for life-threatening infections that can lead to septic shock and death

Extent and Severity of Burns

Burns are also categorized based on the extent and severity of the injury

The Rule of Nines

In an adult, each arm is 9%, each leg 18%, the upper back and lower back are 18%.

There are 11 areas that, when totaled equal 99%

▫ Adults should get medical care if burns cover more than 15% of the body

▫ Children should get medical care if burns cover more than 10% of the body.

Extent and Severity of Burns

Another method for categorizing burns is a combination of the burn’s depth and its size.

If the second-degree burn is no larger than 3 inches (7.6 centimeters) in diameter, treat it as a minor burn.

If the burned area is larger or if the burn is on the hands, feet, face, groin or buttocks, or over a major joint, treat it as a major burn and get medical help immediately.

First aid treatment of minor burns

Check-Call-CareMake sure scene is safe, get first aid kit and

wear appropriate PPE.

If burn area is small, cool it immediately with cold, but not ice-cold, water. Run cold water on burn until it doesn’t hurt.

You may cover the burn with a dry, nonstick sterile or clean dressing.

The only thing you should apply to a burn is cool water and clean dressings unless given other instructions by a healthcare provider.

Call 9-1-1 if…

There is a fire

The person has a large burn

You are not sure what to do

First aid treatment for large burns

Make sure scene is safe, get first aid kit and call 9-1-1

If the person is on fire, put the fire out

Remove jewelry and clothing that is not stuck to the skin

Cover the person with a dry blanket

Check for signs of shock.

Electrical injuries

Electricity can burn the body inside and outside.

Can stop breathing or cause a deadly abnormal heart rhythm.

May only leave small marks on the outside of the body but could cause extensive damage inside.

First aid for electrical injuries

Make sure scene is safe, get first aid kit and AED, wear appropriate PPE.

Call or send someone to call 9-1-1

Don’t touch the person if they are still in contact with the electrical source.

Once they are safe to touch see if they need CPR. If so, perform CPR.

They must receive follow-up care at a healthcare facility.