Burns and Scalds:
Recognising and Treating Thermal Injuries

Burns and scalds are common injuries caused by heat, such as contact with flames, hot liquids, or steam. The severity of burns can range from minor to life-threatening, depending on the depth and size of the injury. Knowing how to provide first aid for burns and scalds can help reduce pain, prevent infection, and promote healing.

What are Burns and Scalds?

• Burns are caused by dry heat, such as flames, hot objects, or friction.
• Scalds are caused by wet heat, such as hot liquids or steam.

Both burns and scalds damage the skin and, in more severe cases, the underlying tissues, muscles, and bones. They can also lead to complications such as infection or shock if not treated properly.

Types of Burns

Burns are classified by their severity and the depth of damage to the skin. The three main types of burns are:

• Superficial Burns: These burns affect only the outer layer of the skin (epidermis) and usually cause redness, mild swelling, and pain. Sunburn is an example of a superficial burn.
• Partial-Thickness Burns: These burns extend deeper into the skin, affecting both the epidermis and the dermis (the layer beneath the epidermis). They cause redness, swelling, blistering, and more intense pain.
• Full-Thickness Burns: These burns damage all layers of the skin and may also affect the underlying tissues. The skin may appear white, charred, or leathery, and there may be little or no pain initially due to nerve damage.

Causes of Burns and Scalds

Burns and scalds can result from various sources of heat, including:

• Flames: Contact with open flames from fires, stoves, candles, or fireworks.
• Hot Liquids and Steam: Scalding from boiling water, hot drinks, or steam from cooking appliances.
• Hot Objects: Contact with hot surfaces, such as irons, ovens, or heated tools.
• Electrical Burns: Burns caused by exposure to electrical currents.
• Chemical Burns: Exposure to corrosive chemicals, such as acids or cleaning products, can cause burns.

Signs and Symptoms of Burns and Scalds

The signs and symptoms of burns vary depending on the severity:

• Superficial (First-Degree) Burns:
  • Red, painful skin
  • Mild swelling
  • No blisters
  • The skin may peel as it heals
• Partial-Thickness (Second-Degree) Burns:
  • Red or mottled skin
  • Swelling
  • Blisters
  • Severe pain
• Full-Thickness (Third-Degree) Burns:
  • White, charred, or leathery skin
  • Possible numbness or lack of pain (due to nerve damage)
  • Swelling
  • The affected area may look waxy or dry

First Aid for Burns and Scalds

Providing proper first aid for burns and scalds can help minimise tissue damage and reduce the risk of infection.

1. Stop the Burning Process:

• Remove the person from the source of heat: If possible, stop the person’s contact with the source of heat. For example, move them away from flames, hot objects, or boiling liquids.
• Cool the burn: Cool the affected area immediately by holding it under cool running water for at least 20 minutes. This helps to stop the burning process and reduce pain. If running water is unavailable, use a cold, wet compress. Do not use ice, as this can damage the skin further.
• Remove clothing and jewellery: Remove any clothing or jewellery near the burn, as these can retain heat. However, do not remove anything stuck to the burn, as this can cause further damage.

2. Cover the Burn:

• Once the burn has been cooled, cover it with a sterile, non-stick dressing or clingflim . Avoid using fluffy materials, which can stick to the burn.
• Do not apply creams, ointments, or butter to the burn, as these can trap heat and increase the risk of infection.

3. Treat for Shock:

• Severe burns can lead to shock, a life-threatening condition in which the body’s organs do not get enough blood and oxygen. Signs of shock include pale, cold, clammy skin, rapid breathing, confusion, and weakness.
• Lay the person down with their legs elevated and cover them with a blanket to keep them warm. Do not give them anything to eat or drink.

4. Seek Medical Attention:

• Call 999 or seek medical help if:
  • The burn is larger than the palm of the person’s hand.
  • The burn is full-thickness.
  • The burn is on the face, hands, feet, genitals, or major joints.
  • The person is a young child, elderly, or has a pre-existing medical condition.
  • There are signs of shock or infection (such as redness, swelling, or oozing).

Special Considerations for Chemical Burns

For chemical burns, it’s important to take specific actions:

1. Rinse the Area Immediately: Flush the affected area with large amounts of cool running water for at least 20 minutes. Be sure to avoid contaminating unaffected areas of skin.
2. Remove Contaminated Clothing: Carefully remove any clothing that has been in contact with the chemical, but do not touch the skin with your hands to avoid spreading the chemical.
3. Seek Medical Help: Always seek medical attention for chemical burns, even if they appear minor.

When to Seek Medical Help

Burns and scalds require professional medical attention in the following situations:

• Large Burns: If the burn covers an area larger than the palm of the hand.
• Deep Burns: Full-thickness burns, even if they are small, should always be treated by a healthcare professional.
• Burns to Sensitive Areas: Burns on the face, hands, feet, genitals, or over major joints need medical attention due to the risk of complications.
• Signs of Infection: If the burn becomes redder, more painful, swollen, or starts to ooze, it could be infected, and medical help is necessary.
• For Young Children and Elderly People: Burns can be more dangerous for babies, children, and elderly individuals, so it’s best to seek help.

Prevention of Burns and Scalds

• Use Caution Around Hot Liquids: Keep hot drinks and boiling liquids away from the edge of counters or tables, especially when children are nearby.
• Supervise Children: Keep children away from stoves, ovens, and hot appliances, and never leave them unattended in the kitchen.
• Check Water Temperature: Always test the water temperature before bathing children or using hot water.
• Use Sun Protection: Apply sunscreen and wear protective clothing when spending time in the sun to avoid sunburn, a common cause of superficial burns.
• Be Careful with Open Flames: Use caution around candles, fires, and fireworks, and never leave them unattended.

Key Points to Remember

• Cool burns immediately with cool running water for at least 20 minutes.
• Cover the burn with a sterile, non-stick dressing, and do not apply creams or ointments.
• Seek medical help for larger burns, full-thickness burns, or burns to sensitive areas like the face, hands, or feet.
• Treat for shock by keeping the person warm and comfortable, and monitor for signs of infection.