Get certified in CPR + First Aid for Adults for just $39.95.
To view this video please enable JavaScript, and consider upgrading to a web browser that supports HTML5 video
JODY: Yeah, yeah, just a minute. I've got the grill going right now. It's just about ready. Just give me a se- , oh, oh, ah, ah, ah, oh, I can't believe I did that. Ah. ROY: Burns can be a complex injury because there's different degrees of a burn. There's also different sizes of a burn. The pink outer ring is noting the first degree burn. It's noted with redness and pain. Then we move to the second degree which is usually blistering, whether they are intact or they're popped, blistering skin is a second degree burn. And then lastly the dark charred area in the center of the burn which is dry looking, could be split open or a full thickness burn all the way to the bone. This is a third degree burn. This can be life-threatening, has a lot of complications, and is nothing to mess around with. I don't care what the size of it, it needs to be seen at the emergency care center appropriate for burns. Now how do we treat these burns? Well, if I saw this, immediately we're calling 911 and getting emergency medical services on the way. But the sequence of treatments are as such: Remove the body from the burn. So if he was unconscious and lying in embers, we would remove that. If it was clothing that was still smoldering, we would move the clothing, safely. But remove the person from the burning agent. Secondly, cool the burn. Now cooling of the burn means potable water, clean water. We're gonna do this for between five and twenty minutes, long enough to actually cool the full thickness of the tissue and stop the burning process. Now the recommendation for the current standards is a loose, dry, sterile, if possible, dressing. I’m going to just lightly begin to wrap from above the burn where it started. I'm going to not put a lot of pressure. Again, in the third degree burn area, most of the nerves have already been damaged to the point where they're not actually sensing any pain. But the surrounding tissues of the first and second degree are going to be excruciating. So we want to keep that idea in our head as we're carefully handling the patient. We're gonna watch this person to see if they're showing any signs of dizziness. If at any point, they seem to be losing their balance, we want to make sure that we get them sitting or lying down in a position of comfort. There are some significant points that we need to make. Number one is we need to make sure that we are watching this person for any signs of inhalation burns. Do they have any swelling or any kind of wheezing? Do they have burn marks on the facial hair, the eyebrows, the nose hair? If they open their mouth and we look inside, do they have any soot or granulated burn stuff inside their mouth? Which would suggest that when the flame exploded, they got scared and inhaled quickly and may have inhaled that superheated temperature of that air. So it's all important for us to keep those in mind because these symptoms might develop into a respiratory problem. Now there's other forms of burns as well that we should be aware of. And that is chemical burns. If it was a dry chemical, it would be important to carefully, while keeping ourselves safe, brush off as much of the dry chemical first before we begin to rinse it off. And then rinsing off the remainder of the wet or dry chemical, we're going to do that for no less than fifteen minutes. The solution to pollution is dilution. So we just keep diluting that chemical down, helping stop the burn. And then we're gonna monitor the patient and watch them until EMS arrives and until the next level of care can take over. So we've covered thermal burns. We've covered chemical burns. And the last one I wanna talk about is electrical burns. Before we ever come in contact with the patient, we need to understand that the energy source must be removed from the patient. That means deenergizing the source, getting the professionals out to cut the power to that line that's fallen down. Whatever it is that needs to be done, but we cannot risk becoming a second patient by touching the primary patient and being electrocuted ourselves. Now some significant differences in electrical burns compared to the other two. Electrical burns tend to have an entry point and an exit point. The entry point, though it can be small, could have that small bullseye of the first, second and third degree burn. But the exit point could be explosive damage. That energy can literally show like a shotgun wound where it exits the ground of the body. And so on one end of the body we might actually have soft tissue and bleeding control, while at the entry point we have a burn to take care of. That burn will be managed the same way we described before with the removing of the burn source, the cooling, and the dressing. Now some other things to think about, though, is the fact that if that electric power was so much that it exploded as it exited, it might also have fractured long bones. So that's something to keep in mind. And then lastly, remember that the electricity as it travels through the body could also affect the conductivity of the heart and damage those conduction points in the heart. And in the next 24 to 72 hours, we can sometimes see the development of life threatening dysrhythmias develop as this person is pretty relatively stable from the burn or the wounds themselves, but then develops cardiac issues secondary to the electrocution.
Burns are a complex injury, as there are varying degrees of burns, different sizes, and different locations that can present unique challenges. And there are also different types of burns – thermal, chemical, and electrical.
In this lesson, when we talk overall about burns, then how to treat them, starting with thermal burns. Then, we'll discuss some information on chemical and electrical burns.
As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and introduce yourself to the victim.
"Hi, my name's _____. I'm a paramedic. I'm going to help you."
The first thing you want to do is assess how bad the burn is. To determine the degree of burn, look for the following signs:
The concerning part about burns is that you may not see the full extent or concern of the injury until hours later. After the burning process has ended, the injured skin starts the healing process. This involves the moving of fluid to the injured area causing swelling, pain, dehydration/shock and other potentially life threatening conditions. Minor seeming injuries may be far more serious if not evaluated or treated by professionals.
Continue to assess for signs of something more serious. How are the pupils? Is the patient breathing normally? Is the patient still responsive and seemingly alert? And continue to monitor the patient for signs of shock
You're likely going to encounter two types of chemical burns – those from dry chemicals and those from wet.
When you're dealing with dry chemicals, you first want to brush off as much of the loose, dry chemical as you safely can. Safety is key. You don't want to become the next victim. After brushing off the loose chemical, rinse the burn for a minimum of 15 minutes, again using cool clean water.
When dealing with wet chemicals, go right into rinsing them off using cool, clean water.
Electrical burn situations require an extra level of safety. Before anything, make sure the energy source has been removed before coming into contact with the patient. This could mean removing the patient from the energy source, cutting the power, or something else.
You cannot risk becoming another patient at the scene.
Manage the entry wound the same as you would a thermal burn. Manage the exit wound as the situation requires, which will likely include treatment options for tissue damage and excessive bleeding.
Warning: As electricity travels through the body it can affect the conductivity of the heart, which could potentially damage the conduction points in the heart and contribute to secondary cardiac issues.
With electrical burns, monitoring for heart dysrhythmias for 24 to 72 hours in hospital might be necessary.
It's important to note that children have greater surface areas relative to their weights than adults. This can become a major factor when it comes to staying warm and hydrated.
Victims with severe burns tend to lose a lot of water through evaporation and leaking from the burned area. This increases our concerns as it can lead to hypothermia and shock. Monitor the victim for signs of dehyration, shock or hypothermia. Immediately seek advanced medical intervention if any of these are seen.
If the burn is minor, and the burning has been completely stopped, at-home treatment might be appropriate. The 2024 ECC Guidelines suggest petrolatum (with or without topical antibiotics such as polymyxin), honey, and aloe have been shown to improve healing time in certain burns. Over the counter pain medications may help with pain when used correctly. All treatment should be under the direction of your physician.