First Aid & Management after Burns
First Aid
Flame Burns
These occurs when the patients is caught by fire e.g., in a house or in a car. Flames must be smothered with blankets or carpets. Cold water applied continuously over the burnt area relieves pain & limits the depth, because heat is conducted to the deeper tissues for several minutes after the flames have been extinguished.

Chemical Burns
Caustic substances cause partial thickness burns. Copious quantities of running water must be applied to the area, except where the burn is due to sodium or potassium. There metals must be pushed off the skin with a matchstick or picked off with forceps.

Scalds
Hot water is the commonest case of scalds. Again, running cold water can limit the extent of damage & reduce the pain.

Electrical Burns
Due to contact with the live wire, electrical burns can occur which can further cause cardiac/respiratory problems. The patient may require mouth to mouth respiration & external cardiac massage. The patient should be transported to the hospital as quickly as possible.

Hospital Management
Minor Burns:

• Cleaned with chlorhexidine.
• Covered with bactericidal non–stick dressing.
• Patient can rest at home.
• Dressings are changed after every 2–3 days by a nurse.
• In 7–10 days, the burnt skin comes off either freely or by a nurse removing it with forceps & scissors.
• In 14–21 days, the skin should be healed.
• Physiotherapy is not usually associated with treatment of patients with minor burns, unless the hands or feet are affected or patient is elderly.

Major Burns:

• This burn covers more than 10% of body area.

A. Early Management:

• Maintenance of a clear airway.
• Pain relief.
• Maintenance of third balance.
• Removal of adherent clothing & covering of the burns with sterile cotton cloths.
• Reassurance & explanation for the patient.

B. Management after 3–4 days:

• Fluid replacement is carried out by intravenous drip & nasogastric tube.
• High protein diet is essential.
• Maintenance of respiratory function.
• Humidification, suction of bronchial secretions.
• Prevention of renal failure is achieved by intravenous fluids in the first instance & then it necessary by haemodialysis or by peritoneal dialysis.
• The mental stability of the patent is preserved by an optimistic approach from all staff.