Burn Injury
Burn injuries can range from minor blisters to life changing, disfiguring and painful conditions that may require long-term hospitalization and treatment. Serious burns can cause deep tissue damage and may lead to years of expensive treatment and recovery. Medical expenses and other losses could easily combine to exceed seven figures. Severe burns prevent many victims from ever working for a living again.
The purpose of my Blog today is to educate the reader on the types and causes of burns and ways to prevent burns from occurring.
Facts About Burn Injuries
According to the Centers For Disease Control, burns are the third leading cause of fatal injuries in American homes. The most common injury to the skin is a burn injury. According to Trauma Burn.Organ estimated 130,000 individuals are hospitalized annually in the United States due to a burn injury.
– 85% of all U.S. fire deaths in 2011 occurred in homes.
– On average in the United States in 2010, someone died in a fire every 169 minutes, and someone was injured every 30 minutes.
– In 2010, fire departments responded to 384,000 home fires in the United States, which claimed the lives of 2,640 people (not including firefighters) and injured another 13,350, not including firefighters.
– Most victims of fires die from smoke or toxic gases and not from a burn injury.
– Smoking is the leading cause of burn injury related deaths, followed closely by cooking mishaps.
Groups Of People Most At Risk For Burn Injuries From Home Fires:
– Children 4 and under;
– Older Adults ages 65 and older;
– African Americans and Native Americans;
– The poorest Americans;
– Persons living in rural areas;
– Persons living in manufactured homes or substandard housing.
Workplace Burn Injuries
Outside of the home in almost every area of the American workplace, employees are exposed to open flame, electrical currents and a variety of other heat sources, as well as flammable and corrosive chemicals and gases.
The U.S. Occupational Safety and Health Administration (OSHA) has created specific standards and regulations for fire and burn safety in the workplace and for the use and handling of hazardous chemicals and gases. All states have adopted these federal OSHA standards and a number of states have added specific industry centric regulations.
What Is A Burn:
The National Institute of Health defines a burn injury as damage to your body’s tissues caused by heat, chemicals, electricity, sunlight or radiation. Scalds from hot liquids and steam, building fires and flammable liquids and gases are the most common causes of burns. Another kind is an inhalation injury, caused by breathing smoke.
There are three classifications of burn injury:
– First-degree burns damage only the outer layer of skin;
– Second-degree burns damage the outer layer and the layer underneath; and,
– Third-degree burns damage or destroy the deepest layer of skin and tissues underneath the skin.
Burn injuries can cause swelling, blistering, scarring and, in more serious cases, shock and even death. Another major problem with a burn injury is the probability of infection because of the damage to your skin’s protective barrier.
Treatment for a burn injury depends on the cause of the burn, how deep it is, and how much of the body it covers. Antibiotic creams can prevent or treat infections. For more serious burns, treatment may be needed to clean the wound, replace the skin, and make sure the patient has enough fluids and nutrition.
Types of Burns
Heat Burn
Heat burns (thermal burns) are caused by fire, steam, hot objects, or hot liquids. Scald burns from hot liquids are the most common burns to children and older adults. Children can suffer burns from sunburn, household appliances and other causes. Scalding liquids, however the most common burn injury in younger children. Burn accidents with children can be as simple as them pulling over a cup of coffee, or as disastrous as pulling on the handle of a pot of boiling water from the stove. A burn injury can also occur when washing their hands under a faucet that is too hot.
These injuries can also be caused by poorly designed household products. Some years ago I successfully prosecuted a lawsuit against the maker of a countertop deep fryer. The fryer was designed to sit on a counter-top and be plugged into a wall mounted electrical socket. The design flaw was that the electrical cord was far longer than it needed to be to function the way it was intended.
The oil was boiling hot and the extra long cord was hanging over the edge of the counter-top and along comes a three-year-old boy who grabbed the cord and pulled the boiling oil off of the counter and onto his face and upper body. The device would have functioned perfectly if the cord had been shortened by 2/3s of it’s length and this injury was foreseeable and could have been prevented but for the design flaw. Many, if not all a heat burn injury can be prevented.
Heat Burn Treatment
If your family member or another suffers a heat burn injury the Mayo Clinic has some suggestions. Remove them from the source of the burn and think to cool the burn. NEVER PUT ICE ON A BURN INJURY. A great first response is to hold the burn injury area under cool, but not cold, water for at least ten minutes.
If running water is impractical use cold compresses. By cooling the burn injury you are reducing swelling by conducting the heat away from the wound.
Once you complete the initial treatment use a sterile gauze bandage and wrap it loosely around the wound. Avoid fluffy cotton material that my get lint into the wound. A less serious burn injury will often heal without further treatment, although you may see changes in the pigment or color of the affected skin. As with all burn injuries, the chance of infection is great. Take special care to look out for signs of infection, swelling, oozing or other ugly looking or smelling event.
You might consider taking an anti-inflammatory agent such as aspirin, or other NSAIDs for adults but use all caution with children and contact your doctor for advice. Never give aspirin to a child or teen.
DON’T:
– Put ice on a burn wound;
– Put egg whites, butter or ointments on a burn injury;
– Break blisters you will be vulnerable to infection;
– Hesitate to call 911 for anything other than a minor burn.
Cold or Freeze Burn Injury
Although we often think of a burn injury as being caused by hot things, cold temperature burn injury can be equally damaging to the body. Cold temperature burns are found when human skin is exposed to wet, windy, or cold conditions. When skin comes into contact with some object that is extremely cold the skin and the underlying tissue can be damaged. The damage can be blisters or tissue damage that may, or may not be reparable. Frostbite, which often causes damage to the finger and toes can and does result in amputation.
When human skin is exposed to some sort of extreme cold a whole bunch of bad things happen within the body itself. The hand or foot that is exposed to prolonged cold will experience a decrease in circulation as the part loses its natural body heat. As circulation decreases the skin and underlying tissue begin to lose feeling. Along with the decreased circulation the person may experience a blood clot that can lead to all sorts of pulmonary problems. As the burn continues to progress the body part will turn blue and begin to swell because of the lack of blood flow in the area. If the person is not removed from the cold situation the skin will turn and ashen pale and severe waves of pain will begin. The burn, at this level could easily begin to develop gangrene and then death.
When a human suffers a cold burn injury that is causing pain you should seek medical assistance immediately. In the meantime, remove the burn victim from the cold causing the injury and begin to attempt to warm the burn areas. If you are in an outdoor area build a fire and use blankets, sleeping bags or jackets to warm the burn area. If you can get out of the cold use warm towels to wrap and warm the burn site. Some sources say to get the person into a warm, not hot, bath in hopes of restoring sensation in the burn area.
Prevention Of A Cold Burn Injury
As with all types of burns the main way to prevent cold burn injuries is to plan carefully what you will be doing in a freezing environment. The first consideration is whether it is necessary to do the task at all. The next is to dress for safety. If you don’t have the proper clothing and footwear limit your time in the cold and take regular breaks in a warm environment.
Electrical Burns
Although all burns can be painful and leave long-term disability electrical burns are notable in that they can cause surface damage as with all burns, but also because they can cause much more injury to the sub-dermal area, meaning that tissues deeper below the surface can be severely damaged.
An electrical burn results from electricity passing through the bodily tissue that causes rapid damage. As a result, electrical burns are difficult to accurately diagnose, and without proper medical help burn injured people can, and often do, underestimate the severity of their burn. In extreme cases, electricity can cause shock to the brain, strain to the heart, and injury to other organs.
Treatment For Electrical Burns
As mentioned above, electrical burns can and often do reach deep into the victims tissue and although the person may not have a lot of visible damage on the skin serious tissue and organ problems might be an issue. The clinic staff at the Mayo Clinic suggests that you call 911 and while helping someone with an electrical burn injury and waiting for medical help, follow these steps:
– Look first. Don’t touch. The person may still be in contact with the electrical source. Touching the person may pass the current through you.
– Turn off the source of electricity if possible. If not, move the source away from both you and the injured person using a dry, non-conducting object made of cardboard, plastic or wood.
– Check for signs of circulation (breathing, coughing or movement). If absent, begin cardiopulmonary resuscitation (CPR) immediately.
– Prevent shock. Lay the person down with the head slightly lower than the trunk, if possible, and the legs elevated.
– Cover the affected areas. If the person is breathing, cover any burned areas with a sterile gauze bandage, if available, or a clean cloth. As with all burns, don’t use a blanket or towel, because loose fibers can stick to the burns.
Chemical Burns
Chemical burns are the result of the human skin coming into contact with a corrosive substance, usually a strong acid, base or chemical. Chemicals that can cause serious injury and death are, unfortunately, all to available and can be found in homes and all types of work places. Never assume that substances at work or that are sold for use in the home are safe. A comprehensive reading of the label warnings before you purchase the product for home use is a great way to avoid having the product in the first place.
Everyday items such as strong acids, drain cleaners (lye), paint thinner, ammonia and gasoline need to be handled with care. When exposed to a chemical a person is usually aware of the burn and can identify its cause, but oft times a milder chemical burn might not manifest itself immediately and become known, like a sunburn, sometime later and make identifying the cause of the burn harder to determine.
Treatment For Chemical Burns
Initial Treatment
If you are with a person who has sustained a chemical burn injury the Mayo Clinic Staff suggests the following steps:
– Remove the chemical causing the burn while protecting your self.
– For dry chemicals, brush off any remaining material
– Wear gloves or use a towel or other suitable object, such as a brush.
– Remove contaminated clothing or jewelry to prevent further burning.
– Rinse the burn immediately. Run a gentle, steady stream of cool tap water over the burn for 10 or more minutes. A shower may be an effective way to do this. Always protect your eyes.
– Loosely apply a bandage or gauze.
When To Seek Emergency Treatment
If the victim of a chemical burn injury faints, gets an ashen complexion, goes into shock or has trouble breathing immediately call 911 and identify, if you can, the chemical causing the problem. If the burn has penetrated the first layer of skin and covers an area of more than three inches in diameter don’t hesitate to call 911.
Also seek emergency help if the burn is to a limb, eyes, hands, feet, face. groin or buttocks. When emergency responders arrive make the chemical container available to them so that they can initiate proper treatment.
Radiation Burn
A radiation burn causes damage to the skin and other tissue and is caused by exposure to radiation. Radiation burns are most often caused by the sun, tanning booths, sunlamps, X-rays, or radiation therapy for cancer treatment, and can range from minor to very serious. The radiation types of greatest concern are thermal radiation, radio frequency energy, ultraviolet light and ionizing radiation. The most common type of radiation burn is sunburn caused by UV radiation.
Unfortunately, in the United States, a deep tan is consider a beauty standard and unless you have been living under a rock, Dermatologists have been warning people that there is no safe tan. To often people forgo sitting in the sun to visit a tanning salon. Tanning salons have been designated by the World Health Organization, a Group 1 Carcinogen, on the same level of danger as cigarettes, asbestos and arsenic.
Treatment For Radiation Burns
Sun Burn
As I mentioned earlier getting a sun burn is a very bad idea. According to the Skin Cancer Foundation it looks bad, hurts, peels and inflicts long-lasting, wrinkle-inducing damage. It’s especially bad for children: Even one blistering burn may double their lifetime risk of melanoma, a serious skin cancer. And it’s totally preventable (with sunscreen, shade and clothing). But mistakes happen. So here are five ways to ease the pain and maybe, just maybe, limit the damage.
If you feel the tale-tell tingling of a burn or see any sign of skin reddening on yourself or your child, get out of the sun and start treatment. Sunburn tends to sneak up on us. It can take four to six hours for the symptoms to develop.
After a cool shower or bath, use a moisturizing cream or lotion containing vitamin C and vitamin E to soothe the skin. Repeat frequently to make peeling and flaking less noticeable. and spokesman for The Skin Cancer Foundation. Note well: scrubbing, picking or peeling your skin or breaking blisters, is a big no-no. This can be a problem for treating young children. Prevention is the very best treatment.
All burns draw moisture from other parts of the body so drink extra water, juice and sports drinks for a couple of days and watch for signs of dehydration: Dry mouth, thirst, reduced urination, headache, dizziness and sleepiness. Children are especially vulnerable, so check with a doctor if they appear ill.
Experts say to take (or give your child) a dose of ibuprofen (for example, Advil) as soon as you see signs of sunburn and keep it up for the next 48 hours, it cuts back on the swelling and redness that is going to occur and might prevent some long-term skin damage. Acetaminophen (for example, Tylenol) will treat the pain, but does not have the same anti-inflammatory effect.
Most sunburns, even those that cause a few blisters, can be treated at home. But if a blistering burn covers 20% or more of the body (a child’s whole back), seek medical attention. Anyone with a sunburn who is suffering fevers and chills should also seek medical help. Finally: For good prevention of a similar burn injury use sunscreen, cover up with clothing and hats and avoiding the sun as much as possible between 10 a.m. and 4 p.m.
What To Do If You Have Radiation Burns From Medical Treatment
As part of any radiation therapy your medical provider will go over all of the possible symptoms following treatment and advise you how to handle any issues that come up. If you have a burn and are concerned, immediately call your treating physician. You will probably be told to:
– Keep the skin moisturized and lubricated to prevent itching and cracking of the skin. Be sure to use fragrance-free products.
– Wash with lukewarm water only, not hot water.
– Avoid hot baths. This will further dry your skin. Take a quick shower instead.
– Pat yourself dry with a towel instead of rubbing your skin.
– Do not rub off the markings your radiation therapist made on your skin. They are necessary to show where to place the radiation.
– Do not use heating pads, ice packs or bandages on the area receiving the radiation.
– Avoid using oils that will reduce the efficacy of radiation treatment.
– Use non-adhesive dressings, as traumatic removal could cause further damage to already compromised skin.
– Do not wear tight clothing around the treated area.
– Avoid using a skin care product immediately before radiation therapy. This could interfere with treatment.
– Choose clothes and bed sheets made of soft cotton.
– Use an electric razor if your doctor or nurse says you can shave.
– Avoid exposing the treated area to the sun while you are being treated.
– Wear sun-protective clothing, especially over the treated area.
– After your treatment is over, ask your doctor or nurse how long you should continue to take precautions from the sun.
Conclusion
In our modern society danger is always present. Burn injuries are part of the danger and my advice is to pay attention to what you are doing and don’t be distracted and allow you, or you children, to suffer. Going on vacation to the beach is exciting and a great family event. Plan you beach day carefully and prepare well. Bring hats, extra clothing and plenty of hydrating fluid and sun screen.
As I mentioned earlier, most burns, especially to children and the elderly occur in the home. Keep cleaning chemicals and gasoline where children can’t get to them, use and teach your children kitchen safety as soon as the are old enough to walk.
On the job, always make a survey of the chemicals and electrical devices that you will come into contact with. Read labels and ask questions about use and emergency treatment. Take it upon your self to Google any chemicals to get the low down on how to use them, treat them and avoid injuries.
