First Aid - For Superficial Burns:
* Remove the child from the heat source.
* Remove clothing from the burned area immediately.
* Run cool (not cold) water over the burned area (if water isn't available, any cold, drinkable fluid can be used) or hold a clean, cold compress on the burn for approximately 3 to 5 minutes (do not use ice, as it may cause the burn to take longer to heal).
* Do not apply butter, grease, powder, or any other remedies to the burn, as this increase the risk of infection.
* If the burned area is small, loosely cover it with a sterile gauze pad or bandage.
* Give your child acetaminophen or ibuprofen for pain.
* If the area affected is small (the size of a quarter or smaller), keep the area clean and continue to use cool compresses and a loose dressing over the next 24 hours.
Seek Medical Help Immediately When:
* The burned area is large, even if it seems like a minor burn. For any burn that appears to cover more than 10% of the body, call for medical assistance. And don't use wet compresses because they can cause the child's body temperature to drop. Instead, cover the area with a clean, soft cloth or towel.
* The burn comes from a fire, an electrical wire or socket, or chemicals.
* The burn is on the face, scalp, hands, joint surfaces, or genitals.
* The burn looks infected (with swelling, pus, increasing redness, or red streaking of the skin near the wound).
Understand Burns
In burns, first the outermost layer is burnt and then the deeper layers. The depth of burns depends on the degree of heat and the time for which the skin was exposed to the heat. For example when the hands are burnt, skin on the dorsum being thinner may be burnt fully whereas on the palmer side the skin being thicker all of it is not burnt. Skin that is superficially burnt heals rapidly, while which is totally burnt cannot heal without a skin graft operation. Skin that is burnt partly still has some hair follicles, sweat glands and sebaceous glands will heal spontaneously in due course of time.
When superficial layers of skin are burnt blisters form (scalds) and clear fluid is discharged from the burnt surface. These burns are agonizingly painful but if complications due to infection are avoided they can heal fast (within a few weeks) and do not leave behind scars.
Burns due to flames and chemicals are deep layered and do not affect the hair follicles and sweat glands. In this case many nerve endings get damaged and therefore it is not very painful. These types of burns heal slowly and always leave a scar.
Burns due electricity, radiation and strong chemicals and fire cause full thickness burns but as all nerve endings get damaged there is no pain. These cannot heal without skin grafting. If not grafted they will lead to considerable scarring and deformity.
Infants and old people succumb to burns very easily but in an old man of 70 years even 10% of the burns may be fatal.
It can be done within the first week especially for face, hand and joint areas and thus will help prevent contractions. This process involves taking skin from the healthy areas of the body (usually the thigh area, if not involved), meshing it and putting it on the wound. The donor area also heals with new skin growth. Earlier this technique was practiced only in Europe and America, but today it is practiced in India all over. The greatest benefit involved is that it reduces the chance of getting the infection.
* Our skin is our greatest defence against infection as it prevents the infecting organism from getting in the body. The earlier grafting restores the skin; less will be the chance of infection.
* Prevents formation of contractures and thus deformity.
* It reduces the hospital stay and is cost effective
But like the two sides of the coin it also has some limitations. The greatest limitation is that it needs to be done in a good set up with good operating equipments and other facilities and also the surgeon should be well experienced in this technique.
Everybody should be aware of the first aid procedures, as first aid given in time can reduce the severity of the burn appreciably. First remove the heat source, look for associated trauma and remove the non-sticking garments. Do not try to remove the charred clothing sticking to the skin. If the person's clothes have caught fire put out the flames by whatever means available. Lay him down quickly on ground and wrap tightly with any piece of cloth. Smother the flame by gently rolling the victim or by patting over the covering. Also cool water eases the pain, removes heat, and lowers the temperature in the injured tissue. This prevents further injury to the skin. In extensive burns cool for no longer than 5 minutes, especially in babies and children. Wrap the wound in a clean cloth and without any delay take the patient to the medical care facility for treatment. the face must be left expose to air.
The most important thing regarding burn injuries is that 95% of them are accidental and can be prevented with care and precautions. Public places and factories etc should install proper fire alarms, fire extinguishers and should also be built keeping the fire safety norms in mind. At home extreme care should be taken while inside working in the kitchen or playing outside with the crackers.
Diwali is the festival of lights and happiness and that is what it should be. Playing with firecrackers specially the big ones should be avoided. All firecrackers should be lighted in open area and a bucket of water should always be kept nearby. Children should be supervised all the times. Anars should never be lit while in the hand as they can burst and a large number of burns at Diwali are associated with them. The best is to say no to the firecrackers and have A HAPPY and SAFE DIWALI
A 24-hour Public Service Diwali Helpline No. is being launched by famous plastic surgeon Dr. Anup Dhir in order to provide immediate consultancy during the festive season. The number will be functional from 22nd October to 25th October,2014 and will provide telephonic advice for injuries, wounds, burns etc. caused during the festival of lights.
HELPLINE NO. – 09312377554
Dr. Anup Dhir is a Senior Consultant Cosmetic Surgery at Indraprastha Apollo Hospital.
