Burns And Scalds

1.	Causing injuries to body tissues or skin resulting from heat is generally called burns & scalds. Burns: Bodily injuries resulting from dry heat generated by flames, electric current, hot objects, radiation, over-exposure to sun rays & chemical corrosives, etc. Scalds: Bodily injuries caused by hot liquids & steam etc. Estimating The Burns & Scalds of An Adult Casualty The area of skin surface burnt or scalded can be estimated by the 'Rule of Nine'. Imagine the body as being 100%, so head and neck as 9%; anterior trunk as 18%; posterior truck as 18%; each upper limb as 9%; each lower limb as 18%, external genitalia as 1%. (Note: If the affected area covers only part of the skin areas, it should be assessed by palm measurement. Each palm covers 1% of the body.) Estimating the Depth of Burn (1) First Degree Burn: Swell, redness and pain on the epidermis (2) Second Degree Burn: Blisters will appear in the burnt area epidermis & dermis is segregated. The casualty will feel great pain. (3) Third Degree burn: Skin will turn charred and dark & destroy deeper layers. There is already no sense of pain.
2.	Critical Burns / Scalds The elderly & infants are more susceptible to burns / scalds than adults. If an adult has 5% of second degree burns or an infant has 2-3% of second degree burns or any third degree burn and under the follower circumstances, the casualty should be taken to hospital immediately: - Inhalation injuries - Burns associated with a significant fracture or other major injuries - Second or third degree burns involving head, hands, feet & external genital organs. - Large area of burns - Electrical burns Following Burns or Scalds, the body will experience: - Loss of body fluid leading to hypovolaemic shock - Failure in body thermal regulation due to damage of body skin - Invasion of bacteria due to deficiency in defence against infection. General Treatment
	(1)	Remove the casualty from the heat source.
	(2)	Check the casualty's breathing & pulse.
	(3)	Check the extent & depth of his burns.
	(4)	Cool & treat the burned area.
		- Flush the burned area with water, cool the burned area to alleviate his pain - Cover the wound with a sterilized dressing. - For facial burns, use sheet or triangular bandage to cover the burnt area. Provide openings on the sheet or triangular bandage for eyes, nose & mouth for the casualty.
	(5)	Treat shock.
	(6)	Send the casualty to hospital immediately.
	Note:
	(1)	Do not puncture blisters
	(2)	Do not apply lotion or ointment to the burnt area.
	(3)	Do not apply cold pack to the burnt area.
	(4)	Do not remove clothing sticking to the skin .
	(5)	Do not cough or speak towards the injured area.
3.	Chemical Burns When treating burns caused by chemicals, remove all the chemicals sticking to the casualty's body as soon as possible to avoid deterioration of injury. Treatment :
	(1)	Put on protective clothing & wear gloves.
	(2)	Remove the solid chemicals thoroughly, then rinse the casualty with a large amount of water; the liquid chemicals can be rinsed by a large amount of water.
	(3)	Remove the contaminated clothing & ornaments from the casualty when rinsing.
	(4)	Dress the wound with bandage after rinsing.
	(5)	Send the casualty to hospital.
	(6)	If chemical has splashed into the eyes of the casualty, continue to flush his eyes during transportation to hospital.

4.	Electrical Burns When a high current of electricity passes through the body, it may cause severe burns. Furthermore if the cardiac muscle is damaged by the current, abnormal beating or cessation of the beat may result. . Treatment :
	(1)	Protect yourself, break the current or separate the casualty from the source.
	(2)	If breathing & heartbeat have stopped, apply CPR immediately.
	(3)	If the casualty is unconscious but breathes normally, place him in a recovery position.
	(4)	Treat his burns.
	(5)	Send the casualty to hospital.

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