Resource: First Aid & CPR
Burns and Electrical Injury Care
Burns pose short and long term risks to the casualty. There are many different causes of burning and here we look at a variety of burns assessment tools to aid the evaluation of a first aid response.
Burn Injuries
Burn injuries can cause major fluid lose and possible shock immediately when they occur. In severe cases burns pose a threat to life especially when associated with inhalation injuries. The risk of infection associated is also high with burning as is the psychological trauma of the resulting scarring.
Burns:
- Fire/Flame
- Sun
- Electricity
- Ice
- Hot objects
- Radiation
- Chemicals
Scalding:
- Steam
- Hot liquids
- Hot oil
- (First degree) Superficial – redness to outer layer of skin
- (Second degree) Partial thickness– redness and blisters
- (Third degree) Full thickness- Charring, whole thickness of skin destroyed, minimal pain.
Second-degree or third-degree burns involving critical areas require transfer to burn center
Critical areas include:
- Face
- Hands
- Feet
- Flexion points
- Perineum
A full thickness burn that affects the entire circumference of a digit, extremity, or even the torso.
This can pose the added problem of compartment syndrome. This is where the blood supply to the area of the body beyond the burn has been cut off.
- Scene safe/ Cease contact with heat source/Gloves on
- Call 112/999 for anything greater than isolated superficial injury or any of FHFFP
- Maintain airway for inhalation/ facial injuries
- Commence local cooling of burn area for at least 10 minutes
- Do not burst blisters
- Remove burnt clothing and jewellery unless stuck
- Cover burn with loose wet dressing or water gel
- Prevent chilling (monitor body temperature)
- Maintain care until handover to appropriate Practitioner
Electrical Injuries
Electrical burns can be caused either by high or low voltage current. High voltage currents can jump or 'arc' distances of up to 18 meters or over. In such instances do not approach the casualty. Stay at least 25 meters away until the power source has been turned off by the official agency.
- Overhead power lines
- Household appliances
- Electrical outlets
- Lighting fixtures
- Appliance & water
- Electricity source, Caution!
- Burns or other wounds on skin (Entry & Exit)
- Headache, dizziness, confusion, or memory loss
- Weakness, stiffness, or muscle pain
- Seizures
Events leading up to….
Gardening, Farming, Electrical appliance, Lightning storm
Electrical burns can cause serious internal injuries, examples include:
- Cardiac arrest due to the electrical effect on the heart
- Muscle, nerve, and tissue destruction from a current passing through the body
- Thermal burns from contact with the electrical source
- Ensure scene safety. Cease contact with heat source. Gloves on
- Call 112/999 for anything greater than isolated superficial injury or any of FHFFP
- Maintain airway for inhalation/ facial injuries
- Commence local cooling of burn area for at least 10 minutes
- Do not burst blisters
- Remove burnt clothing and jewellery unless stuck
- Cover burn with loose wet dressing or water gel
- Prevent chilling (monitor body temperature)
- Maintain care until handover to appropriate Practitioner
Inhalation Injury Management
If the casualty has been exposed to fire or heated gases, damage may occur to the mouth and airway. There may be signs of burning around the lips, nose, mouth, eyebrows or lashes.
A dry cough or hoarse voice is an early sign of airway injury and prompt medical care is essential.
If in a closed area, and if safe for the first aider, it is vital to remove the patient to a place free of the risk of further injury and preferably into fresh air.
If smoke or toxic gases may have been inhaled including :
- carbon monoxide from a vehicle exhaust,
- chlorine,
- ammonia
- hydrochloric acid
remove the patient from any enclosed or restricted area into an open area, pour running water over the burn for 20 minutes.
If there is any breathing difficulty allow the patient to find the position enabling easy breathing with the head and chest raised.
After an inhalation incident the patient may suffer from a severe lack of oxygen due to internal damage to the throat, upper airway and lungs.