First Aid: Burns

Burns can occur in any workplace; each year some 13,000 burns injuries are treated in British hospitals and around 200 people die from burn-related injuries. A third of adult burns are work-related. As these figures only represent those burns that are treated in hospital, the actual figure is potentially much higher.

What Can Cause Burns?

causes of burnsCauses of burns can be categorised into six categories:

  • Dry heat – from a metal surface or fire for example. They can cause redness, swelling, and peeling and can lead to white or charred skin or blisters.
  • Scalds – caused by hot water or steam, these can quickly cover a large area and can cause serious injury.
  • Acid and chemical – these have the potential to be very serious dependant on the acid or chemical used.
  • Hot oil – mostly happen during cooking, often due to splashes or spills.
  • Electrical – caused by contact or arcing from electrical sources.
  • Radiation – the most common radiation burn is that caused by sunburn due to exposure to ultraviolet light.

What Are The Degrees of Burns?

The skin has three layers, the epidermis on the outside, the dermis beneath this and the subcutaneous fat below. The depth, or degree of burn is categorised from these layers.

  • A First degree, or superficial burn, burns only the outer layer of the skin and becomes red and swollen.
  • A Second degree, or partial thickness burn, burns both the epidermis and the dermis layers of the skin. Blisters form and the skin looks red and raw.
  •  A Third degree, or Full Thickness burn, has burned through the layers of skin and has reached the subcutaneous fat layer or even beyond. The burn may look pale, charred or waxy. There may even be an absence of pain owing to the nerve endings being burnt away which can mislead both the first aider and the casualty.

How Should You Treat a Burn?

hand under running tap waterAs with all first aid, safety is the priority – do not attempt to treat any casualty until you are sure the area is safe for you, them and anyone else who may come to assist. This may mean a slight delay in treatment until whilst this occurs.

Once you are sure the area is safe, you should:

  1. Stop the burning process – this may mean dowsing any flames with water or smothering with a blanket.
  2. If you are able to, remove any clothing or jewellery on and around the burned area. Do not try to remove anything that is stuck to the burnt skin as this could cause more damage.
  3. Cool the burn with cool or lukewarm running water for a minimum of 20 minute. Never use iced water or any creams or greasy substances like butter. If a large limb is being cooled, the casualty may begin to lose body heat during this process, so be prepared to keep them warm at the same time.
  4. Assess the burn – dependant on the Size, Cause, and Age of the casualty, Location of the burn and Depth, hospital treatment may be required. The acronym SCALD may assist in remembering this assessment.

Using SCALD to Assess a Burn

SCALD acronym meaningThe SCALD acronym sets out the criteria when assessing a burn to determine if hospital care is needed:

  • Size – In adults, any burn greater than 1% of their body size will need to be assessed at a medical facility. As a rule, an adult’s hand when flat is roughly 1% of the body.
  • Cause – As highlighted earlier, acid and chemical burns can be very serious dependant on what was used and may result in a casualty having to go to hospital. A COSHH assessment is also a useful tool for the first aider to have.
  • Age – The age of the casualty will also impact on whether a casualty needs assessment at a hospital, younger people and the elderly have thinner skin, and are more subject to adverse effects because of being burnt.
  • Location – The location of the burn is also important. The NHS advise that any burn to the face, neck, hands feet, any joints, or genitals should go to hospital for assessment.
  • Depth – And finally, the depth of the burn. All Third Degree or Full Thickness burns will need to be seen at hospital.

Once a burn has been appropriately cooled and assessed, it can then be dressed. Use cling film to cover the burnt area, placed on in layers, not wrapped. This will allow the injured part to swell unimpeded. If the casualty complains of the burn feeling hot again, it can be re-cooled with the cling film in place.

Understanding how to respond in an emergency situation could help to save lives and prevent long-term injury. Learn how to handle accidents and emergencies with our QNUK accredited First Aid At Work course – learn more here.

Written by Neil Ward, Training Consultant at WA Management.

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