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Rescue/EMS - Burns
Q: What is the aim of First Aid when it comes to burns?
The aims of first aid should be to stop the burning process, cool the burn, provide pain relief, and cover the burn.
Q: How is the burning process stopped?
The heat source should be removed. Flames should be doused with water or smothered with a blanket or by rolling the victim on the ground. Rescuers should take care to avoid burn injury to themselves. Clothing can retain heat, even in a scald burn, and should be removed as soon as possible.
Q: What should be done with adherent material initially?
Adherent material, such as nylon clothing, should be left on.
Q: How should tar burns be treated initially?
Tar burns should be cooled with water, but the tar itself should not be removed.
Q: How should electrical burns be treated initially?
The victim should be disconnected from the source of electricity before first aid is attempted.
Q: How are burns cooled?
Active cooling removes heat and prevents progression of the burn. This is effective if performed within 20 minutes of the injury. Immersion or irrigation with running tepid water (15°C) should be continued for up to 20 minutes. This also removes noxious agents and reduces pain, and may reduce edema by stabilizing mast cells and histamine release.
Q: Should iced water be used in the cooling process?
No, iced water should not be used as intense vasoconstriction can cause burn progression.
Q: What is one cause of hypotehermia?
Cooling large areas of skin can lead to hypothermia, especially in children.
Q: How should chemical burns be treated in the cooling process?
Chemical burns should be irrigated with copious amounts of water.
Q: What dressings should be used to cover the burn?
Dressings should cover the burn area and keep the patient warm. Polyvinyl chloride film (cling film) is an ideal first aid cover. The commercially available roll is essentially sterile as long as the first few centimeters are discarded. This dressing is pliable, non-adherent, impermeable, acts as a barrier, and is transparent for inspection.
Q: How should polyvinyl be applied?
It is important to lay this on the wound rather than wrapping the burn. This is especially important on limbs, as later swelling may lead to constriction. A blanket laid over the top will keep the patient warm.
Q: What is polyvinyl is not available?
If cling film is not available then any clean cotton sheet (preferably sterile) can be used.
Q: What is polyvinyl is not available for hand burns?
Hand burns can be covered with a clear plastic bag so as not to restrict mobility.
Q: Why should wet dressings be avoided?
Avoid using wet dressings, as heat loss during transfer to hospital can be considerable.
Q: Why should topical creams be avoided at this stage?
Use of topical creams should be avoided at this stage as these may interfere with subsequent assessment of the burn. Cooling gels such as Burnshield are often used by paramedics. These are useful in cooling the burn and relieving pain in the initial stages.
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