First aid for burns: From trauma specialists at Netcare Milpark Hospital

Monday 28 January 2008 - We commemorated National Burns Day on Wednesday 23 January. Despite the fact that South Africa's statistics on burn deaths and injuries are quite alarming, not much was mentioned about National Burns Day in any media.

So what are the stats? According to Childsafe the most common types of burns sustained by children are due to hot liquids or fluids such as boiling water, tea or coffee. More than 60 children are admitted annually to the Red Cross Children's Hospital with fire/flame related burns. The majority of these children come from underprivileged communities who use fossil fuels for heating. There is also a sharp rise in burns cases during the winter months.

Burns account for over a fifth of all deaths in children under the age of one year and it is the leading cause of death amongst children younger than five years.

It is not only children who suffer burn wounds. According to the American Burn Association (ABA) there are more than one million burn injuries each year in the United States, most of which are preventable, and most of which occur in and around the house.

The thing about burns though, is that your chances of survival are excellent – especially when receiving the right treatment. The ABA says that burns victims admitted to specialised burns centres, such as the new one opened this week at Netcare Milpark Hospital, have a 94,4% chance of survival.

The truth is that burns take a second to occur and a lifetime to overcome. So what do you do when a child or a loved one suffers a burn at home? Here follows some first aid advice from specialists at Netcare Milpark Hospital's Trauma Unit:

The first step is to distinguish a minor burn from a serious burn. You need to determine the degree or extent of damage to body tissues.

First-degree burns are the least serious – only the outer layer of skin is burned. The skin is red, swollen and probably painful;

Second-degree burns are where the first layer of skin has been burned through and the second layer of skin (dermis) also is burned. Blisters develop and the skin takes on an intensely reddened, splotchy appearance. These burns produce severe pain and swelling;

Third-degree burns are the most serious and painless. They involve all the layers of the skin and cause permanent tissue damage. Fat, muscle and even bone may be affected. Areas may be charred black or appear dry and white. Difficulty with breathing, carbon monoxide poisoning or other toxic effects may occur if smoke inhalation accompanies the burn.

Burn wounds are treated according to whether the burns are classified as minor or major burns. Third-degree burns are always treated as major burns. If a first-degree burn involves substantial portions of the hands, feet, face, groin, buttocks or a major joint, it will be treated as a major burn. So too will any second-degree burns larger than 7,5 centimetres in diameter.

First aid for minor burns

1. Cool the burn. Hold the burned area under cold running water for at least five minutes, or until the pain subsides. If this is impractical, immerse the burn in cold water or cool it with cold compresses. Cooling the burn reduces swelling by conducting heat away from the skin. Don't put ice on the burn.

2. Cover the burn with a sterile gauze bandage. Don't use fluffy cotton, which may irritate the skin. Wrap the gauze loosely to avoid putting pressure on burned skin. Bandaging keeps air off the burned skin, reduces pain and protects blistered skin. We recommend a “Burnshield” dressing: this proudly South African product is available at all Netcare Pharmacies.

3. Take an over-the-counter pain reliever. These include paracetamol, aspirin or naproxenor acetaminophen. Never give aspirin to children or teenagers.

Minor burns usually heal without further treatment. They may heal with pigment changes, meaning the healed area may be a different colour from the surrounding skin. Watch for signs of infection, such as increased pain, redness, fever, swelling or oozing. If infection develops, seek medical help. Avoid re-injuring or tanning if the burns are less than a year old — doing so may cause more extensive pigmentation changes. Use sunscreen on the area for at least a year.

· Don't use ice. Putting ice directly on a burn can cause frostbite which can damage the skin even further.

· Don't apply butter or ointments to the burn. This could prevent proper healing.

· Don't break blisters. Broken blisters are vulnerable to infection.

First aid for major burns

Immediately call for emergency medical assistance from Netcare 911 by dialing 082 911. Until an emergency unit arrives, follow these steps:

Don't remove burnt clothing. However, do make sure the victim is no longer in contact with smouldering materials or exposed to smoke or heat.
Don't immerse large severe burns in cold water. Doing so could cause shock.
Check for signs of circulation (breathing, coughing or movement). If there is no breathing or other sign of circulation, begin cardiopulmonary resuscitation (CPR).
Elevate the burned body part or parts. Raise above heart level, when possible.
Cover the area of the burn. Use a “Burnshield” dressing or a cool, moist, sterile bandage, or cover with a polythene bag.

The new Netcare Milpark Burns Centre is South Africa's only dedicated private Burns Centre. It forms part of the Netcare Milpark Hospital Trauma Unit and officially opened its doors on Friday 25 January, 2008.