Burns are among the most common injuries that are examined medically in hospitals and medical clinics, and they occur as a result of exposure of the skin to high heat from liquids or solid bodies, as well as direct exposure to flames, or to chemicals and injury by electrical touches.
On this topic, talk to "Your Health", Dr. Muhammad Hababi Al-Qahtani, a consultant of plastic surgery and microscopic microsurgery to correct birth defects in the face, nose and ear, and tissue transplantation at King Abdulaziz Medical City for the National Guard in Jeddah, explaining that the skin consists of the epidermis, the outer layer, and the dermis (Dermis). Subcutaneous, and fatty layer (sub-dermis), and that burns are classified according to the depth of the injury in the skin. He noted that superficial burns are more painful than deep burns. The medical explanation for this is that deep burns destroy the nerve endings in the skin, so the victim does not feel pain after the pain of the fire, while in superficial burns, the nerve cells in the skin remain uninjured, and for this the pain continues at the site of the burn until healing.
He added that the danger of burns lies in their impact on human health in two main ways, directly:
The first is the loss of plasma fluid from the blood, as a result of the destruction of capillaries in the skin, which in turn leads to a serious disruption of blood physiology and fluid balance in the body. The second is to facilitate infection as a result of the destruction of one of the most important lines of defense in the body, which is the skin, and as a result of the availability of a good nutritional medium for the growth of disease-causing microbes.
Degrees of burns - the first degree, in which the epidermis layer is affected, and is characterized by the presence of redness in the affected area that causes slight sensitivity without the occurrence of excruciating pain, and healing occurs within a week, and often there is no physiological change to the skin, for example: White skin is exposed to the sun for a period of Time. The person suffering from first-degree burns does not need medical dressings, and the injury is examined in the emergency or plastic surgery clinic and appropriate treatment is given.
The second degree, in which the skin is infected with a part of the dermis layer and is characterized by the formation of so-called blisters (blisters) as well as physiological changes in the skin. They are divided according to the depth of the injury in the dermis layer into superficial and deep second-degree, and burns of this degree are painful and require medical dressings when consulting a doctor treating burns, and there are medical criteria that are taken into account to treat the patient with hypnosis in the burn unit, including the percentage and location of the injury in the body as well as the patient''s age Burns are healed within 10-14 days. The more superficial the injury, the faster the healing, and deep second-degree burns are followed up medically with bandages in principle, and the doctor specializing in surgical intervention decides to use the skin patch to cover the wounds when healing is delayed.
The third degree, in which all layers of the skin are affected with physiological changes in the skin, and the skin takes on a dark brown color. It is not usually painful and requires surgical treatment using a skin patch.
4th degree, involves injury to deeper tissues such as muscles or bones.
Sources of burns are among the fatalities in the house, smoking causes 35 percent of them, and heating devices cause 34 percent. Nearly half of the injuries are caused by efforts to combat the fire. In the United States and Australia, this category of injuries accounts for about two-thirds of all burns, and contact with hot objects is the cause of about 20-30 per cent of burn injuries among children. Fireworks and explosives are a common cause of burns during holiday seasons in many countries and they constitute Especially dangerous for adolescent males.
Dry heat: such as direct exposure to fire or hot gases.
Moist heat Kaltard for some warm fluids. In the United States, hot liquids are the most common cause of burns.
Chemical heat: Chemicals cause 2-11% of all burns and contribute to up to 30% of burn deaths. Chemical burns may be caused by more than 25,000 substances, most of which are either alkaline (55 percent) or acidic (26 percent). Most of the deaths from chemical burns occur as a result of ingesting common chemicals such as: sulfuric acid in the form found in toilet cleaners, sodium hypochlorite in the form found in bleaching materials, and hydrocarbons in the form found in paint removers, among others.
Electricity: it is classified into high voltage burns (1000 volts or more), low voltage burns (less than 1000 volts), and flash burns upon exposure to electric current, caused in children by electrical wires (60 percent), followed by electrical appliances (14 percent). Lightning may also cause electrical burns. Electrical injuries primarily cause burns, and they may be associated with fractures or injuries to the brain and neck.
High voltage injuries may damage internal tissues such as muscles, nerves, and blood vessels, so the extent of damage cannot be estimated by examining the skin alone.
Friction Burns occur by friction when injured in accidents and expose the injured skin to crushing the skin on a rough surface.
Radiation heat: such as prolonged exposure to sunlight or x-rays, as well as in cases of radiation therapy for tumors.
First aid The situation should be evaluated quickly to determine the best way to remove the injured person from the source of danger, as the blind rush may also injure the rescuer, or spread the fire to a greater extent.
If the direct flame was the cause of the fire, and if the fire was burning in the clothes of the injured person, the rescuer must take cover behind a fire blanket, before approaching the injured. The fire blanket is a large piece of cloth made of inoperable material, and it is available in the market at affordable prices, and if it is not available, an ordinary blanket can be used, or anything on hand can take its place, and as soon as you approach the casualty, it must be quickly wrapped in the blanket, then He pulled it away from the source of the flame to a safe place, then laid it on the ground in a supine position.
Remove the clothes - rings - the hour before the burning part swells.
If the electrical current is the cause of the fire, it is necessary to isolate the electrical current before approaching the injured person, or separate the machine or device that caused the fire from the source of electrical current, and if the source of electrical current is not known, or if it cannot be isolated quickly, then an electrical insulating material must be used. Before approaching the casualty, otherwise the rescuer will be injured as well. Examples of electrical insulation materials include wood and plastic. As for water, it is a material that conducts electricity well, so it is dangerous to use water to extinguish an electrical fire, or to approach an electrical casualty with clothes or shoes wet with water.
In the case of chemical burns, the injured must be removed quickly and cautiously from the source of the injury, and care should be taken not to destroy or dispose of the container containing the substance the cause of the injury, because the first aid instructions in cases of injury are often written on it, even if the vessel has no benefit in this regard Then, it will be of benefit in deciding the type of treatment needed when transporting the patient to the hospital, by knowing the chemical composition of the contents of the vessel, and it is necessary to take the vessel with the cause of the infection when transporting the patient to the hospital.
As long as there is a "burning", the password is "cooling", meaning the use of cold water in treating the injured, where we put the injured part for a period of 10 to 15 minutes under water or until the feeling of pain disappears.
In the case of first degree burns, suffice with cooling, and the burns are treated locally with local treatment for burns.
In the case of second-degree burns, the use of cooling, and not emptying the fluids trapped in the bubbles without medical supervision, as the bubbles contain fluids that may aid in the wound healing process and are removed by a burn doctor.
Covering the affected part with bandages and a topical antibiotic such as Fusidin, and taking the victim to the hospital.
In the case of third-degree burns, the injured person is immediately transferred to the hospital by ambulance, with the affected part covered with bandages, or when they are not available, it is covered with a plastic that is used to preserve food (SaranWrap).
Common mistakes common mistakes to watch out for
Do not put ointments, oils, toothpaste, vitamin E, or butter on burns, as these prevent heat leakage from the skin and work to shift the burn to a higher degree.
Do not use ice directly on the skin, as ice will burn and damage the skin cells.
Do not try to remove clothes that are sticking to the skin, but cut them from the edges.
Do not try to clean burns or open blisters and blisters.
Do not put cotton as a blanket directly on the affected place.
Burn treatment Treatment depends mainly on:
Giving the patient a pain reliever such as paracetamol or sometimes codeine or morphine.
Taking care of the burn and preventing and treating microbial infections, if any.
Giving the patient some intravenous fluids to prevent burn shock, to prevent and compensate for the occurrence of erythrocyte deficiency, and to treat fluid deficiency resulting from the burn, to restore balance to the disturbed electrolyte blood physiology.
When is the injured person transferred to the specialized burn unit? When suffering from second-degree burns (if the percentage of the affected area is 15 percent or less in adults or 10 percent or less in young people), third-degree burns at any age, or burns of the genitals, hand, face, and feet, or Burns from electric shocks and chemicals, or burns to the lung resulting from inhaling fumes, as well as to the patient who also suffers from chronic diseases and health problems such as heart or lung disease, according to the American College of Surgeons and Trauma Care Manual, 1999.
