First aid for burns

The first aid for burns puts before itself the main priority, as in the case of trauma: airway patency, respiration and circulation; with inhalation lesion - 100% O2 .. It is necessary to stop contact of the victim with burning traumatic factors, remove ash and hot materials. The victim is removed from all clothing. Chemicals, with the exception of powder, are washed off with water. The first aid for burns with powdery substances is to smear them, pre-watering them with water. Burns with acids, alkalis or organic substances (for example, phenols, cresols) are washed with a large amount of water for at least 20 minutes until they are completely removed.

First aid for burns at the scene provides for the removal of the victim from the danger zone, the termination of the damaging factors, undressing, removal of the burned to fresh air (in the absence of respiration, an artificial one is performed). Cool the damaged parts of the body with water or cold objects, inject pain medications, apply bandages from sterile dressings or improvised materials (sheets, cloth flaps, etc.) to the wounds. When burning brushes, you need to remove the rings to prevent ischemia of the fingers (as a result of the development of edema).

The most effective method of providing first aid for burns is cooling the burnt surface, this leads to an end to tissue hyperthermia and a decrease in the depth of burn damage. It is carried out with cold water and other liquids, applique of cooled objects (ice, bubbles with cold water, snow, cryopacks), irrigation with chloroethyl or fumes of liquid nitrogen. The greatest efficiency is achieved with direct cryogenic treatment after burning. However, the delayed cooling (up to 30-60 min) is also quite effective.

In case of shock or burns> 15% of the area of the body begins intravenous fluid injection. In undamaged areas of the body, if possible, install 1 or 2 peripheral intravenous catheters 14-16 G. Venesection, in which the risk of infection is high, should be avoided.

Primary fluid replenishment is aimed at treating clinical manifestations of shock. In the absence of shock, the purpose of introducing fluid is to repair losses and maintain a normal balance of fluid in the body. To determine the volume needed to eliminate the deficit of fluid, use the formula Parkland. According to this formula, it is necessary to administer 3 ml of crystalloids (Ringer's lactate solution) per kilogram of body weight multiplied by the percentage of body surface area during the first 24 hours (for example, for a person weighing 70 kg and having a burn area of 40%, 3 ml 70 40 = 8400 ml in the first 24 hours). Half of this amount is administered within the first 8 hours after the prescribed time of injury, the remainder in the next 16 hours. Some clinicians prescribe to patients with extensive burns colloidal solutions within two days after injury, to very young or elderly patients, as well as to persons suffering from diseases heart.

The first aid for burns is also in the treatment of hypothermia and pain. Opioid analgesics are always administered intravenously. Anti-tetanus toxoid in a dose of 0.5 ml is administered subcutaneously or intramuscularly to patients previously fully vaccinated, and to those who have not received an anatoxin for the last 5 years. Patients who have been vaccinated before this time or who have not been vaccinated for the last 5 years are injected with 250 units of human immunoglobulin tetanus intramuscularly with parallel active vaccination.

With small burns, the affected part of the body in some cases is quickly immersed in cold water, although a decrease in the depth of the burn is not proven. After anesthesia, the wound is washed with a soap solution and all remnants of non-viable tissues are removed. Bubbles are processed, except for small blisters located on the palms, soles, fingers. If you are planning to transport the patient to the burn center, you can use clean dry bandages (burn creams prevent you from assessing the condition of burns in the receiving center). At the same time, the patient is warmed and opioid analgesics are administered to maintain relative comfort.

After cleaning the wound, the burn surface is covered with antibacterial ointment and covered with a sterile bandage. Most often, 1% sulfadiazine is used as a silver salt for topical application. It has a broad spectrum of antimicrobial activity. However, in patients susceptible to sulfur preparations, allergic reactions in the form of pain during application or local rash are possible. The drug can also cause a mild, transient and usually clinically insignificant leukopenia.

To ensure a normal breathing excursion of the lungs or blood supply to the limb with severe burns, you may need a scrotal fever (cutting a burned scab). However, if the delivery of the victim is expected within a few hours, the stratopathy can almost always be postponed until this moment.

Antibiotics with a preventive purpose are not prescribed.

After providing first aid for burns and stabilization determine the need for hospitalization.

[1], [2], [3], [4], [5]