Thermal burns

Burn your finger - take hold of the earlobe. This phrase is often spoken by parents to a child who, with a crying, pulls his finger from the hot one. And this is the most common first aid for thermal burns, which is familiar to everyone from childhood. The same applies to smearing the skin with sour cream after a long stay in the sun, when the body becomes the color of red-hot lava. And who among us did not burn his tongue, hurrying to swallow hot food? How to be here? Why apply language? Than it or him to smear?

Thermal burns are consequences of exposure to high temperature (open flame, hot liquid or solid matter) on the skin and underlying tissues.

Nature of burns

Thermal burns entered the life of a person with the appearance of fire, boiling water, hot steam and hot solid, gaseous, and also loose substances. Burns can be different in nature, in burn area, in the depth of skin lesions, and they can also be external and affect internal organs, for example, thermal burns of the respiratory tract during a fire. Whatever burns are, they are united by one thing: they all cause suffering and require special manipulations to provide first aid.

Therefore, it is important to know how to recognize a burn, what is the first help to those who have already suffered and what to be prepared for, if on the path of life you have a meeting with such a disease as a thermal burn.

Manifestations of a second degree burn

Burns of the second degree, except for the redness of the skin, are characterized by pronounced blisters. At the time of getting a burn, blisters may not be present, they appear after a short time. At first, the burnt skin looks rather wrinkled. This "wrinkling" is the future blister, which will gradually fill with a liquid, the color of which can vary from transparent to yellowish. Edema is more pronounced than with a first degree burn. Pain sensations do not pass for several hours and even a day.

Degrees of thermal burns

Thermal burns are divided into four categories according to the severity level. The first category is the easiest and most common in everyday life. To receive a thermal burn of the first degree it is possible from insignificant contact of integuments with something having a temperature of more than 50 degrees. The first summer tan, coloring the skin in a red tint, causing painful sensations, is nothing like a thermal burn of the first degree. Summarize. Burns of the first degree lead to reddening and slight painful sensations on the skin. In addition to these symptoms, a small swelling around the damaged surface is possible.

Local changes in thermal burns depend on their depth:

• at I degree - skin hyperemia;
• at II degree - death of an epidermis with formation of blisters;
• with IIIA degree - partial, and with grade IIIB - complete necrosis of the skin;
• at the IV degree necrosis captures the underlying tissues.

Burns up to grade IIIA are referred to as superficial, since during their healing epithelization of the skin occurs. Burns IIIB-IV degree are deep, heal with the formation of fibrous scars and determine the severity of the burn disease.

The area of skin lesions with burns is most often determined by the rule of "nine". The head and neck, chest, abdomen, half of the back surface, arm, hip, drumstick have a surface area corresponding to 9% of the total surface of the body. In children, the relationship between different parts of the body varies with age, so it's best to orient yourself around the patient's palm area, approximately corresponding to 1% of the body surface. With a thermal burn of the respiratory tract, 10-15% is added to the total skin lesion area. Inhalation burns in children are considered as a threat of progredient development of burn shock. In addition to determining the area and depth of the burn, an important value in assessing the severity of the condition is the defeat of the functionally important areas of the feet, hands, face and perineum.

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

Severe degrees of thermal burns

Third and fourth degree burns are classified as very dangerous, as they affect the whole organism and can lead to death. Symptoms - a large burn area, the absence of skin areas, extensive blisters, sometimes merged into one large, skin color from dark red to black. There is a deep burnout of the skin and muscle layer up to the bone. Here is an incomplete enumeration of what can be a place of a burn, belonging to the category of 3-4 degrees.

How do I set the burn rate?

It is possible to set the burn degree "by eye" only if it is the first degree. Further complications begin. In case of damage to the skin with a slight reddening and the presence of blisters, we can say that this is a second degree burn and there is nothing to worry about. But! If the finger is burned, the excitement is in vain. And if the whole surface of the back? And if this spin belongs to the child? Here, confidence is already falling. We urgently need to see a doctor.

So. With third and fourth degree burns, the body includes one of the protective mechanisms - loses moisture, directing it to the skin, which leads to dehydration. A large role is played by the burn area and the depth of tissue damage. Burns more than 75% of the total body area are considered fatal. Dehydration, the release of a large number of toxic substances into the blood, an infection, a pain shock - these are satellites of severe burns.

Emergency care for burns in children without clinical signs of shock

Begin by cooling the burn area and the surrounding surface of the skin with a neutral liquid (water) until the pain disappears, but at least 10 minutes, in order to stop the process of skin damage. In adolescents, irrigation with cold water (15-20 ° C) is carried out for 30 minutes. It is necessary to empty the damaged skin from clothes before it cools, cutting off unattached clothing around the site of damage and not opening the bubbles, so as not to create conditions for their infection.

If skin burns to grade IIIA have an area of lesion of less than 9% (for children under 5 years - less than 5%), 50% solution of metamizole sodium (analgin) 10 mg per 1 kg of body weight and 1% solution of diphenhydramine (dimedrol) are intramuscularly administered ) 0.1 ml per year of life or 5% solution of tramadol (tramal) in a dose of 1-1.5 mg per 1 kg of body weight.

When skin burns IIIA severity with an area of more than 9%, usually burns shock, so for analgesia, intravenously injected narcotic analgesics - 1-2% solution of trimiperidin (promedola) or omnipoate 0.1 ml per year of life or 0.2 mg per 1 kg of body weight (in children over 6 months of age).

With genital and perineal burns, a catheter must be inserted into the bladder already at the prehospital stage, as swelling of the tissues can lead to a delay in urine. Active infusion therapy for burns in the prehospital stage, especially at an early age, is not practiced, since hypovolemia due to plasmorrhagia develops in 4-6 hours. Such treatment is necessary in case of burn shock, when hemodynamic disturbances develop in the first minutes from the moment of trauma.

Emergency prophylaxis of tetanus in children and adolescents is carried out in the event of violations in the vaccination calendar:

• unvaccinated (older than 5 months) - 0.5 ml tetanus toxoid and 250 ME immunoglobulin anti-tetanus;
• with missed the last revaccination - 0.5 ml tetanus toxoid:
• when carrying out only 1 -2 vaccinations in the history less than 5 years ago, 0.5 ml of tetanus toxoid are injected, and more than 5 years - 1 ml of tetanus toxoid and 250 ME immunoglobulin antitetanus.

With inhalation burns of the airways with hot air and with severe burns of the face, intubation of the trachea, radiography of the chest, determination of the blood gas composition, and the level of carboxyhemoglobin are suitable.

With thermal burns of eyelids and the eyeball, anesthetic substances are injected into the conjunctival cavity - 3-5 drops of a 0.25% solution of tetracaine (dicaine) or a 2% solution of lidocaine. On the eye area, an aseptic binocular bandage is applied.

[6], [7]

First aid for thermal burns of the first degree

With a first degree burn, there is no strict algorithm for the provision of medical care. It is enough to hold the damaged surface under a stream of cold running water or, if this is not possible, attach a towel soaked in cold water to the burned place. A packet with ice will do. In a word, cold is the simplest means. Cold will remove unpleasant painful sensations, remove swelling due to narrowing of small blood vessels. Five - ten minutes of a cold compress will be quite enough. You can use modern aerosol products, which have a disinfecting and, at the same time, analgesic effect.

[8]

First aid for thermal burns of the second degree

It consists in treating the surface with special anti-burn agents, which are abundant in any pharmacy, and must necessarily be in the home medicine cabinet of each family. Cool the fired place under running water, if possible, and apply an anti-burn spray. It is not necessary to apply bandages, it is better to lead the wound with the so-called "open method". It is advisable, without delay, to seek professional medical help. You do not need to open the blisters yourself, this operation can lead to infection on the wound surface, and instead of facilitating you will get aggravation of the situation and a purulent process.

[9],

First aid for thermal burns 3-4 degrees

It consists in an urgent call of a team of doctors. Independent assistance can aggravate the situation. Safe intervention - give the victim a cool drink, an anesthetic, preferably in the form of intramuscular injection. If the injection is not possible, then a strong tablet analgesic also has time to give effect before the arrival of doctors. As a rule, the victims, who received extensive burns, are left for treatment in a hospital. If the burn is local, it takes a small area, then they are treated in a dispensary.

First aid for thermal burns, as practice shows, should be provided immediately. From the intervention of physicians often depends the life and the patient's further well-being.