With winter on our doorstep, I thought it might be a good idea to remind people about a really chilling subject that most medics face every winter: burns.
Burns can be classified into a few types, burns caused by heat, electricity, chemicals or friction. With winter coming, the most common burn will more than likely be a burn caused by heaters.
Most burns affect only the superficial skin, known as superficial or first degree, or extend into the deeper skin but do not involve the full thickness of the skin, known as partial thickness or second degree. Rarely all layers of the skin or deeper tissues, such as muscle or bone, can be injured in which case the burn is either full thickness or third degree.
With heaters and young children, burns are very likely to occur, so please take note of open heaters, open flame fireplaces, bar heaters and, if used in the house, gas heaters. Please make sure that all heaters are safe and that children do not play near the heater. Accidents always occur, and in most cases a burn will more than likely be the least of your concerns.
The treatment required depends on the severity of the burn. Superficial burns maybe managed with little more than simple pain killers, while major burns may require prolonged treatment in specialised burn centers. Cooling with tap water may aid pain and decrease damage however, if exposure is prolonged it may result in low body temperature. Partial thickness burns may require cleaning with soap and water, followed by dressings.
Blisters, created after a person has been burnt, should typically be left unbroken. Full thickness burns usually require surgical treatments such as skin grafting and extensive burns often require large amount of intravenous fluids. The most common complications of burns are related to infection.
If a person does get burnt, please make sure you cool the area down as soon as possible using cool running water. Ice, bicarbonate of soda or cooking oil are old wives tales of remedies and do not work. If a burn is severe, please seek medical attention as soon as possible.
Medics have a very effective way of determining the percentage of body that has been burnt and it’s called the Rule of Nines:
The rule of nines is a standardised method used to quickly assess how much body surface area has been burned on a patient. This rule is only applied to partial thickness (second degree) and full thickness (third degree) burns. The diagram below depicts BSA percentages for adults and infants of one year or less. For children over the age of one year, please see the formula below.
A method for calculating the body surface area is to compare it to the size of the patient’s palm, which equates to approximately 1% body surface area. For example, if a burn area is the size of (5) palm surfaces, the burn would be roughly 5% body surface area. This method can be used to estimate the BSA for both adults and pediatrics. In most cases, you may find it more useful to use the rule of nines when evaluating larger burn areas and the “palm” method for smaller burn injuries.
Until next time, stay safe.
