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Dos and Don’ts of first aid for burns

What to do and when

Burns are a common injury that can range in severity from minor discomfort to life-threatening emergencies. The extent to which a burn will heal often depends on the quality of first aid received immediately after the injury, according to emergency medical services provider Netcare 911.

“Whether it’s a minor burn caused, for instance, by a steaming cup of coffee or a more serious burn, there is little doubt that correct first aid can improve the outcome,” says Gary Paul, clinical head of Netcare 911’s coastal operations. “The following Dos and Don’ts will help lay persons to provide the appropriate care when faced with a burn injury.”

DO

  • Remain calm
  • Extinguish flames (if any)

If a person’s clothing has caught alight, they must STOP, DROP and ROLL to extinguish the flames. “In an emergency when clothing is on fire, action must be instinctive and immediate and so everyone should know the principle of ‘stop, drop and roll’,” Paul says.

  • STOP because running will fan the flames
  • DROP to lie flat on the ground, and cover your face with your hands for protection
  • ROLL over and over to smother the fire until it is extinguished

“Teach children about the stop, drop and roll technique from a young age and reinforce this message from time to time so that in an emergency they will remember what to do.”

  • Look after your own safety

If the patient has an electrical burn and is still in contact with the electrical source, switch off electricity before assisting them. If you cannot switch off the electricity, use an object that does not conduct electricity, such as a wooden broom handle, to separate the person from the power source. When extinguishing flames on a person, be careful that your own clothing does not catch fire. In the case of a chemical burn, use protective eyewear and gloves to ensure that you do not get the chemical on yourself.

  • Cool the burn area

Run cold water over the affected area for at least 20 minutes in the case of minor to moderate burns. This may help to limit the damage to deeper skin tissues, and is also effective for chemical burns, as the water can help to dilute the harmful substance.

  • Call for advice and assistance

Call an emergency medical service provider, such as Netcare 911 (082 911), as soon as it is practical to do so. As each burn is different, give the call operator at the emergency operations centre as much information as possible. This will help them to give you the most appropriate advice and assistance.

Wrap the victim in a clean sheet and take them to a medical facility or wait for an ambulance, whichever will be quicker and more appropriate in the circumstances.

  • Smoke inhalation

One of the leading contributors to death and/or disability is smoke inhalation. Fire victims may not present with physical burns however they can inhale poisonous gases released during a fire. The combination of noxious gases as well as heat can lead to inhalation burns and respiratory injuries that may not be readily apparent. All victims who have been present during a fire with smoke need to be evaluated as soon as possible to prevent secondary complications.

DON’T

  • Don’t attempt to apply any substances to the burn

Do not put ice on the burn, as this can further damage the tissue. In the case of extensive burns, do not cool with water for too long because this could cause hypothermia.

Do not put oily substances, pastes, turmeric, egg white, toothpaste or topical ointments on the burn, or press cotton wool or fluffy material directly onto the burn as this could increase the chance of infection. However, you can use a burn dressing or ointment recommended by a pharmacist, and this should be covered with a bandage or cling film to prevent infection.

  • Never peel off or open blistered skin, as this could expose the burns victim to infection.

How severe is the burn?

Don’t underestimate the severity of a burn. Rather, consult a medical professional.

  • Superficial partial thickness (first degree burns): These burns are painful and red. Sometimes blisters may form. However, they usually heal with little or no scarring.
  • Deep partial thickness (second degree burns): Severe pain, skin discolouration and blisters, often with scarring, are characteristics of these burns. Seek medical advice.
  • Deep thickness (third degree burns): These burns cause deep damage to all three layers of the skin. They destroy hair follicles, blood vessels and nerve endings. The burns victim may also experience breathing difficulties and circulation problems. Seek immediate assistance from emergency medical services or a trauma facility equipped to deal with burn injuries.

Netcare Milpark Hospital has a dedicated, state-of-the-art private burns unit and has treated hundreds of burns patients since the unit opened in August 2008. The burns specialists at this specialised facility deal with even the most challenging burns cases, with patients referred for treatment from other hospitals around the country and throughout the African continent. The state-of-the-art burns unit at Netcare Milpark Hospital has eight private isolation rooms in an intensive care unit (ICU) and a dedicated burns theatre within the ICU. Treating patients in isolation is vital in the fight against infection, which can be a major problem in serious burns cases.

SIDEBAR

Burns prevention tips from Netcare’s Trauma Injury Prevention programme

Netcare Milpark Hospital’s trauma programme manager, Rene Grobler, says that most burns are preventable with a few precautions. “People should seriously consider reducing the temperature of their geysers, as this significantly reduces the chances of scalding injuries, which are among the most common types of household burns.”

“When running bath water, never run the hot tap on its own into the bathtub. Rather, get into the habit of using both the hot and cold tap together to control the temperature of the water, which will help to prevent scalding injuries.”

“Kettles, urns, portable cooking appliances and their cords should be kept well out of reach of children, as should pots and containers with hot liquids,” she cautions.

Simple precautions to avoid burns

  • Invest in and maintain at least two fire extinguishers in your home. Ensure that you know how to use a fire extinguisher before you are faced with an emergency situation.
  • Invest in basic smoke detectors for different parts of your house, i.e. kitchen and sleeping area, or ground floor and top floor if you have a double storey house. Smoke detectors are readily available from most hardware stores.
  • Never use petrol or other flammable liquids or gels to start a braai fire.
  • Take extra care around fires, flame, gas, hot liquids, and cooking equipment. Do not leave children unsupervised around these potentially dangerous heat sources.
  • Do not sleep with electric blankets or heaters switched on.
  • Test the bath water for babies and children. It should be comfortably warm.
  • Store matches and lighters out of children’s reach.
  • Never overload electrical plug points, as this can increase the fire risk.
  • Never smoke in bed, near gas cylinders or other flammable substances. Always dispose of cigarette butts responsibly.