Burns

The first response to burns is always the same, no matter how severe the burn is or what caused it. The first thing to do is always COOL the burn. 

1. Causes and characteristics of burns

Causes of burns:

• Hot liquids (vast majority)
• Hot gases and vapours (including smoke and steam). Breathing in hot gases and steam during a fire can cause burns to the airway. This is the number one cause of death in fires. 
• Flames / fire
• Hot objects
• Heat radiation
• Chemicals
• Electricity
  • Victim being caught in the fire or by a spark
  • Electricity passing through the body
• Other causes, such as radioactivity

Severity of burns depends on:

• The damage to the skin
• The size of the burn
• The position of the burn
• Age of the victim
• Type of heat source
• The temperature of the substance 
• The duration of exposure to the source 
• Part of the tissue affected
• Blood supply to the sin
• Moisture content of the skin
• Thickness of the skin

Risk of burns:

• Depends on the severity
• Damage to a part of the skin, which as a result loses some or all of it protective functions
• Loss of fluid, which can cause a shortage of fluid in the blood vessels, which can put the victim into shock. The skin is then unable to maintain the body’s temperature, so the body cools down and the victim runs the risk of developing hypothermia. 

2. Assessing the victim

First-degree burn: red, dry painful and possibly also slightly swollen skin.

Second-degree burn: red, slightly swollen and painful skin. Blisters will also form. 

Third-degree burn: white / black, dry and leathery skin, little pain (the nerves in the skin are damaged)

3. What the ERO should do

General treatment for burns:

• First cool with lukewarm water, cold water can cause hypothermia
  • If there is no clean tap water available, use a hydrogel compress or bandage or, if there is no other option, surface water.
    At this stage cooling is more important than preventing infection.
• Remove clothes, unless it is stuck to the burn
• Jewellery should be removed where hands and arms are burned, preferably by the victim himself
• After cooling cover second- and third-degree burns with a non-adhesive gauze
  • If the gauze is not available, use plastic household foil, a clean plastic bag, a clean cloth or tea towel or a sheet. If you use plastic household foil, apply it directly to the wound and continue cooling it

If 10% or more of the body is affected, the victim has extensive burns, and you have to call 112. The surface area of the victim’s hand is roughly 1% of the surface area of his body. 

In the case of serious second- or third-degree burns always call 112. You should at any rate call a doctor in the event of blistering, skin damage, facial burns, and chemical or electrical burns. 

If the victim’s clothing is on fire:

• Roll the victim over the ground and / or extinguish the fire with water
• If necessary, use a fire blanket 

Facial burns can mean that the airway has sustained burns, so be extra alert for breathing problems. Treat facial burns as follows:

• Call 112
• Cool the victim’s face, for example, by using a shower
• Have the victim sit in a semi-reclining position if possible
• Have an ambulance crew treat and transport the victim. Victims with burns to the airway must always be transported in a semi-reclining position, which allows them to breathe more easily