Published: January 09, 2008 11:36 pm         

Burns: Cool action brings results

A toddler, tugging on a tablecloth, pulls a pot of hot coffee onto his face and body. An 88-year-old woman puts both hands directly on a hot baking dish in her oven, then spills the casserole on her feet and legs.

These represent two of the most frightening burn scenarios, both requiring emergency treatment. Burns generally involve scalding liquids and contact with hot objects, flame, chemicals, electrical current or radiation. Only the first three, known as thermal burns, are addressed specifically in this article.

Children younger than two, who are just learning to walk and have a great deal of curiosity about the world above them and seniors over age 80, who may have impairments in coordination and movement are most vulnerable. Liquid scalds and burns from touching hot objects are particularly common.

Even when a 911 call is required, a proper response by the person involved and/or bystanders is crucial to avoiding long-term disability or disfigurement.

The first step is always to stop the burning process, while, keeping yourself out of harm’s way. Act quickly to stop the victim’s contact with the hot steam, liquid or object, and remove hot or burned clothing if possible.

The common advice for a person whose clothes are on fire is to stop, drop and roll.

As quickly as possible, cool the burned area with running water for 20 to 30 minutes. This may mean putting a burned hand directly under the tap. Don’t use ice, however, as it may injure tissue.

Immediate cold water treatment for 20 minutes will stop some of the immediate chemical reactions in the body and lessen the severity of the burn injury. When large areas of the body are involved you must be careful to avoid hypothermia. If the person becomes chilled, doctors suggest placing a clean sheet under the patient and then another clean sheet on top. Clean blankets can then be added to keep the patient comfortable while waiting for emergency help.

Your mother may have told you to put butter on a burn. That treatment hasn’t been proven effective and may even trap heat in the burned skin. For a burn that’s going to require medical treatment, it may also complicate the work of cleaning the wound.

For self-treatment of small, minor burns, a cool wet compress and over-the-counter pain medications such as acetaminophen may be used. A triple antibiotic ointment can aid healing and protect against infection.

Call 911 immediately if a person has:

• Extensive partial or full thickness burns on the body, has trouble breathing, is unconscious or has been exposed to a great deal of smoke in a closed space.

• Any full thickness burn – one that’s painless and looks dry and charred.

• Any partial or full thickness burn involving the genitals, eyes, ears, hands, feet or major joints – regardless of size.

• A large partial thickness burn – more than twice the size of your palm.

An important consideration, in addition to the depth and extent of the burn, is the age of the patient. Children and older persons have thinner skin and reduced immunity. An older person may have chronic medical conditions.

For a 20-year-old with burns covering 40 percent of total body surface, the mortality rate is 8 percent; for a person age 70 or over, the same burn has a mortality rate of 94 percent.

About two million burn injuries occur every year, nearly half of which require a trip to the emergency room. Only about 70,000 persons sustain major burn injuries requiring hospitalization, however, and the number of deaths, severe burns and even minor burns has declined substantially over the past 50 years.

The increased use of smoke detectors has resulted in a 74 percent decline in injuries from home fires. Fire fighters and emergency medical personnel have improved tools, training and technique.

Yet the most important way of dealing with burns is prevention. Smoking should be taken outdoors and the thermostat on the hot water heater turned down to 120 degrees or lower.

With common sense, most burns can be avoided.



Rupp is information and assistance case manager with the Northern Oklahoma Development Authority Area Agency on Aging.