Burns

Definition

There are three levels of burns:

• First-degree burns affect only the outer layer of the skin. They cause pain, redness, and swelling.
• Second-degree (partial thickness) burns affect both the outer and underlying layer of skin. They cause pain, redness, swelling, and blistering.
• Third-degree (full thickness) burns extend into deeper tissues. They cause white or blackened, charred skin that may be numb.

Alternative Names

Considerations

Before giving first aid, evaluate how extensively burned the person is and try to determine the depth of the most serious part of the burn. Then treat the entire burn accordingly. If in doubt, treat it as a severe burn.

By giving immediate first aid before professional medical help arrives, you can help lessen the severity of the burn. Prompt medical attention to serious burns can help prevent scarring, disability, and deformity. Burns on the face, hands, feet, and genitals can be particularly serious.

Children under age 4 and adults over age 60 have a higher chance of complications and death from severe burns.

In case of a fire, you and the others there are at risk for carbon monoxide poisoning. Anyone with symptoms of headache, numbness, weakness, or chest pain should be tested.

Causes

Burns can be caused by dry heat (like fire), wet heat (such as steam or hot liquids), radiation, friction, heated objects, the sun, electricity, or chemicals.

Thermal burns are the most common type. Thermal burns occur when hot metals, scalding liquids, steam, or flames come in contact with your skin. These are frequently the result of fires, automobile accidents, playing with matches, improperly stored gasoline, space heaters, and electrical malfunctions. Other causes include unsafe handling of firecrackers and kitchen accidents (such as a child climbing on top of a stove or grabbing a hot iron).

Burns to your airways can be caused by inhaling smoke, steam, superheated air, or toxic fumes, often in a poorly ventilated space.

Burns in children are sometimes traced to parental abuse.

References

Marx JA, Hockberger RS, Walls RM, eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 5th ed. St. Louis, Mo.: London: Mosby; 2002.

Townsend, Jr., CM, ed. Sabiston Textbook of Surgery. 17th ed. Philadelphia, Pa: Elsevier; 2004.

Roberts JR, Hedges JR, eds. Clinical Procedures in Emergency Medicine. 4th ed. Philadelphia, Pa: Saunders; 2004.