11.4 Burns
Burns are another common unintentional household injury. Burns can be caused by dry or wet heat, chemicals, or electricity. Burns from dry heat can occur from fire, irons, hair dryers, curling irons, and stoves (American Institute for Preventive Medicine, 2012; Leahy, Fuzy & Grafe, 2013). Burns from wet or moist heat occur from hot liquids, such as hot water or steam (American Institute for Preventive Medicine; Leahy, Fuzy & Grafe). These types of burns are called scalds. Scalds can occur within seconds and cause serious injury. Chemical burns occur from chemical sources and can also cause serious burns when exposed to skin or if chemicals are swallowed, whether intentionally or unintentionally. Electrical burns can cause very serious injury as they can burn both the outside and inside of the person’s body, causing injury that cannot be seen and which can be life-threatening. Radiation burns can also occur from sources of radiation such as sunlight (American Institute for Preventive Medicine).
Types of Burns
Burns are divided into first, second, and third-degree burns.
First-degree burns affect only the outer layer of the skin (epidermis). These types of burns are the least serious as they are only on the surface of the skin. First-degree burns usually appear red, dry, and slightly swollen (MedlinePlus, 2014). Blisters do not occur with this type of burn. They should heal within a couple of days (American Institute for Preventive Medicine, 2012).
Second-degree burns affect the top layer of the skin and the second layer of skin underneath (dermis). They are more serious than first-degree burns. The skin may appear very swollen, red, moist, (MedlinePlus, 2014) and may have blisters or look watery and weepy (American Institute for Preventive Medicine, 2012).
Third-degree burns are the most serious burn. A third-degree burn affects all layers of the skin and may affect the organs below the surface of the skin. The skin may appear white or black and charred (MedlinePlus, 2014). The person may deny pain because the nerve endings in their skin have been burned away (American Institute for Preventive Medicine, 2012). Third-degree burns require immediate medical treatment. If Health Care Assistants suspect their client has a third-degree burn, they should immediately call 911. Emergency services should also be called anytime a client was exposed to smoke. They need to have their airway checked for possible injury.
Chemical burns can occur anytime a liquid or powder chemical comes into contact with skin or mucous membranes that line the eyes, nose, or throat. Chemical burns may also occur if a chemical is swallowed. These burns can cause serious injury and emergency services should be contacted. If a person receives a chemical burn, the chemical should be removed from the skin by using a gloved hand to brush it off and then wash the area with plenty of cool water. Electrical burns can occur if a person has been using an electrical appliance and is exposed to water or if an electrical short occurs while using the electrical appliance. Using faulty or frayed cords on electrical appliances can result in electrical burns. Electrical burns are a serious injury. Emergency medical services should be immediately activated.
Never use oils such as butter or vegetable oil on any type of burn as this can cause further injury. For first or second-degree burns flush the area with plenty of cool (not ice cold) water for about 15 minutes or until the pain decreases and cover with a clean, dry bandage. Using ice or ice cold water can cause frostbite (American Institute for Preventive Medicine, 2012). For major burns remove any clothing that is not stuck to the skin, cover the burned area with a dry, clean cloth, and seek emergency assistance.
Guidelines to Prevent Burns
- Never allow children or confused adults to use electrical appliances unsupervised.
- Never use electrical appliances near water sources.
- Never use electrical appliances in which the cord appears to be damaged or frayed.
- Never pull a plug from the cord. Always remove a cord from an outlet by holding the base of the plug.
- Electrical appliances should never be used in the bathtub, sink, or near running or standing water.
- Cover electrical outlets with child-proof plugs. Never allow children to put anything inside an electrical outlet.
- Never place a metal object inside an electrical appliance while it is plugged in.
- Ensure stoves and other appliances are turned off when finished with them.
- Turn pot handles inward so that a person cannot accidentally bump a handle and spill hot liquids.
- Check water temperature prior to bathing or showering a client.
- Take care that any hot liquids served are cooled to the point where a client can safely drink them. Burns can very easily happen from spilling or drinking liquid that is too hot.
- Do not keep hot drinks, soups, or other liquids at the edges of tables or countertops.
- Always inform a client when giving them something hot to drink or eat.
- Do not allow clients to walk with hot beverages or food in their hands. Have them seated while consuming hot liquids.
- Do not use space heaters and other personal heaters close to a client where they could accidentally touch or fall against it.
- Check to be sure the hot water heater is not set too high. To avoid scalds from hot tap water, hot water heaters should be set to 50°C (120°F) or less (MedlinePlus, 2014).
- Do not allow children or confused adults to use lighters or matches.
- Discourage smoking in the home, and especially in bed, where a person is at more risk of falling asleep with a lit cigarette.
- Keep chemicals and cleaning solutions securely locked and out of reach of children and confused adults.