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Someone could get burnt in lots of different ways. It could be in either a flame, it could be a hot cooker, an open-oven cooker, it could be an electrical burn or even a chemical burn. Another way that people get burnt is sunburn. People underestimate the power of the sun and the amount of damage it can do. You can have some very serious burns with unprotected skin. Now within first aid and burns, the advice is very simple and straightforward. We need to run the burn under cold running water for 20 minutes. Now, we don't want to cut this time down 'cause if we cut the time down, the problem... The reason we are running it under cold water is to cool the burn thoroughly. And it's surprising how much heat is still kept in the burn. So when we are running cold water on it, we're going to keep that going, you can either have a bucket and pour water over it and so you can scoop it out with a cup, or you can just let it run under a tap or a hose. Now that's the absolute ideal way around for doing it. So do what you can to cool that burn. The other problem with burns is that once you have broken a layer of skin on the body, then infection is a big problem. So when we've spoken in previous videos on bleeding and things like that, we don't tend to mention the infection too much. However, with burns, this can be a big problem. The other thing with a burn is that if you put normal first aid dressings on that burn, they're gonna stick. So for example, if you just got a tea cloth and put it under the tap and just wrapped it around your arm, the actual material, and as it dries, will stick to the surface. So when you go to a hospital, not only if you have got a serious burn, you've also got that material stuck and they are gonna have to remove that, it's going to be extremely painful and also it's going to do a lot more damage. So what we need to do with burns is stabilised the best we can. So we are running them under cold water for at least 20 minutes, and it's really tempting to do it less than that, but we must do it for that length of time. While we are running it under cold water, be aware of things like hypothermia. We wanna make sure the person isn't going to get very cold while we are cooling them off. So if it is a burn to the inner arm, for example, try and lean them so that the water is not going over the rest of their body and it's just this part of their body. And if it is a burn there, you can always wrap them in a blanket or a coat to keep the rest of their body warm. That will be surprising how much pain relief that can occur just by taking the heat out. The other thing we do is put a film, the same sort of film we use for wrapping your sandwiches up, and we will show how to put that film over a burn in a separate video. And as far as how bad a burn is, we can look at different things there. The key thing is, there is a mnemonic called "Scald". Now the S is the size of the burn, and this is really where we're looking at the physical size of the body. In order to assess the size of a burn, we use what's called the Rule of Nines. Now, the palm of your hand is roughly 1% of your surface area. So if we're measuring this on a patient, we need to look at the size of their hand to look at what 1% of their body is. Otherwise, the body is divided into nines. So your right arm is 9%, your left arm is 9%, your head is 9%, your legs, 18% each, front of your body, 18%, back of your body, 18%, and the groin area is the 1%. So that will give a rough idea of the size of the burn. Now, with children, this is slightly different, but with adult size, that gives you a rough idea of how to assess the size. The C of "Scald" is the cause of the burn. So with this, we need to look at what it was actually caused by. So if was it an electrical burn? So, therefore, we have got other dangers that we need to worry about. Electrocution and health safety is on that side. Was it a flame-type burn? Are there any risks or is there any other burns within clothing, or is it a direct temperature burn? The A is the age of the patient. Now, the age of the patient is important because your skin develops at different ages, so if you're dealing with a child, a burn, overly red, small burn could be extremely serious. But if it was on an adult, it might not be as serious. But then when you get much older, your skin gets a lot thinner again, so a burn can be even more serious again. So the age of the patient is a crucial factor when assessing the severity of a burn. L is location. Now, location is important because if the burn for example was on my arm, yeah, that's a serious burn. But that same burn on my face could be a lot, lot worse. Now, firstly, because we're affecting the respiratory system, so it could affect how I'm breathing, but also it can affect a lot more stress. So a burn on the arm, it may well be a scar on that, but you try and have the scars on faces can be really distressing for people. So we are looking at the area of the treatment as well here, because if you are trying to cool down the burn on the arm, it is relatively straightforward, but the one on the face is much harder. But you will need to do it and again, remember to keep them warm. The D of "Scald" is the depth. Now, the depth is also important because it depends how deep the burn is and how painful it is and how much damage is actually being done. So if you have a superficial burn, that's gonna be something like sunburn, where the skin is just red, you would a have a partial thickness burn, where the skin is actually blistering, so that is quite a serious one or a full-thickness burn, where it is going right the way through. Now, one of the characteristics of a full-thickness burn could be that there is not so much pain because all the nerves have been burnt out. But typically, around that full-thickness burn, you will then have other burns, blistering and things which will be painful. So the actual depth of that burn will vary depending on the actual severity of the injury that has happened and what the cause has been. So we use this "Scald" mnemonic to give a rough assessment. And this is quite good for then handing over to emergency services when they arrive. Now, when you're actually treating the burn, we are applying under cold water for 20 minutes. Now, If you don't have water available, there are burns kits available. You typically see these in kitchens and in businesses and in general first aid kits. Now, the advice with first aid now is to try and avoid using burn dressings because cold water is the option. And what it was found was that people were using burns dressing instead of that. Now, and if you have used one of these and I have burned myself and I put the burns dressing on and yes, it did cool it for a few seconds or a minute or so, but very quickly the burn dressing got hot, and then we are back to where the problem is. So running under cold water is a far better solution. So what we're gonna do is just briefly talk about burns kits. Now, in a BSI standard first aid kit, there is a burns dressing in there. It's a dressing. Typically, a small dressing in a pad and it is a liquid dressing, so it does actually cool. So you can apply that directly to the skin, it won't stick. Now, the items inside these burns kits, now this is just one we're looking at here, there's lots of different types. You can get small kits, large kits, or you might just have the components inside a first aid kit. So in here is the burn dressing, this is the gel dressing, and it is literally just a wet dressing, and you can put that straight on the skin. You open these up on the corner, there is this little nick in the corner. If you just pull that open, and then inside, you will see the burns dressing itself. You can see it's very wet and the actual dressing is flat and when you open it up, you have got the main pad that you can go start putting on the skin. Now, this is a standard 10 x 10 dressing, whereas they come in lots of other sizes if you want the smaller and a lot bigger, including full-face ones. Other items inside these burns kits are shears, and the reason we use this is to cut clothing away. Now, it wouldn't be pulling clothing off of you, start with the burn itself because you're just gonna do more damage, you can just cool over the water straight through that. This is great for cutting clothing off. If it's tight, you can always run it on the opposite side of the burn and cut around the top, so that we can just leave that piece of fabric that's actually on the burn itself. Also in the kits are bandages, which could be used over the top of the burns dressing or over the film that you've put over the burn itself just to hold it in place. You wouldn't do them uptight because, with burns, you can get swellings. You don't want tight dressings. And these, if it was getting tight, you can easily just cut them straight off. Also in here are some smaller sachets of burn gel. These, you just need to put a little bit more onto a burn, they are for smaller burns and there is a kit, instructions on what to do with basic first aid in this particular kit. And also and really importantly, there are two pairs of gloves. And then, the reason we have gloves with these burns kits is gonna be obvious in the sense, when we are doing first aid, we put gloves on. But what we said earlier on, infection is a big problem, so having gloves on will help the infection site 'cause you're not gonna pass bacteria on your skin onto the other person. And this is just one particular burns kit here that we sell and one brand of burns kit. But there are others around with different sizes, so there are some very small units or some larger ones. Well, it may well be, you just have the components within the BSI type first aid kits.
Dealing with Burns: First Aid Guide
Understanding Burn Types
Burns can occur through various means, including contact with hot objects, steam, chemicals, electricity, or sun exposure.
Treating Burns: The General Rule
The primary approach to treating burns is to cool the affected area under running water for a minimum of 20 minutes or by gently pouring cool water over the burn for the same duration. This thorough cooling helps prevent further damage and ensures the skin is adequately cooled.
When Running Water Isn't Available
In situations without access to running water, burn kits become valuable. These kits are commonly found in kitchens and areas with an elevated risk of burn injuries.
Burn dressings found in these kits are gel-based, designed to cool the burn without adhering to the injured area.
Maintaining Cleanliness
Handling burns requires utmost care, as they compromise the body's natural infection barrier. Therefore, it's crucial to maintain strict cleanliness when dealing with burns.
Understanding Burn Severity
Burns can vary in intensity and fall into different categories:
- Superficial burn: Affects the outer skin layer, typically caused by brief contact with heat sources like irons or flames. Symptoms include redness and pain.
- Partial-thickness burn: Involves damage to both the outer skin layer and part of the second layer, resulting in blisters, redness, swelling, and pain.
- Full-thickness burn: Affects all skin layers, potentially causing pain or nerve damage, sometimes leading to a lack of pain sensation.
Note: Burns can also be a combination of partial and full thickness, with varying severity across the affected area.
Factors to Consider
Several factors influence burn injuries:
- Patient's age: Young and elderly individuals typically have thinner skin, making them more susceptible to burns.
- Location of the burn: The burn's location on the body can impact its severity.
Assessing Burn Size
For assessing burn size, the "Rule of Nines" is commonly used:
- Hand: 1%
- Head: 9%
- Front of the body: 18%
- Back of the body: 18%
- Each leg: 18%
- Each arm: 9%
The burn's severity depends on the percentage of the body affected, as calculated using the Rule of Nines and the burn's thickness (partial or full).
This calculation is essential for informing Emergency Services about the situation.
First Aid Solutions
Various dressings and first aid solutions for burns are available, including burn wrap and special dressings, gels, and sprays. These products are designed to protect and soothe burn injuries.
Dealing with Burned Clothing
If clothing is stuck to a burn, avoid peeling it off. Instead, carefully cut around the affected area when necessary to prevent further damage.
Additional Burn Kit Items
Common items found in burn kits include safety scissors for cutting clothing, gloves for protection, and saline solution for cleansing.