Burns- First aid and management

With Deepavali, the festival of lights just around the corner, many Indian homes brighten up with candles and diyas lit everywhere around. The most common medical emergency at this time are ‘burns’. We are providing you with few tips on how to handle the situation if such an untoward incident were to happen.

Burns are injuries to the skin and deeper tissues caused by exposure to heat, chemicals, electricity or radiation. Burns are classified by the depth and the percentage of total body surface area involved.

First degree burns usually only involve the outer most layer of the skin called the epidermis. They are extremely painful and tender, the skin becomes red in the burn site and they blanch (turn white) when pressure is applied over them. The skin over the burn may peel in a day or two and heal within a week.

Second degree burns involve the dermis, the deeper layer of the skin. Here there is swelling and formation of vesicles or bullae, large fluid filled vesicles. They can be more or less painful depending on the depth of the burn. They can take about 2-3 weeks to heal. Burns that heal within 2-3 weeks rarely scar unless they become infected.

Third degree burns extend through the whole thickness of the skin and involve the underlying fat, muscles and bone too in some cases. The area may become dry and white or black and charred, or may appear brown and leathery. There is loss of sensation in the site of the burn, no pain as the nerve endings are destroyed. Skin grafting is needed in such cases and they take a very long time to heal.

The most common complications of burns are loss of fluids leading to hypovolemic shock if the burns are deep and involve a large surface area. Infection can result in generalized sepsis which can result in death if not treated promptly. Infection can increase scarring. Scarring and contractures in deep or extensive burns can cause severe impairment of function in the areas involved especially if around the joints or perineum.

Care for burns

For first and second degree burns:

Put the burnt part in running cold water for about 5-10 mins or immerse the burnt part in a bucket of cold water for some time to help reduce the swelling and wash away any chemicals in a chemical burn. Avoid using ice or ice water.

Remove any rings, chains or jewellery from the injured site immediately but gently, before the parts swell up.

Aloe vera gel or the extract directly from the plant can be applied on the burnt area. The Homeopathic Calendula ointment or cream which is available in local pharmacies like Walmart, Walgreen and Target, can also be topically applied on burns to soothe and heal.

Apply a clean dry sterile guaze dressing over the burn wound to prevent exposure to air and infection.

Change the dressing everyday. The burn should be cleaned completely with water and any residual ointments removed. Apply a light dressing over it and cover with a clean sterile guaze or cloth. Do not try to break the blisters if any as it increases the risk of infection. Do not apply any oil or butter on burns.

Keep the burnt area, esp if it is the extremities elevated above the heart level till the swelling subsides.

Some patients may require a tetanus toxoid booster vaccination if they haven’t been vaccinated for tetanus within the past 5 years.

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For third degree burns:

Get immediate medical help.

Remove the victim away from the disaster site to prevent further harm. Make sure they are not further exposed to smoke or fire, without putting yourself at risk.

Don’t wash the burns in running water. Don’t remove any clothing stuck to the burnt tissue. Don’t apply any ointment or salve over the burn. Rush to the doctor or call emergency medical care.

Also get immediate medical help if the burn involves the face, the genitals, hands, feet or is over any major joint. For victims below the age of 2 or over the age of 60, treat the burn as a major one, take them to emergency care right away.

Homeopathic treatment for burns

There are wonderful remedies in homeopathy which help reduce the pain, reduce the scarring and help the burn tissue heal smoothly. The most common remedies used are:

Arnica– Helps to reduce the swelling and pain caused by a burn. If given immediately, it can reduce the shock to the system.

Calendula– Can be given to prevent infections and to heal with minimum scarring. Calendula creams are available that can be topically applied over the burnt area to promote healing.

Other remedies used in Homeopathy for burns and infection due to burns are many like Urtica urens, Hypericum, Hepar Sulph, Cantharis, Calcarea Sulph, Causticum and many more. The choice of the remedy can be determined by your Homeopath as it varies depending on the nature of the symptoms of the patient and the intensity of the problem.

Remember to put off any diya’s or candles if you are not going to be home. With love, care and precaution, we wish all our patients and their families a safe and prosperous Diwali.