Burn treatment consists of relieving
pain, preventing infection, and maintaining body fluids,
electrolytes, and calorie intake while the body heals. Treatment of
chemical or electrical burns is slightly different from the
treatment of thermal burns but the objectives are the same.
Thermal burn treatment
The first act of thermal burn treatment is to stop the burning
process. This may be accomplished by letting cool water run over the
burned area or by soaking it in cool (not cold) water. Ice should
never be applied to the burn. Cool (not cold) wet compresses may
provide some pain relief when applied to small areas of first- and
second-degree burns. Butter, shortening, or similar salve should
never be applied to the burn since it prevents heat from escaping
and drives the burning process deeper into the skin.
If the burn is minor, it may be cleaned gently with soap and water.
Blisters should not be broken. If the skin of the burned area is
unbroken and it is not likely to be further irritated by pressure or
friction, the burn should be left exposed to the air to promote
healing. If the skin is broken or apt to be disturbed, the burned
area should be coated lightly with an antibacterial ointment and
covered with a sterile bandage. Aspirin, acetaminophen (Tylenol), or
ibuprofen (Advil) may be taken to ease pain and relieve inflammation.
A doctor should be consulted if these signs of infection appear:
increased warmth, redness, pain, or swelling; pus or similar
drainage from the wound; swollen lymph nodes; or red streaks
spreading away from the burn.
In situations where a person has received moderate or critical burns,
lifesaving measures take precedence over burn treatment and
emergency medical assistance must be called. A person with serious
burns may stop breathing, and artificial respiration (also called
mouth-to-mouth resuscitation or rescue breathing) should be
administered immediately. Also, a person with burns covering more
than 12% BSA is likely to go into shock; this condition may be
prevented by laying the person flat and elevating the feet about 12
in (30 cm). Burned arms and hands should also be raised higher than
the person's heart.
In rescues, a blanket may be used to smother any flames as the
person is removed from danger. The person whose clothing is on fire
should "stop, drop, and roll" or be assisted in lying flat on the
ground and rolling to put out the fire. Afterwards, only burnt
clothing that comes off easily should be removed; any clothing
embedded in the burn should not be disturbed. Removing any
smoldering apparel and covering the person with a light, cool, wet
cloth, such as a sheet but not a blanket or towel, will stop the
burning process.
At the hospital, the staff will provide further medical treatment. A
tube to aid breathing may be inserted if the patient's airways or
lungs have been damaged, as can happen during an explosion or a fire
in a enclosed space. Also, because burns dramatically deplete the
body of fluids, replacement fluids are administered intravenously.
The patient is also given antibiotics intravenously to prevent
infection, and he or she may also receive a tetanus shot, depending
on his or her immunization history. Once the burned area is cleaned
and treated with antibiotic cream or ointment, it is covered in
sterile bandages, which are changed 2-3 times a day. Surgical
removal of dead tissue (debridement) also takes place. As the burns
heal, thick, taut scabs (eschar) form, which the doctor may have to
cut to improve blood flow to the more elastic healthy tissue beneath.
The patient will also undergo physical and occupational therapy to
keep the burned areas from becoming inflexible and to minimize
scarring.
In cases where the skin has been so damaged that it cannot properly
heal, a skin graft is usually performed. A skin graft involves
taking a piece of skin from an unburned portion of the patient's
body (autograft) and transplanting it to the burned area. When
doctors cannot immediately use the patient's own skin, a temporary
graft is performed using the skin of a human donor (allograft),
either alive or dead, or the skin of an animal (xenograft), usually
that of a pig.
The burn victim also may be placed in a hyperbaric chamber, if one
is available. In a hyperbaric chamber (which can be a specialized
room or enclosed space), the patient is exposed to pure oxygen under
high pressure, which can aid in healing. However, for this therapy
to be effective, the patient must be placed in a chamber within 24
hours of being burned.
Chemical burn treatment
Burns from liquid chemicals must be rinsed with cool water for at
least 15 minutes to stop the burning process. Any burn to the eye
must be similarly flushed with water. In cases of burns from dry
chemicals such as lime, the powder should be completely brushed away
before the area is washed. Any clothing which may have absorbed the
chemical should be removed. The burn should then be loosely covered
with a sterile gauze pad and the person taken to the hospital for
further treatment. A physician may be able to neutralize the
offending chemical with another before treating the burn like a
thermal burn of similar severity.
Electrical burn treatment
Before electrical burns are treated at the site of the accident, the
power source must be disconnected if possible and the victim moved
away from it to keep the person giving aid from being electrocuted.
Lifesaving measures again take priority over burn treatment, so
breathing must be checked and assisted if necessary. Electrical
burns should be loosely covered with sterile gauze pads and the
person taken to the hospital for further treatment.
Alternative treatment
In addition to the excellent treatment of burns provided by
traditional medicine, some alternative approaches may be helpful as
well. (Major burns should always be treated by a medical
practitioner.) The homeopathic remedies Cantharis and Causticum can
assist in burn healing. A number of botanical remedies, applied
topically, can also help burns heal. These include aloe (Aloe
barbadensis), oil of St.-John's-wort (Hypericum perforatum),
calendula (Calendula officinalis), comfrey (Symphytum officinale),
and tea tree oil (Melaleuca spp.). Supplementing the diet with
vitamin C, vitamin E, and zinc also is beneficial for wound healing. |