Thermal and chemical burns: classification, first aid

A burn is the most difficult of all types of injuries. Thermal damage to the skin is common (boiling water, hot devices or an open flame), but there may be other prerequisites for their occurrence.

Classification of burns, first aid and a brief description - further.

Types of thermal injuries

Any severe burn is a rather severe and complex damage to the skin of a person, requiring urgent attention and qualified help from medical personnel. By the type of factors causing wounds, burns are divided into:

• thermal, due to contact with hot objects, boiling water or an ordinary flame;
• chemical, with contact with the skin and mucous membranes of chemicals, often with acids or alkalis;
• electrical caused by current;
• radiation, when radiation is the leading factor in damage (sun, etc.).

Classification

There is another classification - according to the depth of tissue damage. This is crucial for determining a treatment strategy for disease manifestations and monitoring changes during its implementation. Before proceeding with first aid, a burn and its classification according to severity should be determined by a specialist. So distinguish:

• I degree - burns, which are characterized by redness of the skin.
• II - with the release of bubbles with transparent contents.
• IIIA degree - with the appearance of blood impurities in the vesicles.
• IIIB - with the loss of all skin layers.
• IV degree (the most dangerous) - burns that affect muscle tissue.

Medical support is necessary for any degree of damage, for example, for superficial injury or one that is associated with the most severe pain. In addition, even after the termination of the effect of heat on the skin, destructive processes in it can take place for quite some time, exacerbating the symptoms.

When hospitalization is needed

Naturally, not every thermal damage poses a threat to life. But, in turn, an underestimation of their seriousness can lead to negative results. Urgent hospitalization should be if:

• burns affected more than 20% of the surface (in children and the elderly - 10%);
• damage of the III degree with a coverage area of ​​5% of the body;
• II degree and higher, located in areas of important ligaments or organs (for example, lymph nodes or eyes);
• electric shock;
• a combination of skin burns with damage to the respiratory tract;
• damage from chemicals.

If the victim has revealed skin lesions of any level (based on the classification of burns), first aid should be provided immediately, since all the injuries listed above are life-threatening.

Threat assessment

The use of medical care depends on the cause of the burn, and it should be provided quickly. Any second affects the level of injury, increases the area of ​​the wound, increases the complexity of the treatment. First aid depends on the classification of thermal burns.

Exposure to high temperatures leads to coagulation of skin proteins, which leads to the death of its cells. Depending on the temperature and duration of exposure to the traumatic agent, the classification of thermal burns allows 4 degrees of difficulty. For example, the long-term effect of exposure to heat with a lower temperature causes the same damage as the short-term effect with the highest.

A burn can occur with prolonged contact of tissues with a thermal agent and at low temperatures. For example, it was proved that exposure to a temperature of +42 ° C for 6 hours leads to skin necrosis. If heating reaches +50 ° C, then the same reaction will occur in 3 minutes. This heat is the threshold for the epidermis, white blood cells and osteoblasts die at a temperature of + 44-46 ° C. The characteristics of the burn depend on the area and depth of penetration.

To assess what kind of threat is the thermal effect, you need to understand not only its depth, but also examine the affected area. The value is not only in the strength of the effect of temperature, but also in a relative, expressed as a percentage indicator, indicating the number of unaffected areas of the body and affected. There are several ways to determine the area of ​​a burn.

Some are based on the designation of the boundaries of individual affected areas, others indicate the area of ​​the burn, which is recounted relative to the area of ​​the body affected by the fire. Since the human skin covers from 16,000 to 21,000 cm ² , special formulas have been proposed that allow calculations of the burn area taking into account the height and weight of the victim.

In order to minimize the results of an injury, you need to understand how severe it is. For this purpose, a classification of thermal burns was developed, in accordance with which a set of first aid measures was created.

Basic Rules

Regardless of the classification of burns by severity, first aid should be provided in compliance with all rules. First of all, you need:

• If a person is in a fire zone, pull him out into the air as soon as possible.
• Remove victim from heat source.
• If clothes catch fire, extinguish the flame by throwing a blanket over a person, a raincoat, pouring water on him, throwing snow or sand on him.
• Free the victim from burnt clothing using a knife or scissors.
• Remove victim from hot steam.

It is necessary to remove from the burnt all jewelry (watches, chains, etc.), if necessary, cut or break them.

Important: under no circumstances should you try to tear off material that adheres to the skin or, even worse, dissolves and penetrates the layers of the dermis, as is the case with some synthetic tissues.

For cooling, running water (best) or plastic bags or heating pads attached to the affected area with snow, ice and cool water are used. Cold helps reduce pain, but also prevents deep tissue damage. The victim should be transported to a hospital or emergency room as soon as possible.

What can and cannot be done with thermal injury

Not only taking into account the classification of thermal burns, first aid should be provided, but also with the knowledge that it is impossible to do. For example, it is strictly forbidden to open the bubbles that occur during thermal damage to the skin, no matter how terrible they may seem. As a rule, if the blisters are intact, the dermis itself prevents the infection from penetrating deep into the tissue. This is how the protective mechanisms inherent in the human body are arranged. If they are broken, microorganisms and infection will fall on the wound, causing infection, which will further aggravate the injury.

You can and should use sterile dressings that are abundantly moistened with an antiseptic substance (not based on iodine). Panthenol, for example, can help quite well if you spray it over the entire plane of the lesion. If there is no first antiseptic available, dry dressings can be applied.

Never grease burns with fat, cream, yolk and other substances that people recommend as a folk remedy. The result will be sad: fats form a film on the wounds, due to which the skin becomes hotter, and the yolks tighten it. In addition, they exacerbate the intake of not only air, but also medications that people will receive in the clinic. In the end, as a result of these actions, rough scars form.

Relieve pain

After first aid (burns and their classification should be installed before it), it is necessary to alleviate the pain. Doctors use necrotic analgesics for this, but there is an opportunity to get along with “Analgin”, “Baralgin”, “Ketorol”, “Dexalgin”. Each of them is quite a strong drug. Local anesthesia is also possible if there are special wipes soaked with an antiseptic and any analgesic.

Then an adjustment for water loss is required. If the victim is conscious and does not have vomiting, give water, juice in an amount of 0.5-1 l. In particular, if he does not want to drink, it is worth convincing him that this compensates for the loss of fluid through the damaged surface and will prevent the onset of pain shock.

Types of burns can be determined depending on violations of the skin. It is important to provide competent assistance in the first minutes, taking into account the characteristics of the damage and urgently contact a medical institution. Subsequent treatment will be prescribed by a professional.

First aid for chemical burns

The classification of these injuries also depends on the degree of tissue damage, and assisting the victim includes almost the same actions as with other types. The only difference is that the effect of the harmful factor on the skin itself should be stopped, and this is done by removing chemicals under a strong stream of water, preferably under a tap.

Most often, chemical burns occur as a result of contact with the skin of organic acids (nitric, sulfuric, hydrochloric), it can also be from other potent substances (potassium, sodium, quicklime), salts of heavy metals (silver, nitrates, zinc, phosphorus) and other chemicals. Similar injuries occur in the workplace, where workers come in contact with life-threatening ingredients. Accidental ingestion of acid results in burns to the mouth, gastrointestinal tract, and stomach.

Action of chemicals

The effect of various chemicals on the skin is based on a violation of its integrity, which any of the above means is capable of. When one of them hits a part of the body, the exposure lasts until it is removed from the surface of the body.

When acids come in contact with the skin, tissue dehydration occurs depending on the type of dry necrosis, and the scab is usually dense. A chemical can easily penetrate the deepest layers. Sometimes it is possible to determine what got on the skin by the color of the scab: when exposed to sulfuric acid, the gray color of the skin flakes, and the nitrogen color is yellow.

Often, due to protein oxidation and saponification of fats, the scab becomes wet, and the lesion becomes harder. This phenomenon is characteristic of some types of chemical burns, so doctors can quickly determine the factor that caused them and prescribe the right treatment.

No to soda

You can not neutralize the acid with alkali and vice versa, do not use soda. Heat generation has the ability to create a combined burn (chemical + thermal), and such help can only aggravate the situation. If the burn has occurred under the influence of dry bulk products, shake them off as soon as possible and only after that start washing. Try to prevent medication from entering intact skin.

First aid value

Regardless of the classification of burns (chemical, thermal, etc.), their treatment should begin as soon as possible. High-quality support provided in the first seconds allows you to simplify the position of the victim, improve the prognosis of the disease, prevent the development of complications, and in some cases help to survive.

Thus, a burn is tissue damage caused by excessive exposure to the sun or other radiation, contact with flames, chemicals, electricity, or inhalation of smoke. Burn treatment should be prescribed by a qualified healthcare professional.

With superficial lesions, you should also consult a doctor, because sometimes a not very noticeable burn can lead to the development of an infectious process in the patient's body. Doctors will find out the degree of injury and provide all the necessary first aid (burn classification is also established only by a specialist).