How to help a burn victim

A burn is damage to body tissue resulting from exposure to high temperature. In addition to thermal, burns can also be electrical, chemical and radiation.

Thermal or heat burns are the most common, especially in the younger age group - in young children, the vast majority of burns occur as a result of scalding with boiling water.

There are several classifications of burns; in our country, the A.A. classification is accepted. Vishnevsky, dividing damage into degrees depending on the depth of tissue damage. Knowing the classification allows you to quickly navigate the situation and not make mistakes when providing first aid. So, according to Vishnevsky, there are 4 degrees of burns:

1. Stage of erythema, or redness;
2. Bubble stage;
3. Stage of skin necrosis;
4. The stage of necrosis of the skin and underlying tissues (fatty tissue, muscles, tendons, and sometimes bones), also called the charring stage.

The first two stages are classified as mild, while the third and fourth stages are classified as severe or deep burns. This division is arbitrary, since it does not take into account the area of ​​the lesion and special anatomical zones (these include the face, eyes, groin area, joints), however, it gives an idea of ​​the severity of the lesion and what first aid measures should be taken.

First aid for mild burns

Mild burns do not require hospitalization; as a rule, home treatment is sufficient, but only if first aid was provided correctly. So, with such lesions, after the cessation of exposure to the traumatic factor, it is necessary:

1. Remove clothing from the burn area, if any. At the same time, it is unacceptable to pull off clothes, because... you can damage the skin even more (if necessary, the fabric should be cut);
2. Place the burned area under running cold water for 10-20 minutes or apply a cold compress. It is unacceptable to use ice to cool the skin, because... tissue frostbite may be added to the burn;
3. Treat the affected area with an antiseptic. You can use anti-burn agents; it is allowed to treat the burned surface with alcohol. You cannot use iodine, a solution of potassium permanganate, as well as oil, fatty ointments and creams - anything that interferes with air exchange. For household burns, Panthenol Spray with dexpanthenol has proven itself well. Unlike analogues, which are cosmetics, this is a certified medicinal product. It does not contain parabens, making it safe for both adults and children from the first day of life. It’s easy to apply—just spray it on the skin without rubbing. PanthenolSpray is produced in the European Union, in compliance with high European quality standards. You can recognize the original PanthenolSpray by the smiley face next to the name on the packaging;
4. Apply a loose sterile bandage to the damaged area of ​​skin, but do not use cotton wool, because its fibers are quite difficult to remove from the wound surface;
5. If the pain is intense, give the victim an anesthetic. You can use Paracetamol, Aspirin (it is not advisable to give it to children), Nimesil, Nurofen, etc.

As a rule, these first aid measures for mild burns are quite sufficient. Such injuries heal within 10-14 days, the main task in their treatment is to prevent additional injury to the affected area and infection.

First aid for severe burns

In case of thermal injuries of the III and IV degrees, as well as II degree burns affecting large areas of the skin or anatomically significant areas, care is provided in a hospital, so it is necessary to call the victim an ambulance as soon as possible. While waiting for the doctor to arrive and after eliminating the damaging factor, first aid measures for severe burns are as follows:

1. You need to make sure that there are no areas of smoldering clothing left. There is no need to remove scraps of clothing from damaged skin;
2. Cover the burned surface with a sterile, or at least clean, loose bandage if possible;
3. For deep injuries, do not immerse the injured area of ​​the body under water, and do not use ice. Instead, wet the bandage with cold water;
4. Give the victim warm tea or warm salted alkaline water (to prepare it, mix 1-2 g of baking soda and 3 g of salt in 1 liter of water);
5. Place the victim so that the burned part of the body is above the level of the heart.

In this case, you should not use topical medications, even such as Panthenol; wound treatment will be done in the hospital.

First aid for electrical burns

First aid for an electrical burn consists of isolating the victim from the damaging agent, after which it is necessary to check for a pulse and breathing. If they are absent, it is necessary to begin resuscitation measures - closed cardiac massage, mouth-to-mouth or mouth-to-nose breathing. You should call an ambulance as soon as possible, continuing resuscitation measures until the pulse and breathing stabilize or until a doctor arrives.

Superficial skin damage caused by an electrical burn is treated in the same way as a thermal burn.

First aid for chemical burns

A chemical burn is caused by exposure of the skin or mucous membrane to acids, alkalis and other caustic substances. Despite the fact that the damaging agents may be different, first aid for burns of this type begins the same: the damaged area must be placed under running water for 10-20 minutes. This is true for all chemical burns, with the exception of burns with quicklime and sulfuric acid.

After rinsing with water, the burn site is treated with a weak alkali solution, such as soda (1 teaspoon per glass of water) or a soap solution (it is advisable to use laundry soap, without additives). Sulfuric acid burns should be treated with a slightly alkaline solution, without first rinsing with water.

After washing, alkaline burns are treated with a weakly acidic solution - a solution of vinegar or citric acid is suitable.

Burns caused by quicklime are treated immediately with oil or fat - and this is the only case when fatty ointments are used in first aid for burns.

It should be borne in mind that burns from alkalis are more dangerous, since they do not create a clear boundary between the damaged area and healthy tissue. This is the so-called liquefaction necrosis, which tends to spread even after the end of exposure to the damaging agent.

* Instructions for medical use Panthenolspray Reg. beat P No. 012187/01 dated 08/22/2011

Burns are a common type of skin injury. They arise due to the influence of various factors that can cause destruction of cell membranes and coagulation of intracellular protein. This causes tissue damage. Every victim, regardless of the degree of burn, needs to receive medical care. Unfortunately, many people do not know what to do if burns occur. Moreover, the methods they were once taught turn out to be outdated and ineffective.

Photo 1. First of all, it is important to assess the degree of the burn. Source: Flickr (Sarah Alston)

Basic mistakes

The main mistakes when providing assistance are:

1. Lubricating the surface with fat-containing products. It is unknown where the rule of applying butter, milk, sour cream or various ointments to a burn came from. This method is not only ineffective, but also dangerous. Fat forms a film over damaged skin that prevents the surface from cooling. Simply put, the skin is baked under a layer of oil.
2. Sprinkling with salt, flour, soda and starch. This rule also looks more like a recipe for preparing a dish than first aid. These substances not only contaminate damaged tissues, but also draw water from cells, which adversely affects their functioning.
3. Application of a tourniquet for deep burns of the extremities. Some people, fearing that bleeding may develop in the wound, apply a tourniquet. In fact, no blood comes from the burn surface, since the blood vessels are sealed due to protein coagulation in them. A tourniquet disrupts the trophism of the burn surface and will only worsen the condition.

Rules for first aid for burns

First aid is an important element of burn treatment. The success of subsequent treatment depends on the correctness of its provision. Specific actions depend on the type of burn.

Help with thermal burns

Thermal burns occur when objects whose temperature is above 50 °C come into contact with the skin. The first thing to do is remove the damaging factor. The damaged area must not be touched. Further actions depend on the severity of the burn..

The degree of burn can be assessed visually. In the 1st degree, only redness of the skin area occurs, in the 2nd degree - the formation of a bubble filled with a clear liquid. The third and fourth degrees are more difficult to distinguish from each other. With the 3rd, necrosis of all layers of skin occurs with preservation of muscles and bones. The fourth degree is characterized by necrosis of deep-lying tissues. Necrosis appears as a black, charred area of ​​the body.

For a chemical burn

There are two types of chemical burns: acid and alkaline. If they occur, you must:

1. Rinse the damaged area with running water (exception: in case of a burn with a powdery substance - dry removal from the skin);
2. At the same time, find out from the victim whether he received a burn from acid or alkali;
3. If you receive an acid burn, wash the surface with a 2% alkali (soda) solution; for a burn with alkali - 2% acid solution;
4. Apply a clean bandage.

Photo 2. A first-degree burn can be left without a bandage, this will allow the skin to heal faster. Source: Flickr (ingrid).

For an electrical burn

In this case, the main thing is to open the circuit, that is, remove the source of electrical current. remember, that Do not touch the victim with your hands while the current is applied to him. First aid is provided as for thermal burns. The exception is the serious condition of the victim. In the event that respiratory or circulatory arrest occurs due to the action of electric current, it is necessary to begin resuscitation measures.

It is important! All victims who lack consciousness, breathing and pulse in large arteries are subject to resuscitation. Resuscitation consists of performing chest compressions (pressing on the sternum) with a frequency of at least 100 per minute and mouth-to-mouth breathing with a frequency of at least 8 per minute. The ratio of compressions to breathing should be 30:2. Resuscitation measures are carried out until spontaneous breathing and circulation occur or until medical assistance arrives.

For radiation burns

A radiation burn is a burn caused by ionizing radiation. Moreover, all clothing and fabrics of the victim are radioactive, touch to them You can't do it without protective suits.

The victim must remove all clothing, then he must be completely treat with running water or special solutions. After this, radioprotective agents are given to drink (they are in the individual first aid kit). The victim must be immediately taken to a medical facility.

Note! The main danger with this type of injury is not the burn itself, but the possibility of radiation sickness.

Help with eye burns

The first thing to do is rinse eyes with plenty of clean cold water. This will wash away the chemicals for a chemical burn and cool the skin and mucous membranes for all other types of burns. The victim must be given an analgesic to drink, since this type of burn is very painful. At the same time, it is important to call an ambulance as quickly as possible or take the victim to an eye injury department.

For burns of the mucous membrane

Most often, mucosal burns occur in the mouth, nose, throat, esophagus, larynx and trachea. For a burn to the mouth and nose, first aid is no different from that for skin damage. Surface also necessary treat with water or special solutions and take the victim to the hospital. Instead of rinsing your nose, you can swab it with swabs soaked in cold water.

It is important! If there is a burn to the esophagus, trachea or larynx, first aid is difficult to provide. The main thing here is to determine what happened, stop contact with the damaging factor and take the victim to the hospital.

Features of first aid

The occurrence of complications and terms of rehabilitation depend on the correct actions of others and the victim himself. Help depends on the degree of damage:

For superficial burns enough Rinse damaged area of ​​skin with cold running water water for at least 15 minutes. If the burn surface is small, this assistance may be sufficient. For extensive burns, call an ambulance.

Deep burns are dangerous, regardless of the area affected. If they occur on the damaged surface, it is necessary apply a clean gauze pad soaked in cold water. The napkin must be secured with a bandage and only after that the damaged area can be immersed in cold water. At the same time it is necessary call an ambulance.

First aid is provided by medical workers with specialized secondary education. For example, an ambulance paramedic. At the same time, in addition to cooling the affected surface, vital functions are maintained.

If pain is severe, the victim is given non-narcotic or narcotic analgesics. If the patient has lost a lot of fluid, infusion therapy begins.

In addition, the paramedic monitors hemodynamics, pulmonary ventilation and diuresis. If they change, the violations that have arisen are corrected.

Term "burn" often deciphered as skin damage associated with exposure to high temperatures. In fact, a burn refers to more than just damage to the skin. It is more correct to say that this injury affects the tissues of the body. For example, burns of the respiratory tract and esophagus occur. Burn injury can occur not only when exposed to high temperatures (thermal burns), but also to chemicals (chemical burns), and electric current (electrical burns).

Thermal burns

Thermal burns occur upon contact with open fire, hot solid objects or gases, boiling liquids, steam, burning mixtures such as napalm and phosphorus, light energy during a nuclear explosion. The severity of a burn injury depends on the depth of the injury, its area, location, and duration of exposure to the damaging factor. The most dangerous damaging properties are flame and steam under pressure. In these cases, burns to the upper respiratory tract and eyes may occur.

Burns are classified according to their degrees:

1st degree burns called superficial. There is redness of the skin, swelling and burning pain in the burn area. These manifestations disappear within 3-6 days, then peeling of the skin begins and pigmentation remains.
2nd degree burns characterized by blisters. In the area of ​​the burn injury, blisters appear immediately or over time as a result of the superficial layer of skin peeling off. The bubbles are filled with liquid and burst over time. This whole process is accompanied by severe pain in the burn area, even after the bubble bursts. If a 2nd degree burn is not infected, healing occurs in 10-15 days.
3rd degree burns associated with necrosis (necrosis) of the deep layers of the skin. After such burns, a scar remains.
At 4th degree burns necrosis of the skin and deeper tissue occurs (charring). Damage may affect subcutaneous fat, muscles, tendons, and bones.

A feature of 3rd and 4th degree burns is slow healing.

First aid for burns

First aid for any burns, first of all, is eliminating the cause - damaging factor. The next steps will be application of aseptic dressing to prevent infection, shock warning, transportation to a medical institution. All actions must be performed with caution, avoiding damage to the skin:
• extinguishing clothes that caught fire;

• evacuation of the victim from a high temperature zone;
• smoldering and excessively heated clothing must be removed;
• you cannot tear off clothing stuck to the burn area; it must be cut off around the injury, applying an aseptic bandage directly on top of the remaining piece of clothing;
• if it is cold outside, it is dangerous to remove clothes from the victim, this will lead to the development of shock and worsening of the condition.

The first aid provider's job is to: applying a dry aseptic dressing in order to prevent infection of the burn injury. For dressing, use a sterile bandage or an individual bag. If these products are not available, you can use a simple cotton cloth, ironed or moistened with an antiseptic. Antiseptic solutions can include ethyl alcohol, potassium permanganate, ethacridine lactate (rivanol), and vodka.

What not to do:
1. Touch the burn with your hands;
2. Puncture the blister;
3. Wash the burn injury;
4. Tear off stuck clothes;
5. Lubricate the burn with oil, fat, petroleum jelly (this will lead to infection and complicate the initial surgical treatment of the injury).
For 2nd, 3rd and 4th degree burns, the onset occurs quickly. shock. The victim must be laid down and covered, because if thermoregulation is disrupted, he will shiver. It is necessary to give the patient plenty of fluids to replenish the loss of circulating blood volume. To relieve pain, narcotic analgesics (promedol, morphine, omnopon) are used. It is advised to give the patient coffee or tea with wine, and a little vodka.
To determine the area of ​​the burn, the palm rule is most often used:

1 palm of the victim = 1% of the body ,

a burn of the respiratory tract is taken to be 30% of a 1st degree burn.

For extensive burns the patient is wrapped in a clean sheet, the injured area is kept immobilized (immobilization), and transported to a medical facility.

When ensuring immobilization, you need to ensure that the skin in the area of ​​damage is as stretched as possible (for example, if the inner surface of the elbow is burned, fix the arm in an extended position, if the outer surface is bent). Great care must be taken during transportation. In a medical institution, the victim will undergo initial treatment of the burn, eliminate shock, administer anti-tetanus serum, and prescribe local and general treatment.

Incendiary mixtures

From civil defense materials we know about incendiary mixtures and substances such as napalm used in the armies of Russia and foreign countries (thermite, electron, phosphorus, pyrogel, incendiary liquids).
Burns caused by incendiary mixtures, unlike burns caused by other factors, heal more slowly and form rough scars. Often such burns lead to disability. Compared to other burns, these cause burn disease with a smaller injury.

Termite - mixtures containing iron oxides and ignition compounds. Burns with almost no flame.
It is unacceptable to use a very small amount of water when extinguishing thermite, because this mixture decomposes water to oxygen and hydrogen, forming an explosive gas (explosive mixture).

"Electron" - alloys containing magnesium as a base, as well as a small percentage of aluminum, zinc, manganese and iron.
“Electron” burns with a dazzlingly bright, bluish-white flame at very high temperatures (2500 - 3000°C).
Thermite and electronic incendiary bombs can be extinguished without any problems. They are covered with sand, thrown from the roofs of buildings onto the ground with shovels, and placed in a barrel of water.

Napalm - a mixture of various types of gasoline or kerosene with a thickener (aluminum soap), which burns at a temperature of 800-1200 ° C, forming a variety of toxic substances. The combustion of napalm mainly produces carbon monoxide. Burns with a red flame. If napalm gets on your clothing, you must quickly take it off. The flame is knocked down with sand, water, and pressed to the ground. Under running water, napalm can splash and increase the area of ​​damage; it is better to immerse the affected part of the body in water. Napalm burn injuries are mainly 3rd and 4th degree.
The tissues that are dead from a napalm burn are brownish-gray in color, the surrounding skin turns red, swells, and blisters with bloody fluid form. When the face is affected, the person sees nothing; the eyelids are very swollen. Such burn injuries are accompanied by suppuration, the pain is stronger, the temperature rises, the pulse quickens, and there is anemia and leukocytosis in the blood. Healing occurs very slowly.

Pyrogel - a mixture of condensed gasoline with magnesium compounds and asphalt (or resin). Burns like napalm, but at higher temperatures. Due to the fact that the pyrogel sticks to clothes, skin and everything it gets on, it is difficult to extinguish it.

White phosphorus - forms smoke even at room temperature, self-ignites in air, burns with a yellow flame.
Phosphorus burns have a garlicky smell, glow in the dark, and smoke when the burn crust is broken. White phosphorus is poisonous; it is absorbed into the blood, causing serious damage to the nervous, cardiovascular systems, liver, and kidneys. Phosphorus is extinguished by dousing it with water and applying a wet bandage. Phosphorus is chemically “neutralized” with a 2% solution of copper sulfate, 5% potassium permanganate, 3% hydrogen peroxide in a saturated solution of baking soda.

Due to the complexity of producing incendiary mixtures such as napalm at home, mixtures that are easier to prepare are made, for example, Molotov cocktails and cacodile.

Cacodile made from butyl alcohol, replacing oxygen with arsenic. A container with a cacodile explodes when it hits a hard surface, releasing thick white smoke of a deadly poison - arsenic. After inhalation, death occurs within a few minutes.
Molotov cocktail prepared from 2/3 gasoline, oil and other flammable liquids (alcohol, kerosene, acetone, etc.) The liquid is poured into a bottle, a wick is made, which is set on fire. The flame from a Molotov cocktail cannot be extinguished with water. If you don’t have a fire extinguisher, you need to use sand, roll on the ground, or use thick natural fabric to block the access of oxygen to the flame.

Burns from radiation exposure

In war conditions, burns are often accompanied by mechanical injuries and radiation injuries. The area of ​​the burn injury may be contaminated with radioactive substances, which greatly complicates and slows down healing.
In a nuclear explosion Light energy is released, causing direct (primary) burns, as well as secondary injuries that occur when clothing catches fire. Numerous fires occur at the site of a nuclear explosion. A bright light flash from a nuclear explosion burns the eyes (eyelids, cornea and retina), often leading to temporary or permanent loss of vision and clouding of the cornea.

If the burn area from a nuclear explosion is 10-15% of body surface, burn shock may occur. At first, the burnt person is very excited, then the excitement is replaced by inhibition of the central nervous system. Nausea and vomiting are observed, the patient is thirsty, because... The volume of circulating blood decreases sharply, which also leads to a decrease in urine output. The victim has chills, trembling, and symptoms of poisoning due to the release of toxic substances into the blood.
First aid for burns from a nuclear explosion, it differs in that the victim must be put on a gas mask and quickly taken to a medical facility after all the usual actions for burns. Here the situation is complicated by combined injuries - a combination of wounds, burn injuries, concussions with the action of penetrating radiation and radioactive substances.

Chemical burns

When body tissues come into contact with concentrated acids, alkalis and heavy metal salts, chemical burns.
Acid burns occur when exposed to concentrated sulfuric, hydrochloric, nitric, acetic, and carbolic acids. A dry dark brown or black scab with clear boundaries forms on the skin and mucous membranes. In case of an acid burn, rinse the burn area with a stream of water for 15-20 minutes. The exception is sulfuric acid: it heats up when diluted with water, which can worsen a burn injury. Next, the burn area is washed with solutions with an alkaline reaction - soapy water, baking soda solution (1 teaspoon per glass of water).
Alkali burns occur upon contact with concentrated caustic soda, caustic potassium, ammonia, and quicklime. A wet, dirty green scab forms on the surface of the burn, with no clear boundaries. After 20 minutes of washing the burn area under running water, treat with solutions with an acidic reaction - a solution of 2% citric or acetic acid.
After treatment, an aseptic bandage must be applied to the burn wound.

For phosphorus burns it is necessary to wash off the pieces of the substance under water using gauze or cotton wool. Next, treat the wound with a solution of copper sulfate. It is strictly forbidden to lubricate the burn after treatment with oil or fat, because this promotes the absorption of toxic phosphorus.
Quicklime burns Under no circumstances should it be washed with water. Removal of the substance and processing is carried out with oil. After this, apply a gauze bandage.
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Electrical injuries

When a person comes into contact with high voltage electric current, as well as lightning, electrical injuries. Local manifestations of electrical injuries resemble 3rd and 4th degree burns. The wounds can be very deep, reaching the bone. The edges are calloused, gray-yellow in color.

Common manifestations of electrical injuries may include: loss of consciousness, respiratory arrest, cardiac depression, decreased temperature. All this may look like the victim has died. However, listening to heart sounds can help identify signs of life. All this happens with prolonged contact with high current. Milder symptoms include fainting, dizziness, and general weakness.

First aid consists of ceasing the effect of the current source on the victim. You need to turn off the voltage by turning the switch, switch, or remove the wires with a stick or rope.

Do not touch the victim with unprotected hands, this will lead to electrical injury to the person providing assistance. .

After eliminating the source of injury, the victim must be examined. If there are burns, it is necessary to apply an aseptic bandage. Give the victim a pain reliever (analgin, pentalgin, etc.), a sedative (tincture of valerian, motherwort) and a heart remedy (validol, valocordin, Zelenin drops). The consequences of electrical injuries can manifest themselves within several hours (before a heart attack), so the victim must be taken to a medical facility.

In case of severe manifestations, a combination of artificial respiration and chest compressions is performed until breathing is completely restored or obvious signs of death are determined (for each air injection, 5-6 pressures are applied to the heart area).
You cannot bury a person who has been struck by lightning in the ground. Instillation prevents effective assistance, impairs blood circulation and breathing, and hypothermizes the victim.