How you should manage a burn injury

Burns are one of the most painful and difficult skin conditions physicians treat. You’ve likely sustained some type of burn yourself, maybe a sunburn, a burn from hot cooking oil, or from accidental contact with open flames. Burns range from minor to life threatening.

This post is the first in a series about skin problems. I frequently see skin rashes, lesions, and trauma in my family medicine practice, and I am a distributor for a skin care product company (see my about page).

Burns are one of the most painful and difficult skin conditions physicians treat. You’ve likely sustained some type of burn yourself, maybe a sunburn, a burn from hot cooking oil, or from accidental contact with open flames. Burns range from minor to life threatening.

HOW YOU SHOULD MANAGE A BURN INJURY-WATERCRESSWORDS.COM

 

How to ensure effective burn recovery

by Jamie Costello (author bio below)

 

Identify burn type and severity

The type of treatment for your burn will depend on the cause and severity. There are different types such as

  • chemical
  • electrical
  • scalding
  • thermal/fire
  • ultraviolet light/sun exposure

In general we identify three levels of burnsfirst, second and third degree, based on how deep into the skin the burn extends. You might have one or all of these from a single injury. Each leads to its own unique problems and thus require varying levels of treatment.

Layers of the Skin diagram
The layers of the skin (epidermis and dermis), as well as an inset with a close-up view of the types of cells in the skin (squamous cells, basal cells, and melanocytes). Source: National Cancer Institute Creator: Don Bliss (Illustrator) This image is in the public domain and can be freely reused. Please credit the source and, where possible, the creator listed above.

 

 

First Degree Burns-superficial (includes sunburn)

Your symptoms may include things such as

  • redness
  • swelling
  • pain
  • skin peeling during healing.

Treatment is simple for these types of burns as a result. It includes

  • soaking or rinsing the wound in cold water,
  • taking over the counter pain relievers as needed
  • apply aloe vera to soothe the skin
  • applying antibiotic ointment
  • Cover with non stick gauze to protect the area.

Fortunately these burns rarely leave scars.

The wellness site  mindbodygreen lists several other uses of aloe vera gel. 

 

Second Degree Burns-partial- thickness

Second-degree burns are typically worse.

Symptoms are similar to first degree but more painful and includes blistering. The blisters usually pop spontaneously or a physician may open them; after opening, the burn will seep fluid, giving the burn a weeping appearance.

It is vital that this type of burn is kept clean and bandaged so as to prevent infection.Since this is now an open wound, it can more easily become contaminated with bacteria. Otherwise, the treatment is typically the same as superficial burns, with added emphasis on keeping it wrapped.

A second-degree burn will typically heal in around three weeks without scarring, though it may leave permanent skin discolouration.

 

Third Degree Burns- full-thickness

A third-degree burn is the most severe type of burn you might experience. These burns cause a waxy colouring, charing, dark brown colouration to the skin, leathery texture, as well as blisters which never develop.

These burns require evaluation in a medical facility, preferably an emergency room, and victims usually are admitted to a specialized burn unit in a hospital. Often there are other traumatic injuries such as bruises and broken bones.

If you do receive third-degree burns, then you will always experience scarring and skin contracture(tightening or shrinking).  A lot of the time the only way to treat this is with surgery, in particular, cosmetic surgery  after the fact.

There are only particular treatments that are available to treat a patient for a burn depending on its severity. A common treatment however is skin graft. This is where skin is removed from one area of the body and transferred to another via a skin cutting tool known as a dermatome.

The recovered area is then dressed and repaired with stitches. This can be an option for patients but it’s important to remember that no matter what procedure is chosen, it can take several weeks to recover. During my time of observing and assisting Gary Ross, a cosmetic surgery specialis, the wellbeing of patients after treating scars was evident and patients were strongly advised that they should care for themselves correctly.

 

 

This link from healthline.com shows graphic photos of burn injuries, use caution.

Burns Gallery

 

man on a beach, his face is red
This man has developed sunburn on his face. Photo by Oleksandr Pidvalnyi on Pexels.com

Possible Complications

The risk of complications for regular burns are relatively slim, but your chances rise much higher if you suffer from a third-degree burn.These often cause excess blood loss leading to shock which may lead to death in extreme cases.

All burns carry the risk of becoming infected due to bacteria entering the broken skin. This is why it is important to keep more severe burns clean and under wraps to avoid serious complications such as sepsis.

Extensive and/or deep burns may eventually require skin grafting.

If you have anything other than a minor superficial burn, you may need vaccination to prevent tetanus infection.  MedicalNewsToday offers this explanation of tetanus.

“Tetanus, also called lockjaw, is a serious infection caused by Clostridium tetani. This bacterium produces a toxin that affects the brain and nervous system, leading to stiffness in the muscles.

 

If Clostridium tetani spores are deposited in a wound, the neurotoxin interferes with nerves that control muscle movement.

The infection can cause severe muscle spasms, serious breathing difficulties, and can ultimately be fatal. Although tetanus treatment exists, it is not uniformly effective. The best way to protect against tetanus is to take the vaccine.”

 

 

Minimizing  and dealing with scarring

Burns will always naturally heal over time, but they can leave unseemly scarring behind in their wake. Treating the healed burn with aloe vera and other moisturizing type creams may avoid this. For an added benefit this will also likely help with your pain management.

Burns can be extremely painful, but if you treat them correctly as soon as you receive one you can avoid the worst of the pain and scarring.

  • Assess the severity of your burn
  • Treat with initial basic care as described
  • Get help when needed. for more severe burns.

Otherwise, you may end up with burn complications and scarring that could have been minimized or prevented.

 

Prevention of burns and promoting home safety

Not all burns happen because of fires. Household chemicals, scalding water, and household appliances can also cause burns. Here are some fire and burn prevention and safety tips for your home from familydoctor.org

Preventing burns in your home

 

“Think about how you would get out of your home in a fire emergency. Make a family escape plan and have regular fire drills at home. Designate a meeting place outside your home in case there is a fire.”

a man in a black hoodie tossing a flaming object
Don’t play around with fire! Photo by Henrik Pfitzenmaier on Pexels.com

 

Check out this  First Aid Guide for treating burns at home from skinsight.com

Remember, a third degree and some second degree burns will require professional attention, but here is what to do initially.

Burn First Aid

“It is important to try to assess the seriousness of a burn, which is determined, primarily, by the size of the burn and its depth. When in doubt, treat as a serious burn.”

Be prepared with a  home first aid kit

First aid is important for situations that don’t require a trip to the hospital or emergency room. Besides burns these might be

  • minor cuts and scrapes
  • insect bites and stings
  • bruises
  • minor nose bleed
  • poison ivy rash

Many people put together a first aid kit for home and their car. A well-stocked first aid kit provides you with the supplies you need to be ready for most minor emergencies.

Here are suggestions for putting together a home first aid kit, or you can buy one already put together. It’s important to replace supplies as you use them, and check expiration dates on anything that expires.

First aid kit supply list from familydoctor.org 

 

Kits available from Amazon-affiliate link

Introducing my guest contributor and a final word

I want to thank my guest contributor Jamie Costello.

photo of Jamie Costello
Jamie Costello, medical University student, Manchester, U.K.

 

 

 

 

Jamie is a medical University student based in Manchester, United Kingdom (this is the U.S. equivalent of college). He is originally from Bristol , a town in the South West of England. He plans to go into Medical/Pharmaceutical Research once he completes his University degree.

 

The inspiration and interest to write about this topic came from Jamie’s previous work experience alongside Gary Ross, MBChB, MD, a specialist in cosmetic surgery based in Manchester England.

As part of his college course, Jamie observed multiple patient cases  at the practice. This helped to develop his knowledge of procedures, including the treatment of burns and scars.  Jamie shadowed Mr. (Dr.)  Ross in  procedures, talking with him through each treatment and learning how they were managed, including the benefit and risk of each.

He was impressed with the clinic staff’s attention to the wellbeing of patients and concern that they would continue proper follow up care of their treatments. I believe he learned a great deal that will help him to be successful in his future medical career.

When not studying he enjoys hanging out with friends, playing soccer, and opportunities to meet new people.

 

 

 

 

 

 

 

 

Jamie and I hope you have learned something useful  from this post . As always, your best source of medical advice is from your own personal physician.

If you have questions about the  seriousness of your injury, seek medical attention immediately. 

Please share this post and follow this blog for more information and inspiration to help you explore the HEART of health.

Dr. Aletha 

 

 

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Vaccination prevents disease- part 1

 

Prevention is a focus in healthcare now  and immunization has  been one of the most effective ways to prevent disease ever developed.

The list of diseases that are “vaccine preventable” is long and continues to grow.

Vaccine recommendations may be based on a person’s

  •  age,
  • gender,
  • ethnicity and
  • concurrent conditions, especially diabetes mellitus, chronic lung diseases, heart disease and  immune suppressing disorders.

Vaccine administration may vary by

  • the number of doses recommended,
  • how far apart the doses should be given, and
  • which vaccines can be administered at the same time.

 

Immunization protocols have  become so complex that even physicians have difficulty keeping it straight without the use of paper or digital checklists. This is one area where the Internet and EMRs (electronic medical records) can be useful.

Create an immunization schedule for your child from birth to 6 years of age

2016 recommended immunizations for children
2016 recommended immunizations for children (the 2017 schedule is available on the CDC website)

 

Vaccines for infections caused by bacteria

I use the name of the disease and/or the bacteria, rather than the vaccine name, since there are different brand names for the vaccines depending on the manufacturer.

So successful have these vaccines been that most young doctors have never seen a patient with these diseases (unless perhaps they specialize in infectious disease, immunology, emergency medicine or critical care). And even I, who graduated medical school in 1978, have only seen a few, and none in recent years.

Diphtheria-primarily a respiratory tract illness in young persons

Pertussis, better know as whooping cough, also a respiratory illness, which has made a comeback in recent years, apparently due to a waning of immunity

Tetanus, also called “lockjaw”– due to a toxin which may contaminate a dirty wound

Menigococcal disease, which is one of many causes of meningitis (inflammation of the brain lining), but one of the most deadly, even with treatment

Streptococcal pneumoniae disease; the vaccine is often referred to as the “pneumonia vaccine”, but the bacteria can also cause ear infections, sinusitis, meningitis and sepsis (bloodstream infection)

Haemophilus disease is similar to pneumococcal, but more of a concern in infants and children

 

Six Things YOU Need to Know about Vaccines

 

 

 Pneumococcal Vaccination from JAMA

infections caused by Streptococcus pneumoniae

 

 

 Pandemic- a book review

Infection is still a major health issue worldwide

and epidemics are still a threat. This book explains why.                 Pandemic by Sonia Shah

Vaccination prevents disease, part 2

Should your family receive vaccinations?

This post is being updated with the current CDC vaccination recommendations. With a few exceptions for medical reasons I believe all adults should discuss vaccination with their physician and be immunized for any diseases for which they are at risk.

Current vaccination recommendations, 2019

This post is being updated with the current CDC vaccination recommendations. With a few exceptions for medical reasons I believe all adults should discuss vaccination with their physician and be immunized for any diseases for which they are at risk.

And I recommend that parents do the same for their children and adolescents.

RECOMMENDED ADULT IMMUNIZATIONS 2019
RECOMMENDED CHILD AND ADOLESCENT IMMUNIZATIONS 2019

Some questions to ask about vaccines and the immunization process include.

  • What contagious diseases is a person likely to be exposed to?
  • What are the risks of those diseases?
  • What are the risks of a particular vaccine for that person?
  • What are the risks versus benefits to other people?
  • What else can we do to prevent an infection?

Infectious disease control methods

The  developed countries  have eliminated or controlled many of the environmental sources of contagious disease by manipulating our environment.

  • indoor plumbing
  • water treatment facilities
  • screens on windows
  • air purification
  • wear gloves to prepare food
  • inspect restaurants
  • signs in many public restrooms reminding us to wash our hands.
Hand hygiene saves lives.
Hygiene remains vital to infection prevention even when immunizations are given.

However, we have not eliminated another source of infectious disease- and that is other humans.

Rarely do we isolate or quarantine people with infections. Most of us have gone to work, school or social events with symptoms suggestive of infection- a cough, runny nose, upset stomach- putting our friends and colleagues at risk.

Please review these excellent resources on vaccine use

A basic review of  Childhood vaccines  and Adult vaccines from UpToDate, a researched, non- commercial medical publication for doctors and patients

The Science Behind Vaccination from The New York Times

 7 things about vaccines from The Washington Post

Reconsidering vaccination a blog post review of the book The Vaccine Friendly Plan

Voices for Vaccines – a parent-led organization that supports and advocates for on-time vaccination and the reduction of vaccine-preventable disease.

Thanks for reading and sharing this important information about protecting the HEART of health.

I appreciate all of you who follow this blog; there are numerous other blogs to choose from so I am honored you chose to spend some time here. A special welcome to all my new followers from this past month.

To start following Watercress Words , use this form to get an email notification of new posts . Please find and follow me on Facebook, Pinterest and LinkedIn, links are on the left side bar here and the Home page. Thanks so much.

Dr.  Aletha