Burns

Question 1

Management

Answer 1

Depends on extent and depth

• burns are classified as superficial or deep)

Always consider pain relief.

Small burns should be immersed in cold water immediately (e.g. tap water) for 20 mins.

Chemical burns should be liberally irrigated with water.

• Apply 1 in 10 diluted vinegar to alkali burns and sodium bicarbonate solution to acid burns.

Refer the following burns to hospital:

• >10% surface area, esp. in a child
• all deep burns
• burns of difficult or vital areas (e.g. face, hands, perineum/genitalia, feet)
• burns with potential problems (e.g. electrical, chemical, circumferential)

Replacement fluids essential for severe burns:

• e.g. IV Hartmann’s solution 2–4 mL/kg/ %burn in first 24 h

Question 2

Treatment of superficial burns

Answer 2

Most scalds cause partial thickness (superficial) burns.

If skin intact leave and apply mild antiseptic

• e.g. use a fine mist water spray such as aqueous chlorhexidine.

If blistering, apply;

• hydrocolloid sheets or
• Fixomull, covered by an absorbent dressing

Then cleanse serous ooze from the adhesive material once or twice daily.

Question 3

Exposure (open method)

Answer 3

Keep open without dressings

• good for face, perineum or single surface buns

Renew coating of antiseptic cream every 24 h

Question 4

Dressings (closed method)

Answer 4

Suitable for circumferential wounds

Cover area with non-adherent tulle (e.g. paraffin gauze)

Dress with an absorbent bulky layer of gauze and wool

Use a plaster splint if nec.

Question 5

Burns to hands

Answer 5

A first-aid method for superficial blistered burns to hands is;

• to apply strips of retention adhesive dressings as described above.
• They conform well to digits.

Then apply a crepe bandage around the hand:

• leaving the fingers and thumb free
• so that the fingers can move freely in the bag.

Consider placing the arm in a sling.

At 7 days, soak the dressings in oil for 2 h before coming into the clinic for change of dressing.