Burns and Electric Shock

Overview

Most burns are minor injuries that occur at home or work. It's common to get a minor burn from hot water, a curling iron, or touching a hot stove. Home treatment is usually all that's needed for healing and to prevent other problems, such as infection.

There are many types of burns.

• Heat burns (thermal burns) are caused by fire, steam, hot objects, or hot liquids. Scald burns from hot liquids are the most common burns to children and older adults.
• Cold temperature burns are caused by skin exposure to wet, windy, or cold conditions. They can also be caused by touching cold items such as dry ice without protection.
• Electrical burns are caused by contact with electrical sources or by lightning.
• Chemical burns are caused by contact with household or industrial chemicals in a liquid, solid, or gas form, such as acids. Natural foods such as chili peppers, which contain a substance that irritates the skin, can cause a burning sensation.
• Radiation burns are caused by the sun, tanning booths, sunlamps, X-rays, or radiation therapy for cancer treatment.
• Friction burns are caused by contact with any hard surface such as roads ("road rash"), carpets, or gym floor surfaces. They are usually both a scrape (abrasion) and a heat burn.

Breathing in hot air or gases can injure your lungs (inhalation injuries).

Burns injure the skin layers. They can also injure other parts of the body, such as muscles, blood vessels, nerves, lungs, and eyes. Burns are defined as first-, second-, third-, or fourth-degree, depending on how many layers of skin and tissue are burned. The deeper the burn and the larger the burned area, the more serious the burn is.

How serious a burn is depends on several things, such as:

• The depth, size, and cause of the burn; the affected body area; and the age and health of the burn victim.
• Any other injuries that occurred, and the need for follow-up care.

Burns in children

Babies and young children may have a more severe reaction from a serious burn than an adult. A burn in an adult may cause a minor loss of fluids from the body. But in a baby or young child, the same size and depth of a burn may cause a severe fluid loss.

How safe a child's environment needs to be depends on the child's age and how much the child needs to be supervised. At each stage of a child's life, look for burn hazards. Then use appropriate safety measures to keep things out of a child's reach. Since most burns happen in the home, simple safety measures decrease the chance of anyone getting burned.

When a child or vulnerable adult is burned, it's important to find out how the burn happened. If the reported cause of the burn doesn't match how the burn looks, it may be a sign of abuse. In that case, resources for help, such as social services, are offered. Self-inflicted burns will need treatment as well as an evaluation of the person's emotional health.

Infection

Infection is a concern with all burns. Watch for signs of infection during the healing process. Home treatment for a minor burn will reduce the risk of infection. Deep burns with open blisters are more likely to get infected and need medical treatment.

Self-Care

First aid for burns

If you think that you might have a severe burn, use these first-aid measures while you arrange to be seen by your doctor.

• First, stop the burning to prevent a more severe burn.

  Heat burns (thermal burns).

  Smother any flames by covering them with a blanket or water. If your clothing catches fire, don't run. Stop, drop, and roll on the ground to smother the flames.

  Cold temperature burns.

  Try to warm the areas. Small areas of your body (ears, face, nose, fingers, toes) that are really cold or frozen can be warmed by blowing warm air on them, tucking them inside your clothing, or putting them in warm water. Don't rub or massage frozen skin.

  Liquid scald burns (thermal burns).

  Run cool tap water over the burn for 10 to 20 minutes. Don't use ice.

  Electrical burns.

  After the person has been separated from the electrical source, check for breathing and a heartbeat. If the person isn't breathing or doesn't have a heartbeat, call 911.

  Chemical burns.

  When a chemical burn occurs, find out what chemical caused the burn. Call your local Poison Control Center or the National Poison Control Hotline (1-800-222-1222) for more information about how to treat the burn. Natural foods such as chili peppers, which contain a substance that irritates the skin, can cause a burning sensation.

  Tar or hot plastic burns.

  Run cold water over the hot tar or hot plastic right away. It will cool the tar or plastic.

• Next, look for other injuries. The burn may not be the only injury.
• Remove any jewelry or clothing at the site of the burn.

  If clothing is stuck to the burn, don't remove it. Carefully cut around the stuck fabric to remove loose fabric. Remove all jewelry, because it may be hard to remove it later if swelling occurs.

• Prepare to be seen by a doctor.

  If you are going to see your doctor soon:

  • Cover the burn with a clean, dry cloth to reduce the risk of infection.
  • Don't put any salve or medicine on the burned area, so your doctor can properly assess your burn.
  • Don't put ice on the burned area. It doesn't help, and it can damage the skin tissue.

Caring for a minor burn

Here are things you can do at home for minor burns, such as first-degree burns or sunburns.

• Use cool cloths on burned areas.
• Take frequent cool showers or baths.
• Apply moisturizing lotions or creams.

  These skin lotions can be used to relieve itching. But don't use them if the burns have fluid weeping from them or have fresh scabs.

  There isn't much you can do to stop skin from peeling after a sunburn—it's part of the healing process. Lotion may help relieve the itching.

• Try other remedies.

  There isn't clear proof that other common remedies are safe and effective, but they may help. For example, you can use an aloe vera lotion or gel, apply calamine lotion for itching, or try an oatmeal bath product, such as Aveeno.

• Try medicine.
  • Using 0.5% hydrocortisone cream on the burned area may help. You will need to check with your doctor first if you need to use the cream for a child younger than age 2 or for use in the genital area.
  • An antihistamine may help stop itching. Be safe with medicines. Read and follow all instructions on the label.
• Protect burns while they heal.

  Newly healed burns can be sensitive to temperature. Healing burns need to be protected from the cold, because the burned area is more likely to develop frostbite. And a newly burned area can sunburn easily. Protect the new skin from sun exposure for the first year after a burn. You can do this by covering the new skin with clothing, staying in the shade, or using sunscreen.

• Don't smoke.

  Smoking slows healing because it decreases blood supply and delays tissue repair.

Caring for a chemical burn

Not all chemical burns are treated with water. Follow the instructions below to care for those other types of burns.

• Carbolic acid or phenol burns. Use isopropyl (rubbing) alcohol first to flush the chemical off the skin. Then flush with water. If alcohol isn't available, flush with a large amount of water. Do not flush the eye with alcohol.
• Sulfuric acid burns. Flush with a mild, soapy solution if the burns aren't severe. Sulfuric acid feels hot when water is added to the acid. But it's better to flush the area and not leave the acid on the skin.
• Dry powder burns. Brush the powder away first. That's because adding water can make a liquid that burns. After the powder is brushed away, flush with water for 20 minutes. Lime is an example of a dry powder burn.
• Metal compound burns. Cover these burns with mineral oil.

A chemical burn can be caused by alkaline or acid products, metals, and hydrocarbons, such as gas.

Most chemical burns of the skin are treated first by rinsing (flushing) the chemical off your body with a large amount of water. It's important to treat the burn correctly to avoid further problems.

This is general information for treating a chemical burn. Call a Poison Control Center for more specific information.

If someone has swallowed a chemical that may be a poison or that may cause burning in the throat and esophagus, call your local Poison Control Center or the National Poison Control Hotline (1-800-222-1222) right away for information on treatment. When you call the Poison Control Center, have the chemical container with you, so you can read the content label to the Poison Control staff member. The Poison Control Center can help determine what steps to take next.

1. Flush the area with water.
   • Flush for at least 20 minutes. Don't use a hard spray of water. It can damage the burned area.
   • Have the person with the burn remove the chemical substance if he or she is able.
   • Put on gloves to protect yourself from the chemical, if you need to remove it.
2. Remove anything that the chemical may be on.

   As you flush the area, take off any clothing or jewelry that has the chemical on it.

3. Continue to flush, if needed.

   If the area still has a burning sensation after 20 minutes, flush the area again with flowing water for 10 to 15 minutes.

If you need to see a doctor for the burn, take the chemical container with you.

Caring for an electrical burn

Rinse the burns with water, and apply a bandage. There may be burns where the electrical current entered the body and where it left the body. If you have a visible electrical burn to the skin, an evaluation by your doctor is usually needed.

Caring for a tar or plastic burn

• Run cold water over the hot tar or hot plastic right away.

  This helps stop the burning.

• Do not attempt to peel the tar or plastic off after it has cooled.

  This may remove skin that is stuck to the tar or plastic.

• Loosen the tar or plastic with mineral oil or ointments such as Vaseline or Polysporin.

  This can help remove the tar or plastic. Tar will likely peel off after a few days as the skin cells below the tar flake off normally.

• Wash and treat the burned skin after the tar or plastic is removed.

If you have any trouble removing tar or plastic from the skin, you need an evaluation by a doctor.

When to call for help during self-care

Call a doctor if any of the following occur during self-care at home:

• New or worse trouble breathing.
• New or worse pain.
• New or worse signs of infection, such as redness, warmth, swelling, pus, or a fever.
• Symptoms occur more often or are more severe.

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