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Heat burns and scalds
All heat burns should be cooled as quickly as possible with running cold water (sea or fresh), applied for at least ten minutes, or by immersion in basins of cold water. If it is not possible to cool a burn on the spot, the casualty should be taken to a place where cooling can be carried out. Try to remove clothing gently but do not tear off any that adheres to the skin. Then cover the burned areas with a dry, non-fluffy dressing larger than the burns, and bandage in place.
In cases of severe burns followed by shock, obtain RADIO MEDICAL ADVICE as soon as possible.
Electrical burns
Make sure you do not become the next casualty when approaching any person who is in contact with electricity. If possible, switch off the current. Otherwise, insulate yourself before approaching and touching the casualty, by using rubber gloves, wearing rubber boots, or standing on an insulating rubber mat.
Electrical lines may be removed from the casualty with a wooden pole, a chair, an insulated cord, or other non-metal object.
Then check casualty immediately for breathing and heartbeat.
If casualty is not breathing, give artificial respiration.
If heart has stopped, apply heart compression. Send for help.
When the casualty is breathing, cool any burnt areas with сold water and apply a clean, dry, non-fluffy covering to these areas.
The treatment for electrical burns is the same as the thermal burns. It includes relief of pain, prevention and treatment of shock, and control of infection.
Electrical burns may be followed by paralysis of the respiratory center, unconsciousness, and instant death.
Chemical Splashes
Remove contaminated clothing. Drench casualty with water to wash the chemical from the eyes and skin. Give priority to washing the eyes, which are particularly vulnerable to chemical splashes. If only one eye is affected, incline the head to the side of the affected eye to prevent the chemical from running across into the other eye. Wash the chemical out of the eye with copious amounts of water as for long as is necessary to ensure that none remains (usually at least 10 minutes).
Care of burns and scalds
The treatment of burns and scalds is the same, whether they are caused by dry or wet heat.
Classification
Skin has an outer layer (epidermis) and a deep layer (dermis). The latter contains the sweat glands, hair follicles, and nerves relaying sensation and pain to the skin.
First-degree burns affect only the outer skin layer, causing redness, mild swelling, tenderness, and pain.
Second-degree burns extend into the deeper skin layer (dermis):
Superficial second-degree burns cause deep reddening, blister formation, considerable swelling and weeping of fluid.
Deep second-degree burns may not be easy to distinguish from third-degree burns immediately after the injury. Pain may be severe because of damage to the nerve endings.
Third-degree burns involve the whole thickness of skin, and may extend to the underlying fat, muscle, and bone. The skin may be charred, black or dark brown, leathery or white, according to the cause of the burn. Pain may be absent owing to destruction of the nerve endings.
Treatment
Try to remove patient to hospital within 6 hours, otherwise seek RADIO MEDICAL ADVICE in the case of:
- third-degree burns;
- babies;
- burns of face and genitalia, and large burns around joints;
- burns of over 18% of the body surface in adults, or 10% in children or older persons
Pending his removal to hospital, put the patient to bed and seek to restore the fluid balance by encouraging him to drink as much as possible. Give him oral rehydration salts solution to drink. If vomiting occurs and persists, intravenous infusion of 0.9% (9g/litre) sodium chloride may be necessary, after receiving RADIO MEDICAL ADVICE. Relieve pain and start standard antibiotic treatment. Less serious cases can be treated aboard ship. Wash your hands and forearms thoroughly and put on a facemask. Remove the firs-aid dressing to expose either a single burned area (in multiple burns) or a portion of a single burn. The aim is to limit the areas of burned skin exposed at any one time to lessen both the risk of infection and the seepage of fluid. Clean the skin round the edges of the burn with soap, water and swabs. Clean away from the burn in every direction. DO NOT use cotton wool or other linty material for cleaning, as bits of it are likely to be left in the burn.
Leave blister intact, but clip off all the dead skin if blisters have burst. Flood the area with clean warm boiled water from a clean receptacle to remove debris. With a swab soaked in boiled warm water, dab gently at any remaining dirt or foreign matter in the burned area. Be gentle, as this will inevitably cause pain.
Next cover the burn with neomycin ointment. Now apply a covering of absorbent material to absorb any fluid leaking from the burn, i.e. a layer of sterile gauze covered with a layer of sterile cotton wool. Hold this in place with a suitable bandage. In more serious cases start the standard antibiotic treatment.
Dressings should be left undisturbed for a week unless they become smelly or very dirty, or the temperature is raised. Re-dress areas as above.
- Answer the following questions
- What kinds of burns do you know?
- What are their major signs? What is the difference between them?
- How are the burns classified?
- What should be done in case of burns?
- Translate from Russian into English
Ожоги различают: термические, электрические, химические и радиационные. По степени тяжести они различаются: I – краснота, II – пузыри, III – омертвление кожи, IV – обугливание.
Оказывая помощь при ожогах, следует предпринять следующие меры:
· промыть ожоговую поверхность морской водой, наложить стерильную противоожоговую повязку и полить ее сверху раствором анестезина в спирте (из аптечки).
· Не вскрывать пузыри и не удалять кусочки кожи с поверхности ожога.
· Не менять повязку до заживления ожога.
· Давать пострадавшему по 2 таблетки тетрациклина 4 раза в сутки.
При ожогах глаз или их поражении солнечной радиацией защитите глаза от света (темные очки), от прямых и отраженных от воды солнечных лучей, промойте их пресной водой.
При ожогах кислотой рекомендуется обильное промывание водой или содовым раствором, при ожогах щелочами – обмывание раствором борной кислоты или разведенным уксусом.