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Burn care is a critical component of emergency medical services (EMS). Emergency care providers must prepare to treat any type of burn, from a minor burn to a full-thickness burn. While most people know to treat a small burn by running cool water on it, some severe burns require medical attention from EMS workers or urgent care. This blog post will highlight the importance of preparing for emergency burn care to minimize damage before burn victims are transported to a hospital or burn center.
Burn Care Basics
Burns are not like other wounds; they require more specialized care and treatment. Burn care focuses on the management of burns to optimize healing and minimize scarring. EMS burn care includes cleaning, debridement, and dressing burn wounds, as well as the management of associated pain and infection. After transportation, critical care is provided by specially trained surgeons or within emergency department burn units.
EMS providers play a key role in the initial management of burn patients, as they are often the first to arrive on the scene. The goals of EMS burn care are to stabilize the patient, relieve pain, and prevent further injury. EMS providers must have a good understanding of burn physiology and the different types of burns to provide appropriate care. Burns are classified based on depth, etiology, and size.
Identifying a Burn Injury
Burn injuries are serious, painful, and dangerous. Major burns can be life-threatening. Burn injuries vary in severity, but all share common features. The skin will appear red and inflamed while being warm to the touch. Burned skin may prohibit movement in the affected area. Before treatment of burns, understand the type of burn.
Thermal Burn
A thermal burn is a burn injury caused by exposure to heat, such as a scald. They’re often caused by contact with hot liquids, flames, or objects. The severity of a thermal burn depends on the temperature of the heat source, the duration of exposure, and the total body surface area (TBSA) affected.
Chemical Burn
A chemical burn occurs when the skin is exposed to a chemical substance that damages the tissue. This can happen if the chemical comes into direct contact with the skin or if it is inhaled or ingested. Chemical burns can range from mild to severe, depending on the chemical involved and the amount of exposure. Some chemical burns may only cause redness and swelling, while others can lead to serious symptoms like blistering, cramping, and difficulty breathing.
Electrical Burn
An electrical burn is a type of thermal burn that occurs when the skin comes into contact with an electrical current. The electrical current creates a local heating effect that causes burned tissue and skin. Electrical burns vary in severity, from small superficial burns to more severe deep burns.
Sunburn
A sunburn is a form of radiation burn that occurs when the skin is exposed to ultraviolet (UV) rays from the sun. The UV rays damage the skin cells, causing inflammation, redness, and pain. Sunburns can range from mild to severe and can even lead to skin cancer.
In severe cases, sunburn occurs with dehydration, fever, and sun poisoning. In most cases, sunburn does not need emergency medical care. Sunburn is easily combated with pain medication (ibuprofen or acetaminophen) to dull the pain, aloe vera lotion to facilitate healing, and fluid resuscitation if needed.
Partial Thickness Burn
A partial-thickness burn makes the skin look red and blistered. Partial-thickness burns can classify as either superficial partial-thickness or deep partial thickness. Superficial partial-thickness burns only damage the top layer of skin, while deep partial-thickness burns damage the second layer of skin and may also damage the nerves and blood vessels.
Partial-thickness burns can heal on their own, but deep partial-thickness burns may require medical attention to heal properly. Treatment for a partial thickness burn will depend on the severity of the burn but may include pain medication, antibiotics, and dressings.
Full Thickness Burn
A full-thickness burn is a burn that extends through all layers of the skin. The injury may be caused by heat, chemicals, electricity, or radiation. Full-thickness burns are also known as third-degree burns. They are the most severe type of burn, often requiring skin grafts or other surgery for treatment. Full-thickness burns can be very painful and may cause swelling, blistering, and blackened or dead tissue. When a full-thickness burn encases an entire extremity (even the torso), it is labeled as a circumferential burn.
Smoke Inhalation Injury
Smoke inhalation is the leading cause of death in house fires. It occurs when you breathe in hot smoke from a fire. The smoke can burn your respiratory system, including your lungs. People with smoke inhalation often have difficulty breathing and may need to be hospitalized. Some people may also develop pneumonia or bronchitis. Treatment for smoke inhalation typically includes oxygen therapy and ventilation.
Types of Burns
The severity of burns is defined by four major categories.
First-Degree Burns
First-degree burns are red, painful, and tender to the touch. They do not blister but may change color or develop a white or yellowish crust as the skin heals.
Second-Degree Burns
Second-degree burns are also red and painful, but blisters form on the skin — and fluid can be expressed from these blisters when pressed.
Third-Degree Burns
Third-degree burns completely burn the epidermis and dermis. The burn site appears either white or charred while changing the skin texture to feel leathery. The damage causes the burn area to lose feeling.
Fourth-Degree Burns
Fourth-degree burns affect both layers of skin, deep tissues, and could also affect muscle and bone. This deep burn completely destroys nerve endings, leaving the burn area numb.
Supplies for the Treatment of Burns
EMS should always be prepared to provide treatment of burns with certain supplies in their first aid kits. Emergency healthcare providers should minimize the pain and risk of further infection as soon as possible. This includes cleaning, removing debris, and dressing the wound to promote healing and avoid contamination.
The following are some important supplies to stock in your emergency burn kit.
For small burns, it’s beneficial to have access to running water to cool the burned area. For more severe burns, EMS providers may need to provide airway support and intravenous fluid resuscitation.
Transporting Burn Patients
To address the challenges of severe burns, the American Burn Association (www.ameriburn.org) developed treatment guidelines that EMS care providers should follow when transporting burned patients to a burn center. These guidelines were created to ensure the best quality of life for the severely burned, improving their survival chances.
Supplies for Emergency Burn Care
The key to burn care is having a clear understanding of the types of injuries and the appropriate treatments. This will help emergency medical services prepare for severe burns and provide care that meets the needs of patients who have suffered these types of injuries before taking them to a hospital or burn center for further evaluation. When preparing for emergency burn care, find your supplies at Penn Care.
