- 1st Degree
Burn (superficial burns) - Reddened skin without blisters (usually doesn't need to be seen)
- 2nd Degree Burn (partial thickness burns)
- Reddened skin with blisters (heals from bottom up, takes 2
to 3 weeks)
- Small closed blisters (narrower than 1 inch) serve
as a dressing and reduce pain. Also the blister fluid contains
- Large closed blisters (wider than 1 inch) may
need debridement. They commonly break open and the dead skin then needs
to be removed
- All open blisters need trimming of the dead
skin (can be done by caller or in the office). Most open blisters are
empty of fluid. A blister with a small opening and slow fluid leak can
be recognized by the appearance of wrinkled skin.
- 3rd Degree Burn (full thickness burns)
- Deep burn with white or charred skin.
The burned area loses sensation to pain and touch (feels numb). Usually needs
a skin graft to prevent bad scarring if it is larger than a quarter (1 inch
or 2.5 cm) in size.
burns are skin injuries caused by heat. Common examples are burns from hot water
or hot drinks. Other common causes of thermal burns include hot ovens, stoves,
electric or kerosene space heaters, exhaust pipes, hot grease, hair-curling
irons, and clothes irons.
- Chemical burns result from lye, acids, or other tissue-damaging
chemicals splashed on the skin. If the chemical is washed off immediately, most
of these accidents will cause only first-degree burns.
First Aid for Thermal Burns
(don't take time to remove clothing) put the burned part in cold tap water or
pour cold water over it for 10 minutes. (Reason: lessens the depth of
the burn and relieves pain)
First Aid for Chemical Burns
remove any contaminated clothing.
- Then flush the chemical off the skin with warm water for 10
minutes. For large areas, use a shower.
See More Appropriate Topic (instead of this one) If
WHEN TO CALL YOUR DOCTOR FOR BURNS
Call 911 Now (you may need an ambulance) If:
- Large 2nd
or 3rd degree burn
- Difficulty breathing with burn to the face
- Difficulty breathing after exposure to flames, smoke, or fumes
Call Your Doctor Now (night or day) If:
- You think
you have a serious burn
- Blister is present (EXCEPTION: small closed blister less
than ½ inch wide)
- Center of the burn is white or charred
- Burn completely circles an arm or leg
- Eye or eyelid burn
- Electrical current burn
- Explosion or gun powder caused the burn
- Acid or alkali (lye) burn
- Chemical on skin that causes a blister
- Hoarseness or cough after exposure to flames, smoke, or fumes
- Headache or nausea after exposure to flames, smoke, or fumes
- Burn looks infected
Call Your Doctor Within 24 Hours (between 9 am
and 4 pm) If:
- You think
you need to be seen
Call Your Doctor During Weekday Office Hours If:
- You have
other questions or concerns
- Diabetes and mild burn of foot or lower leg
Self Care at Home If:
- Mild thermal
or chemical burn and you don't think you need to be seen
HOME CARE ADVICE FOR 1ST DEGREE
BURNS OR SMALL BLISTERS
A mild thermal or chemical burn can be treated at home.
Cleansing: Wash the area gently with an antibacterial liquid soap
and water once a day.
Blisters: Don't open any small closed blisters; the outer skin protects
the burn from infection. For small broken blisters, trim off the dead skin with
a fine scissors. (Reason: the area under these flaps of skin can become an ideal
breeding ground for infection.)
Antibiotic Ointment: For burns with broken blisters, apply an over
the counter antibiotic ointment (e.g. Bacitracin) and cover it with some gauze
or a Band-Aid. (Reason: to decrease pain and risk of infection) Change the dressing
Tetanus Shot: If your last tetanus shot was more than 10 years ago,
you need a booster. Call your doctor during regular office hours (within the
next 3 days).
Expected Course: It will probably hurt for 2 days and peel like a
sunburn in about a week. Fortunately, first and second-degree burns
don't leave scars.
Pain Medication: For pain relief, apply cold compresses and take acetaminophen
every 4-6 hours (e.g. Tylenol; adult dosage 650 mg) OR ibuprofen every 6-8 hours
(e.g. Advil, Motrin; adult dosage 400 mg).
- Do not take ibuprofen if you have stomach problems, kidney disease,
are pregnant, or have been told by your doctor to avoid this type of anti-inflammatory
drug. Do not take ibuprofen for more than 7 days without consulting your doctor.
- Do not take acetaminophen if you have liver disease.
- Read the package instructions thoroughly on all medications
that you take.
- Call Your Doctor If:
- Severe pain persists more than 2 hours after giving pain medicine.
- Burn starts to look infected (pus, red streaks, increased tenderness)
- You become worse or develop any of the "Call Your Doctor"
This information is not intended be a substitute for professional medical
advice. It is provided for educational purposes only. You assume full
responsibility for how you choose to use this information.
Adult HouseCalls Online. Copyright © 2000-2004
David Thompson, M.D. FACEP
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