Contents
Burns can be caused by thermal, chemical, electrical, radiation factors. Depending on the degree and localization, they can be located on the skin of the extremities, face, perineum and genital organs, oral mucosa, esophagus and respiratory tract.
The depth of the lesion can reach both superficial layers and deep-lying tissues, on which their classification depends. Depending on the area, their severity is determined.
Thermal burns
Thermal burns are the most common and can be caused by the direct action of hot objects, open flames, and boiling liquids. They are of particular danger in children and the elderly, since they cause a significant loss of fluid from the burn surface and intoxication with severe local manifestations and negative reactions of a general type. The volume of therapeutic measures aimed at eliminating the problem at the pre-hospital stage does not depend on the degree of burn and consists of a clear order.
Termination of the action of high temperatures on damaged tissues. The sooner the patient’s contact with the damaging thermal agent is limited, the less damage will be caused.
Releasing damaged areas from clothing, foreign objects and hot elements. The exception is cases of burns with various substances that form a dense scab and a connection with damaged skin.
Cooling fired tissue. A very important point that must be fulfilled. This is due to the fact that hyperthermia is maintained for a long time in tissues exposed to high temperatures. This contributes to an increase in the degree and area of the burn compared to the initial indicators. To prevent this from happening, cooling is carried out with cold water or ice.
Closure of the burn surface. This is necessary in order to limit its contact with the surrounding aggressive world, which will prevent the reproduction of harmful microorganisms in damaged tissues. For this, bandage-gauze dressings of various types can be used, both dry and based on water-soluble ointments (levomekol, oflokain, levosin, methyluracil, synthomycin, panthenol, betadine). The main requirement for them is that they should not cause irritation of wounds and increase pain. To reduce pain, you can periodically water them with a cool solution of novocaine or furacilin.
Adequate anesthesia. For these purposes, tableted and injectable forms of non-steroidal anti-inflammatory painkillers (ketalgin, dexalgin, diclofenac, nimesil, paracetamol), as well as standard preparations of analgin, diphenhydramine, tempalgin and others can be used.
Transportation of the victim to the nearest surgical or traumatological hospital. Here, measures should be taken to prevent or reduce the manifestations of burn disease and infection of injured surfaces. For this purpose, broad-spectrum antibacterial drugs, infusion solutions are introduced taking into account the severity of the burn and fluid loss, hemotransfusion of blood components and colloidal solutions, drugs that normalize microcirculation processes, local treatment of burned areas is carried out using plastic techniques for replacing wound defects with donor skin.
Burns of the upper respiratory tract and eyes
Burns of the upper respiratory tract and eyes are a special type of thermal burns, which are mainly caused by hot flames and smoke. They are also very dangerous, since in a matter of hours they can lead to the death of the patient due to progressive respiratory failure due to obstruction of the trachea and bronchi. It is very difficult to help such patients at the pre-hospital stage. It is necessary to evacuate the victims from the danger zone as soon as possible and provide free access to fresh air, administer painkillers and urgently deliver the patient to the nearest hospital.
Under these conditions, antibacterial and infusion therapy should be carried out, as well as sanitation bronchoscopy (examination of the trachea and bronchi), with the help of which thick mucus and foreign particles are evacuated, which will restore the patency of the respiratory tract. If necessary, repeat bronchoscopy is performed. In case of progressive respiratory failure, patients are transferred to artificial lung ventilation.
In case of eye burns of thermal or chemical origin, it is necessary to rinse them with plenty of water. This will cool the tissues and free them from aggressive chemical compounds. The eyes are instilled with drops containing local anesthetics (novocaine, dicaine, lidocaine) and antibacterial drugs (levomecithin, tobrex). All victims should seek medical attention from an ophthalmologist.
Chemical burns
Chemical burns can be represented by damage to the skin and mucous membranes of the oropharynx and esophagus due to exposure to aggressive acids, alkalis and various chemical compounds used as poisons and household chemicals. In this case, special types of tissue necrosis of coagulation or colliquation types arise. The first, characteristic of acid burns, when a dense scab is formed, the second – for alkalis with the formation of long-term non-healing weeping surfaces.
The scope of measures for such burns includes the following complex:
Stop contact of the skin surface or mucous membranes with the chemical as soon as possible;
Remove any objects in contact with the burnt surface;
Rinse the burn wound with plenty of running water. This will wash away the remaining substance and neutralize them. If it is possible to use neutralizing solutions in cases of known nature of the chemical compound. To neutralize alkalis, the wound is washed with weak acids, for acids – with alkalis;
Adequate anesthesia;
Closure of the wound surface with a dry bandage. It is not recommended to use various ointments and panthenol foam due to the fact that the formation of aggressive compounds with substance residues is possible;
Mandatory hospitalization in a medical institution where specialized medical care will be provided.
A special type of this type of burns are damage to the esophagus. Medical care should never be delayed, as they are fraught with the development of extensive ulcerative mucosal surfaces, which can be complicated by bleeding and post-burn stenosis with obstruction even for liquid food.
In order to avoid dangerous complications, at the slightest suspicion of deliberate or accidental use of unknown chemical compounds, the stomach and esophagus must be washed with plenty of water, followed by its evacuation from the stomach using a probe. This will wash away the aggressive components and dilute the chemical compounds that have already arrived. In the future, in a hospital, early bougienage (expansion) of the narrowed sections of the esophagus is carried out, enveloping agents such as Almagel, Phosphalugel, Venter, Maalox are prescribed, antibiotic prophylaxis and infusion-transfusion therapy are carried out.
electrical burns
Electrical burns do not happen so often, but differ in their severity and scale of damage. The burn surface itself can be insignificant and limited only to the fingers of the hand or the heel region, which close the electric arc. But at the same time, they are completely charred with concomitant bone fractures, ruptures of muscles, tendons, nerves and blood vessels.
You can help the victim only by taking the victim away from the source of electric current and hospitalizing him in a hospital. Do not touch a person who is under the influence of electricity with unprotected hands. For these purposes, materials that do not have electrical conductivity should be used. Local treatment of the affected limbs consists in immobilizing them with splints or splints made from improvised materials, covering the burn surface with a dry bandage. In case of cardiac arrest or ventricular fibrillation, resuscitation measures are indicated in the form of electrical defibrillation or chest compressions.
Radiation burns
Radiation burns are caused by radiation released during atomic explosions and therefore occur infrequently. If sunburns are attributed to this group, then this group of injuries is more frequent. Radiation burns are possible in cancer patients after radiation therapy. They can be located on the skin or mucous membrane of the stomach and intestines. This type of burn is also much more severe than thermal burns, causing severe suffering to patients.
First aid is mainly provided in the lesion and should be organized as soon as possible. Damaged areas of the skin are washed with soap and water, all clothing is completely removed, which always turns out to be contaminated with radioactive particles. Dry dressings or soaked in solutions of aqueous antiseptics (furatsilin, chlorhexidine, decasan) are applied to the burned surfaces.