Burns and Treatment

Adrian learnt the dangers of Paraffin the hard way! Dont make the same mistake!

...Protect your golden tool!?, well of course we highly recommend this. Another way to put it, which applies for just about everything in general,

Prevention- is better than cure! Although there’s also two old saying that go, “you live by the sword, you die by the sword” & one which I am positive everyone’s familiar with, “you play with fire, you get burnt”. So technically its bound to happen at some point or another, however, there are some steps that we can take to prevent or at least make unwanted situations less likely to occur (See our posts on “fire dancing safety guide” & “Hints&Tips-by inflamed”). But in the end of the day, as long as you live in the same world as everyone else, accidents are bound to happen.

So I’ve done research (Including some good old- personal experience.) In the rest to follow are some guidelines on first aid- specifically for burns, which is something that I feel everyone, especially fire dancers/performers should know.

Burns & Scalds are injuries to body tissues caused by heat, chemicals or radiation. Burns caused by ‘wet’ heat such as steam or hot liquids, are called scalds. Burns vary in depth, size & severity, they may damage the underlying parts of the body as well as the skin. Most burns will require medical attention.
Heat is the most common cause of burns. Other causes include contact with dry/liquid corrosive chemicals whether acid/alkali, & over exposure to radiation or sun rays.

There is a considerable risk of infection with burns because, in damaging the skin (which is actually the largest organ of our bodies in fact, & is adapted for particular functions, namely- insulation, temperature control & protection.) therefore the skin loses its protection against germs when burnt, easily leading to infection.
There is also a danger of shock developing, because serum leaks out of the circulatory system & into the burnt area.

Types of burns:
Dry Burns-
Flames, cigarettes & hot equipment such as staff/chains are all common causes of dry burns. Fast-moving objects rubbed against the skin produce dry friction burns. Alternatively, they may be caused by the skin rubbing against an object (rope, grass)
Scalds-
Wet heat such as steam, hot liquids & fat produce scalds.
Cold Burns-
Contact with substances such as liquid oxygen/nitrogen can cause cold burns.
Chemical Burns-
Acids & alkalis, found in domestic cleaning products as well as industry may cause burns when they come into contact with the skin.
Electrical Burns-
Electrical currents & lightning generate heat & burn the skin & underlying tissues.
Radiation Burns-
Sun rays & light reflected from bright surfaces (e.g. snow) can damage the skin & eyes.
Very rarely, radiation burns can come from X-rays. (Where an overdose is absorbed by the skin causing burns.)

Classification of burns:
Burns are classified according to the area & depth of the injury. These factors will determine what treatment is required & whether the casualty requires hospital attention. However, any burn covering an area greater than 2,5 square cm involving more than the surface of the skin or burns arising from electrical contact, must be referred to a doctor or hospital.
Area-
The area of a burn gives a rough guide as to whether or not a casualty is likely to suffer shock. The greater the area involved, the greater the possibility of shock (due to greater fluid loss.)
Severity-
There are three levels of burning. However, it is often difficult to distinguish between them, particularly in the early stages. A large burn will almost certainly contain areas of all three.

Superficial burns (1st degree):
These involve only the outer layers of skin & result in general redness, swelling & extreme tenderness. This type of burn usually heals well.

Intermediate burns (2nd degree):
These involve the formation of blisters & the area around the burn will be swollen & red. These burns can become infected, so you should seek medical aid.

Deep burns (3rd degree):
These involve all the layers of skin. The skin appears pale, waxy & sometimes charred. However, these burns will be relatively pain free because the nerves are damaged. These burns always require medical attention.

Blisters:(Mother natures plasters)
Blisters are thin ‘bubbles’, which form on skin damaged by friction or heat. They are caused by tissue fluid (serum) leaking into the burnt area just under the surface of the skin.
During healing, new skin forms at the base of the blister underneath the serum, the serum is reabsorbed &, eventually, the outer layer of skin peels off. NEVER break a blister-, as doing so will only increase the risk of infection.
Unless a blister breaks or is likely to be further damaged, it requires no treatment. If it does need protection, apply a dressing large enough to extend well beyond the edges of the burnt area.

Clothing on fire!
If clothes catch alight, without prompt help the result is widespread severe burning, shock & possible death. If the accident occurs indoors prevent a conscious casualty from panicking & rushing outside. As the movement &/or breeze outside will just fan the flames.
Lay the casualty down as soon as possible to prevent flames sweeping upwards & quickly put out the flames by dousing the casualty with water or other non-flammable liquid (unless the clothes are contaminated with paraffin in which case water would only spread the flames, instead use sand or a fire extinguisher if one is at hand.)
Alternatively, wrap the casualty tightly in, preferably a fire blanket, if one is not available use a coat, curtain, blanket, rug or any other heavy fabric then lay the person flat on the ground. This starves the flames of oxygen & therefore puts them out.
DO NOT use nylon or other inflammable materials to smother flames.
If your own clothes have caught alight & help is not immediately available, extinguish the flames by wrapping yourself up in suitable material & lying down.
Generally you should not roll along the ground as this can cause burning of previously unharmed areas. So only if no suitable material is available, should you actually stop, drop & roll. Preferably; stop, roll (yourself in suitable material) & drop!

Dry burns & scalds:(Treatment)
These are the most common types of burns & are a major cause of accidental death (particularly amongst children & the elderly.)
Burns & scalds must be cooled as soon as possible in order to prevent further damage to underlying tissues & to alleviate pain, swelling & the possibility of shock. The most effective method of cooling is to flood the area gently with cold water.
Any clothing, which has been soaked in boiling fluid, should be removed as soon as it begins to cool. However, cooled, dry, burnt clothing should NOT be removed because doing so may introduce an infection.
Small burns or scalds can generally be treated on site. However, if you are in doubt about the severity of the injury, or if the casualty is an infant, sick or an elderly person, always seek medical advise.

General symptoms & signs:
-Severe pain in & around the injured area if the burn is 1st or 2nd degree. The area may be numb if the burn is 3rd degree.
-Redness, swelling of area, & some times blistering (if the burn is 2nd degree.)
-Grey, charred, peeling skin around a severe burn
-Symptoms & signs of shock. The degree of shock will relate directly to the extent of the injury.

Aim-
Reduce the effect of the heat, prevent infection, relieve pain & minimize shock. Arrange urgent removal to hospital if burns are severe or extensive.

General treatment-Minor burns
1-Reassure the casualty. Place the injured part under slowly running cold water or immerse it in cold water for 15 minutes – longer if the pain persists.
DO NOT use ice, or ice cold water-as doing so can make the burn worse & restrict blood flow.
IF, no water is available, any cold, harmless liquid such as milk or beer can be used instead.
2-Gently remove any rings, watches, belts, shoes or other constricting clothing from the injured area BEFORE it starts to swell.
3-Dress the area with clean, preferably sterile, non-fluffy material.
DO NOT use adhesive dressings (plasters.)
DO NOT apply lotions, ointments, butter or fat to injury.
DO NOT break blisters, remove any loose skin or otherwise interfere with the injured area.

Then do nothing! At least for the first 24 hours, leave the burn alone. Burns should be allowed to begin the healing process on their own, however, drinking lots of water to replenish lost fluids & sleep will aid the healing process.

Starting 24 hours after the incident, wash your injury gently with antiseptic soap & cool water or a mild bicarbonate of soda solution (+/-3 teaspoons per half basin of water) once or twice a day. Keep it covered, dry & clean between washings.

Two to three days after the incident, break off a fresh piece of aloe & use the plants natural healing moisture, or squeeze on an over the counter aloe cream. Both have an analgesic action that will make your wound feel better. (DO NOT use aloe if you are using blood thinners or have a medical history of heart problems.)

When your burn is starting to heal, break open a capsule of vitamin E & rub the liquid onto your irritated skin. It will feel good & may prevent scarring. Alternatively reach for an over the counter remedy such as tissue oil, bio oil or sunburn-cooler. (Apply any of these to the skin with a gentle massaging action using the fingertips.)
Dab on an antimicrobial cream. An over the counter antibiotic ointment containing the active ingredients: Silver sulphadiazine; polymyxin B sulfate or bacitracin will discourage infection & speed your healing process.

First Aid & Recovery Kit: (Burns)
-Myprodel, alternatively anything else that can assist in alleviating pain.
-Latex Gloves, to prevent possible infection of HIV when assisting casualties.
-Clean, sterile gauze dressings- to prevent infection. (Paraffin gauzes sold under the trade name Paranet/Jelonet come in packages containing 10 pieces of 10x10cm, costing approximately R40.)
-Clean, preferably sterile, non-fluffy bandages.
-Scissors, to trim/modify bandages if necessary & safety pins to secure bandages in position.
-Antiseptic soap.
-Bi-carbonate of soda.
-Aloe cream. (It’s also a good idea to keep an aloe plant or two at home)
-Antimicrobial cream, such as Silbecor (Containing the active ingredient Silver Sulphadiazine) Approximate cost R40. N.B.-Only for the treatment of minor burns!
-Vitamin E capsules &/or bio/tissue oil.

We also highly recommend that whenever fire dancing to at least keep a fire blanket, fire extinguisher/s & a bucket or two of sand nearby. At least one person should be ‘spotting’ & available to assist in any way if the need arises. Always ensure you are familiar where fire extinguishers/hoses & emergency exits are located.

Notice:
This article is intended as a reference volume only, not as a medical guide or manual for self-treatment. If you suspect that you have a serious injury, or are unsure of the severity of your burn, please seek competent medical care! The information here is designed to help you make informed choices about your health. It is not intended as a substitute for any treatment prescribed by your doctor.