# First Aid/Burns

A burn is the exposure of tissue to heat (thermal burns), chemicals (wet or dry), by electricity, or by radiation.

## Recognition

There are 4 degrees of burns:
* Superficial Burn - First-degree skin will be dry, red, may swell and will usually be painful. An ordinary sunburn is a common example.
* Partial thickness - Second-degree skin will be red and may swell, usually very painful, has blisters that may open and release a clear fluid. This will make the skin appear wet.
* Full Thickness - Third-degree may destroy underlying tissues such as fat, bones, nerves, and muscles. Skin may be brown or black and will look charred. Tissue underneath may appear white. It may not be painful due to nerve endings being destroyed.
* Severely Full thickness - "Fourth-degree" may severely destroy underlying tissues. Skin will be black and will look severely charred. Tissue underneath will appear white. It will not be painful due to nerve endings being severely destroyed.

## Treatment
### Thermal burns

You must stop the burning by removing the person from the source of the burn, being careful not to endanger yourself. Check for any life-threatening conditions by checking the Airway, Breathing, and Circulation. Cool the burn with copious amounts of pure water until the pain is relieved (in case of dry chemical burns, brush off residue first).
After the victim feels some relief, cover the burn loosely with a sterile, dry (preferably non-adhesive) dressing, such as "cling film". Do not use butter, oils, creams, etc.; they can trap heat and increase risk of infection. They will also need to be cleaned out by the hospital later, which only increases the pain the patient must endure. Also do not use antiseptics that may aggravate sensitive skin. Treat for shock. Burns affect the body's ability to regulate temperature. Ensure the person does not become over-heated (very rare) or chilled (very common). Cool the burn wound not the burn patient.
Aloe vera extract, silverdene (Silver Sulfazdiazine), topical analgesics, and NSAIDs (such as ibuprofen or aspirin) are commonly used medications. Consult a doctor before use.

### Chemical burns

If there is a dry chemical, brush it off the skin using paper, cloth, or with a gloved hand. Be sure not to get any on yourself or more on the patient. Once the bulk of the dry chemical is gone, flush with running water as above. Call EMS immediately. If the burn is caused by a wet chemical, flush with plenty of water for 15 minutes and while flushing, call EMS immediately.

### Electrical burns

Electrical burns look like third-degree burns, but are not surrounded by first- and second-degree burns. They always come in pairs: an entry wound (smallest) and exit wound (larger). Call EMS immediately if a person has been shocked as electrocution can cause cardiac and respiratory problems. Be prepared to give CPR or defibrillation. Care is the same for thermal burns.

### Radiation burns

Radiation burns, though typically caused from a nuclear source, can also include ultraviolet radiation, in the form of sunburn, which should be treated as a thermal burn. The most common radiation burn is due to radiotherapy treatment, and are usually epidermal or superficial dermal burns. Burns caused by a nuclear power source, though rare, are still possible. Radiation burns can not be treated by a lay rescuer, but the usual principles of burn 1st aid apply. Individuals working in high-risk environments for possible radiation exposure, such as radiotharapy departments or nuclear power facilities, are trained in the management of radiation burns. The rescuer may unknowingly put himself/herself at risk of radiation exposure by treating someone with a radiation burn. For all nuclear radiation burns, call your local emergency number immediately.
Radiation burns also come in the form of snow blindness (or other intense light burns to the retina). Cover the eyes with sterile gauze, and contact EMS immediately. Do whatever you can to keep the victim comfortable, monitor ABCs, treat for shock, and keep the victim calm.

### Critical Burns

The following burns require medical attention as soon as possible. They may be life-threatening, disabling, and disfiguring. Call the local emergency number if:
* The burns are to a child younger than five years old or to an elderly person.
* The patient is having difficulty breathing.
* The burns are on more than one body part.
* There are burns to the head, neck, hands, feet, or genitals.
* There are burns to the mouth or nose (these may be signs of burns to the airway).
* The burns result from chemicals or electricity.