For healthcare professionals the winter months are commonly known as “burns season”. It is the time of year when the number of burn related injuries could spike as people increasingly use open fires, paraffin, gas and electric heaters to stay warm.
The World Health Organization (WHO) indicates that over 96% of all fatal fire-related deaths occur in low to middle-income countries, with burns estimated to account for 180 000 deaths globally every year. Annually over a million people in Africa are affected by a burn-related injury, while globally 18% of hospital admissions are as a result of burn injuries.
According to emergency medical services provider, Netcare 911, most burns in South Africa are caused by heat sources such as hot water or fire, and occur mainly in the home and workplace. Children often sustain burns in the kitchen or bathroom, while burns in the workplace are often due to fire, scalding, chemical and electrical burns.
“Children are naturally inquisitive and as soon as they become mobile or start walking, they begin exploring their environment. This could result in them pulling down pots or kettles filled with boiling hot water, touching hot objects such as stovetops or playing with fire, matches or candles,” says David Stanton, head of clinical leadership at Netcare 911. “House fires are often caused by candles or paraffin lamps left unattended and Primus stove explosions. Electrical burns are also seen fairly often.”
“Given the high incidence of burn related injuries it is imperative to ensure that proper safety measures are in place to prevent serious burn injuries.”
“The extent to which a burn will heal often depends on the quality of first aid received immediately after the injury. The most important aspect to keep in mind when faced with a burn injury is to ensure that the affected person is removed from the source of heat and to cool the burnt or scalded area immediately with cool water,” he adds.
Tips to ensure the correct first aid treatment after a burn injury
Stanton says the first, most important rule is to move away from the heat source as soon as possible when a burn happens. “If your clothes have caught fire, follow the golden rule: stop, drop to the ground and roll to try to smother the flames. This rule also applies when you’re helping someone else who is in trouble.”
“Stop the burning process and remove any sources of heat. If the fire is small enough, put out any flames to prevent further contact with the burning material. If a person has been injured by hot liquid or steam, ensure that the person is removed from the source as soon as possible.”
“Before assisting someone else, make sure that it is safe and that you will not be putting your own life in danger,” he notes.
Stanton also suggests caution before using a blanket or rug to extinguish a fire. “Some fabrics and materials, especially the more synthetic ones, may actually make matters worse. Using water in general or a fire extinguisher, particularly in the kitchen, is always first prize.”
“Remove any clothing that might be covering the burn,” he says. “Clothes can retain heat and should be gently removed as soon as possible. However, do not pull off clothing that has stuck to the skin. This may cause skin damage.”
“If you are trying to remove foreign materials from the burn site and find that they are firmly stuck, rather let emergency medical services and medical professionals take care of the situation,” he suggests.
The burning process in the area affected will continue even after the person has been removed from the source of the burn. To stop this, treat the burn immediately with cool, but not ice-cold, water. Depending on the location, size and severity of the injury, hold the affected area under cool running water until it becomes less painful. If larger areas of skin are affected, standing under a cool shower may be useful. “The goal is to reduce the heat as quickly as possible,” he explains.
It can cause damage to the skin if the affected area is immersed in very cold water, ice or if frozen items are placed on it. If an affected area is particularly large, it can also potentially lead to hypothermia and affect blood pressure and circulation.
Do not rely on unfounded advice to apply butter, egg white, toothpaste or any types of lotions to the affected areas. “These substances can be difficult to clean out later and can cause infection. Supporting healing and reducing scarring should always be the overriding aim,” notes Stanton.
Ensure that a sterile dressing is applied, as it will help to relieve the pain, reduce damage to the skin and prevent infection. “In order to keep the sterile dressing on the wound, cover it with a bandage,” he recommends.
However, when applying a dressing, take care not to break the skin and do not attempt to peel any blisters. “In addition, ensure that the wound is not covered by any fluffy, sticky or adhesive materials as this could further damage the area, and could potentially lead to infection,” Stanton emphasises.
When to seek medical assistance
“If the burn injury is severe, causes significant pain and/or is larger than the palm of your hand, visit an emergency department or call an emergency medical services provider such as Netcare 911 on 082 911 for assistance. If the burn becomes infected, you have not had a recent tetanus vaccination, or blisters occur, you should seek medical advice from your doctor or emergency medical services provider,” Stanton concludes.
Burns: what you need to know
Degrees of burns
According to the South African Burns Society, there are three different types of burns:
- First degree: Red skin, no blisters. Usually heals with little or no scarring.
- Second degree: Blisters and thickened skin. This can be a burn of either partial or full thickness of the skin, and full thickness burns may require skin grafting for the best healing.
- Third degree: Overall thickening of the affected skin, with a white colour. This burn is all the way through the skin.
Sources of burn injuries
- Thermal burns can come from explosions, flame, hot liquids and contact with hot materials like heated glass or coals.
- Chemical burns are caused by strongly acidic or alkaline substances, and require special care to stop injury to the skin.
- Electrical burns are caused by electricity, as the name implies, and need to be evaluated by a medical professional even if they look fine, as they can’t be accurately judged just by the external appearance.
Prevention tips in and around the home
Burns can often be prevented. Stanton shares the following tips to ensure safety and prevention is top of mind in the home environment:
- Be careful and keep a close eye on babies and children around candles, paraffin lamps, electrical heaters with exposed elements, and open fires.
- Use fireplaces, heaters and electric blankets safely.
- Be alert to prevent injury from spills when carrying hot drinks and food.
- Run cold water first into a bath and add hot water only afterwards.
- Keep a close eye on children in the kitchen especially near stoves, kettles, ovens and irons.
- Check all electrical outlets to ensure that they are child safe.
- Invest in a fire extinguisher for your home and learn how to use it correctly.
- Make sure that you store matches and lighters out of the reach of children.
- Ensure that young children fully understand the dangers of fire and electricity.
- Babies, children and the elderly are especially at risk of burns. Take precautions to help protect them.
References and further reading
The World Health Organization: who.int/topics/burns/en
The South African Burns Society: http://www.saburnsociety.co.za/
Issued by: Martina Nicholson Associates (MNA) on behalf of Netcare 911
Contact: Martina Nicholson, Graeme Swinney, Meggan Saville and Estene Lotriet-Vorster
Telephone: (011) 469 3016
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