Burns

Burns are injuries to the skin or underlying tissue caused by heat, chemicals, electricity, or friction. Severity depends on the depth of the burn and the percentage of body surface area affected, and extensive burns are medical emergencies.

• Pain and redness in superficial burns
• Blistering in partial-thickness burns
• Pale, leathery, or charred skin with reduced pain sensation in full-thickness (deep) burns
• Signs of shock — rapid heart rate, low blood pressure — in extensive burns
• Difficulty breathing or soot around the mouth/nose may indicate airway or inhalation injury

• Direct contact with flame, hot liquids or objects (scalds), or hot surfaces.
• Exposure to caustic chemicals.
• Electrical injury.
• Prolonged sun exposure (sunburn) or friction.

• Assessed by estimating the depth of the burn (superficial, partial-thickness, or full-thickness) and the percentage of total body surface area affected, often using the "rule of nines" or palm-size method.
• Location matters — burns to the face, hands, feet, genitals, or major joints, and circumferential burns, are considered more serious regardless of size.
• Assessment for airway involvement is important in burns from fire in an enclosed space.

Immediate first aid involves cooling the burn with clean, cool (not iced) running water for about 20 minutes and removing any smouldering clothing or jewellery, while avoiding creams, oils, or traditional remedies applied directly to the wound.

Pain relief is given, and the wound is covered with a clean, non-stick dressing.

For larger burns, intravenous fluid resuscitation is calculated based on body surface area burned and body weight to prevent shock.

Wounds are cleaned and dressed, with a topical antimicrobial agent such as silver sulfadiazine commonly used for partial-thickness burns to reduce infection risk, and tetanus immunisation status is checked and updated if needed.

Burns covering a large body surface area, full-thickness burns, burns to the face, hands, feet, or genitals, suspected airway injury, or burns in young children or the elderly should be referred urgently to a facility capable of specialised burn care.

• Keep matches, lighters, hot liquids, and cooking areas out of reach of young children.
• Set water heaters to a safe temperature to prevent scalds.
• Use protective equipment when handling chemicals or working with electricity.
• Install and maintain smoke alarms and have a fire escape plan at home.