Burns – Diagnosis and Treatment

Diagnosing Burn Injuries

Healthcare professionals identify burn injuries by looking at the skin and checking the affected area. They consider the type of burn (thermal, chemical, electrical, radiation) and describe the burn’s depth (superficial, partial-thickness, or full-thickness).

The Rule of Nines helps estimate the percentage of body surface area involved.

Burn Severity Checklist:

• Depth (first, second, or third-degree)
• Area involved (Minor: <10%, Major: >10%)
• Location (face, hands, feet, groin)
• Signs of infection or complications

Doctors may order X-rays or lab tests, especially for severe burns or chemical exposures. They transfer patients with large or deep burns to specialized burn care facilities.

Burn Care and Recovery Steps

Immediate Actions for Serious Burns

Act quickly and carefully when someone suffers a serious burn:

• Eliminate the Source: Move the person away from the heat source. Make sure the danger is gone.
• Check Breathing and Airway: Check if the person is breathing. Start rescue breathing if trained and needed.
• Remove Restrictive Items: Gently remove jewelry or tight objects near burned areas before swelling occurs.
• Protect the Burned Area: Loosely cover the wound with a sterile gauze or clean cloth.
• Elevate if Possible: Raise the injured limb above heart level to reduce swelling.
• Monitor for Shock: Watch for cool skin, weak pulse, or shallow breathing.

Table: Major Burn First Aid Steps

Step	What to Do
Safety	Remove from burn source
Airway	Ensure breathing, start rescue breathing as needed
Remove Items	Take off jewelry, belts, tight objects
Cover Burn	Use gauze or clean cloth, keep it loose
Elevate Area	Lift limb above heart, if possible
Watch for Shock	Look for cool/clammy skin, weak pulse, shallow breaths

Hospital Remedies and Medical Interventions

Medical professionals use several treatments after first aid to promote healing and prevent problems:

• Cleaning and Debridement: Staff clean wounds and remove dead tissue with water-based treatments or baths. This helps prevent infection and supports healing.
• Fluid Support: Patients with large burns receive IV fluids to prevent dehydration and shock.
• Managing Pain and Anxiety: Doctors give pain and anxiety medicines during dressing changes and recovery.
• Infection Prevention: They apply creams or ointments like silver sulfadiazine to fight bacteria. If infection develops, they start IV antibiotics.
• Wound Coverings: Nurses use special dressings or skin substitutes to help wounds heal. Dry gauze is used before transferring to a burn center.
• Vaccination: Patients may receive a tetanus shot after a severe burn.

Staff monitor pain, infection, and wound healing closely. They maintain IV access for fluids and medicine. Doctors give systemic antibiotics if infection spreads.

Movement and Activity Support

Physical and occupational therapists help patients regain movement and daily skills:

• Stretching Exercises: Therapists lead stretching to keep skin and joints flexible and prevent stiffness.
• Strengthening and Mobility: Exercise builds muscle and improves movement, especially if burns cover joints or large areas.
• Everyday Skills: Occupational therapy teaches basic activities like bathing, eating, or dressing if burns affect movement.

Therapy often starts soon after injury. Recovery may take months as patients regain strength and confidence.

Surgical Care and Advanced Techniques

Doctors sometimes perform surgery or other procedures for burn care:

• Breathing Assistance: If burns affect the face or neck, doctors may insert a breathing tube to keep the airway open.
• Nutritional Support: Patients with large burns may need a feeding tube if they cannot eat by mouth.
• Cutting Eschar: When a tough scab forms around a limb or chest, doctors may perform an escharotomy to relieve pressure and restore blood flow or breathing.
• Skin Transplants: For deep or large burns, doctors may use skin grafts or temporary skin substitutes.
• Other Procedures: Staff may remove dead skin, clean wounds, and change dressings to support healing.

Summary Table: Surgical and Other Interventions

Procedure	Purpose
Breathing tube	Keeps airway open with swelling or inhalation injury
Feeding tube	Provides nutrition for those unable to eat
Escharotomy	Relieves pressure, restores blood flow or breathing
Skin graft	Covers large or deep wounds, speeds healing
Skin substitutes	Temporary cover for wounds
Debridement	Removes dead tissue, reduces infection risk

Caring for Minor Burns at Home

People can safely treat minor burns at home with simple steps:

• Stop the Burn: Move away from heat or sunlight.
• Cool Down: Run cool water over the burn for up to 20 minutes or use a cool, wet cloth. For burns in the mouth, suck on ice chips briefly.
• Remove Tight Items: Take off rings or jewelry before swelling begins.
• Apply Soothing Lotions: Use gentle lotions like aloe vera after cooling the skin.
• Protect the Wound: Lightly bandage the burn with a clean, non-fluffy bandage.
• Use Pain Relief: Take over-the-counter pain medicines like ibuprofen or acetaminophen.
• Prevent Future Damage: Protect healed skin with sunscreen and keep it moisturized.

Actions to Avoid With Burns

Avoid actions that can make burns worse:

• Don’t Use Ice or Cold Water: Extreme cold can damage tissue and cause hypothermia, especially with large burns.
• Don’t Break Blisters: Blisters protect against infection. If one breaks, clean it gently and cover with an antiseptic dressing.
• No Fluffy Bandages: Cotton fluff can stick to wounds and cause infection.
• Don’t Apply Grease or Creams Not For Burns: Home remedies like butter or oils trap heat and increase infection risk.
• Don’t Pull Off Stuck Clothing: Cut around stuck fabric instead of pulling to avoid more skin damage.

Quick List: Burn Do’s and Don’ts

• Do: Use cool water, gentle bandages, clean dressings, and over-the-counter pain relief.
• Don’t: Put ice, butter, ointments not made for burns, or fluffy bandages on burns.
• Do: Remove jewelry before swelling.
• Don’t: Remove stuck clothing or pop blisters.

Managing Burn Recovery and Emotional Support

Burn injuries can cause lasting effects like scarring, contractures, and changes in movement. These physical changes, along with frequent treatments and possible complications, can affect daily life and emotional health.

Ways to Cope:

• Connect with Others: Support groups help people share experiences and find encouragement.
• Focus on Nutrition: Eating well aids healing and reduces complications.
• Attend Regular Rehabilitation: Rehabilitation improves mobility and prevents contractures.
• Stay Informed About Complications: Learning about risks helps people take steps to prevent problems.

Healthcare professionals can suggest resources for support if needed.

Getting Ready for Your Visit

Prepare before seeing a doctor for a burn. You may need to visit a burn center, emergency department, or family doctor, depending on the burn’s location, depth, and size.

Treat severe burns, burns on the face, hands, or joints, or burns that cause trouble breathing as emergencies. Hospitalization may be necessary for serious cases.

Bring important information and a list of questions to your visit. Write down details about the burn and anything unusual you’ve noticed. Include a list of medicines you take and any health problems, such as diabetes.

Sample Questions to Ask:

• Do I need special treatment for this burn?
• Are there different treatment options to consider?
• Are prescription medicines needed, or can it be treated at home?
• How long does healing usually take?
• Are there signs I should watch for that mean I need more urgent care?
• Will follow-up visits be needed?

Having this information helps the medical team decide the best care and understand your unique needs.

How Your Healthcare Provider Will Guide You

The provider will ask how the burn happened. They will also ask when and where it took place.

They might ask if you have had difficulty breathing or other symptoms since the injury. Other questions may include:

• Whether you have tried any home treatments
• If you have a history of medical conditions, like diabetes
• What changes you have noticed in the burn’s appearance