# Handling Thermal Burns



## GPS1504 (Dec 13, 2013)

When the ability to create fire was first developed by early man, rejoicing was in order. This new source of warmth likely saved many lives, as did the ability to cook food and kill bacteria. For all of the benefits fire has provided over the course of time, one large drawback has consistently loomed, that being its ability to cause severe burns and even death. Although evolution has brought us to a place where dependence on fire for survival is not what it once was, there is the possibility that TEOTWAWKI can send us right back to a state of fire dependence. Should this occur, it will be important to know how to treat thermal burns in advance of their occurrence.

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_Photo: Urgent Care Locations_

When a burn occurs, the first step in treatment is to eliminate the threat. This means removing the person from the heat source and putting out any residual flames. There is a possibility that the burned person may have come in contact with a hot surface that is no longer present or it could be that their clothing is still on fire and needs immediate dousing. The quickest way to do this is through the use of the 'Stop, Drop, and Roll' action we were taught as children. This action may be uncomfortable to a burn victim, but it is a quick way to smother flames and put them out.

Once the fire is completely out, you can begin the process of assessing damage. Since the type and severity of burns will determine how they are to be treated, you will need to estimate the amount of surface area that has been burned. This is easiest to do by quickly estimating the percentage of flesh that is burned by locating the burned area and measuring it in comparison to your palm. Your palm accounts for about 1% of the body's surface area, so if the area is about the size of four palms, the body is 4% burned.

While most burns are first degree in nature, there are several classifications for burn type and severity. These include:


First degree burns, which are superficial and stop at the epidermis, feel dry and appear red.
Second degree burns often appear red and go on to blister with either clear or white blisters that bleed in some cases. These extend deeper into the skin than first degree burns.
Third degree burns extend through the entire dermis and make the skin feel coarse and thick. In addition to having a leathery appearance, they will have a stiff quality and dark coloration.
Fourth degree burns are those that have moved beyond skin and into muscle and bone, charring the body in the process, and often requiring amputation.

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_Photo: Journal of American Medicine_

When the time comes to apply treatment, first degree burns and small second degree burns can be treated by rinsing them with cold water and applying a cold compress (do not use ice and it causes blood vessels to constrict, equating to further damage). After applying a compress for about 20 minutes, rinse the area once more to clean it of debris and foreign objects that may be stuck to the skin, then wrap with sterile gauze that should be changed daily. Do not pop blisters that form, and do not apply butter as this is an old wives' tale that should not be attempted. Topical antibiotics can be applied if you have them, but if not, honey can be used to aid in healing.

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_Photo: Exponent.com_

If more than 10% of the body is burned, the method above should not be used as cold water can actually make things worse by taking a body that now has issues with temperature regulation and making it hypothermic. Instead, focus your efforts on lifesaving instead, maintaining breathing and blood circulation. If there is clothing or jewelry contacting the body at the burn site, do not remove it as that could cause more damage to already delicate tissue. It is better to cut away loose fabric and leave that which has become stuck in place for the time being.

Unfortunately for severe burns in a situation where medical care is not available, the most that can usually be done is making an effort to sustain life and prevent infection. It is only at the hands of medical professionals that life-saving efforts such as surgical debridement (removal of dead tissue), skin grafting, and amputations should be performed.

Another aspect of burns is internal damage. You may not be able to see these burns, but burnt debris accumulation around the mouth and nose are a good indicator of such an injury. As we breathe, it is possible to inhale high levels of heat that can wreak havoc on the respiratory system, but again, situations such as this can only be helped by supportive care, antibiotics, proper hydration, proper body temperature regulation, and time to heal.

Ultimately the best way to survive a burn is to prevent one. If you take precautions around campfires and avoid close proximity when fire is present, you will have a better chance of avoiding painful burns. However, if something unavoidable takes place, have a plan for caring for potential injuries to the best of your ability.

The information contained herein is no substitute for professional medical care, but in the absence of doctors of hospitals, it might give you an idea where to start.


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