Burns- Simple to treat, but painful to bear

From simple sunburns during a holiday to hot steam from that Dum-Biryani, many of us have experienced burns at one time or another. Burn can easily be caused by heat, chemicals, electricity, and sunlight or in some instance radiation. It has been found from a study that around 4 lakh people are affected with burn related injuries in Bangladesh annually, where children and females are were estimated as the risk population.

It has been noticed that nearly half of severe burns and scalds (cheka-in benglai) occur in children aged under-five. And most of these accidents happen in the kitchen. Many accidents involve the child reaching up and pulling a cup or mug of hot drink. Another most common is slipping of hot liquid from the stove or touch from teapots, irons or heaters.

What to do at home
! Remove the fire/heat source and stop contact of the victim with the hot objects / electricity. In situations, the common advice is to 'stop, drop and roll' process, if the clothing is on fire.
! Run tap water within 30 seconds (i.e. cool the injured area, as soon as possible with running tap water, mind it, no ice should be used
! The victim may be in great pain; hence pain killers such as Ibuprofen can be taken.
! Toothpaste, butter, eggs, etc should not be applied to the burnt area, there are no known benefits, and rather they may worsen it. It's better to apply tropical antibacterial ointments, (mediations such as Burn creams are also available in market, hence always keep one at home)

When to seek medical attention
! Any partial thickness burn that involves eyes, ears, vital appendages (hands, feet), or joints.
! Any partial thickness burn that is twice the size of one's palm (it's a rough estimation of 9% burn)
! Any full thickness burn, i.e. if there is no pain or skin looks charred.
! If pain is intolerable or are unsure of extent of injury.
! Any sort of breathing problem experienced after the injury.
! If the victim is unconscious or electrocuted.

Special attention
! Electrical burn can cause Arrhythmia even when the patient seems normal, which is dangerous, hence an E.C.G should be done to exclude complications.
! The tetanus shot should be taken accordingly, as burned skin is highly susceptible to infection.
! Never prick the blisters, they may seem ugly, but they are for the natural healing of the skin, They will burst or fade away, on their own, pricking them will delay healing.
! Contractures can develop, which is the worst thing that can be caused due to burn. It causes deformity of the limbs. Hence, plastic surgeons should be consulted, to prevent them.
Burn is a devastating type of injury with long-term physical and psychosocial effects. Along with its traumatic nature, painful treatment can sometimes induce psychopathological responses [Van Loey NE, Van Son MJ]. Interdisciplinary rehabilitation due to physical and psychological complication is not uncommon in burn injury [Esselman PC]. Along with the advancement of medical care, survival rate has been increased, however long term morbidity following burn injury remains a huge burden [Rivara FP]
 

The writer is Research Physician
Centre for Child and Adolescent Health (CCAH)
International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B)