Whenever I teach First Aid as an instructor, I try to give as many real life experiences as I can. Either my own personal experiences or of friends and family. As a parent this is especially easy to do, because I have over 24 years’ experience of administering First Aid to my own children.
One such anecdote that I always use when teaching how to treat burns, is my own experience with my eldest daughter when she was only 7 months old.
We were at Grandmas house and drinking coffee at the kitchen table. The coffee cups were not even very close to the edge of the table, in fact they were in the middle as far away as possible from her. However babies are quick and they lunge sometimes very suddenly when they spot something they want. In my daughter's case she probably saw something shiny at Grandmas, because she is a jewellery designer and there were a few items of jewellery dotted around the table. While Grandma was holding her on her lap, within a split second, my daughter managed to knock a hot cup of coffee all over her and started screaming in pain. It probably covered 50% of her body surface area. I quickly snatched her out of Grandmas arms, whipped off her baby grow quickly and started to run water in the kitchen sink.I held her there screaming for about 20 minutes. It was extremely stressful, she was screaming, I was crying but I held her there for as long as possible. Afterwards I wrapped her up in a towel to stop her from potentially becoming hypothermic. In fact I didn’t realise until afterwards, when I looked at the affected area that there were no marks whatsoever on her skin and she ended up not needing any medical treatment. This is because I acted so quickly in treating the burn and if her baby grow had not been removed so quickly this story may not have ended so well. However I don't always recommend removing clothing unless you are sure it is not stuck to the skin as this can cause more damage.
When treating burns, I always explain the burning process. The first stage of the process is when the skin starts to redden and potentially swell which means it has started to damage the first layer of skin the Epidermis. This used to be called a 1st degree burn it is now called a Superficial burn. The next stage is when the skin starts to redden, swell, blister and peel, this means it has now burned the second layer of skin the Dermis. This used to be called a 2nd degree burn it is now called a Partial Thickness burn. This burn is very painful as the nerve endings are still intact. The final stage of the burning process is when the burn reaches the third layer of skin the waxy subcutaneous layer. This used to be called a 3rd degree burn it is now called a Full Thickness burn. The person may not experience the same level of pain or feel anything when it gets to this stage because the nerve endings have been damaged, however areas around the burn that have not gone through to the third layer of skin will still be painful. Therefore the faster you act the more chance you have of stopping the burning process!
The other risk with burns is that the injured person can go into shock. Shock is a life threatening condition that occurs when the body isn’t getting a sufficient oxygen supply. Signs and symptoms of shock are; pale cold and clammy skin (sometimes a bluey grey tinge to the skin pallor and lips), faintness, yawning, a rapid pulse and fast shallow breathing. If someone displays signs of shock, get them to lie on the floor, elevate their legs and feet (if there are no injuries on that part of the body and it is safe to do so), cover them in a blanket to keep them warm and call 999 for an ambulance.
Another thing to be mindful of is BSA (Body surface area), the larger the body surface area of the burn the more serious it can be. To measure the percentage of the body surface affected by a burn, use the palm of the injured persons to identify what 1% of their BSA would look like. Anything over 1% for a child usually requires medical attention, even if it is superficial.
To treat a Burn the British Burn Association ran an excellent campaign as part of National Burn Awareness day on 19th October 2016. Called the three C’s; Cool, Call and Cover.
Cool: What do we exactly mean by cool? Does the water have to be very cold or can you use ice? What about using a burn shield or burn spray?
From a First Aid perspective we still advise cool tepid water works best. You can either have running tepid water in a sink; use a bowl and a jug, shower or bath. It doesn’t matter as long as you are cooling the burn in the first instance using cool tepid water. The water doesn’t have to be so icy cold in temperature that it is unpleasant and feels like you are being burned a second time. Just nice and cool to help stop the burning process from causing more damage to the layers of skin. We also say for a minimum of 10 minutes but longer if needed, in fact 20 - 30 minutes would be perfect if you can. But do ensure that you don’t make the person you are treating (especially a child) hypothermic in the process. Don’t use ice, because ice can stick to the skin.
Cover: What should I cover a burn with? A bandage? Butter? Cream? Toothpaste?
No butter, no cream and definitely no toothpaste! Old wives tales have a lot to answer for and are untrue.
The best thing to cover a burn with is cling film after you have cooled the burn down for at least 10 minutes but 20 - 30 minutes if you can. Cling film does not stick to burns. It is easy to diagnose what kind of burn it is as you can see through it. It protects the skin from infection, but it also stops the burn from drying out and retains the moisture, this stops the skin cells from dying and taking longer to heal. Pull out the first two bits and get rid of them and use the next bit of cling film which should be nice and clean. Make sure you cover the burn without it being too tight as burns tend to swell.
Also teach your children to Stop, Drop and Roll’ should their clothes catch fire.
Stop: If you stop moving it will prevent fanning the flames further and also allow people to help you faster.
Drop: Drop down to the floor flat and cover your face with your hands to protect it.
Roll: Roll over and over to smother the flames, don’t stop until the flames have been smothered extinguished.
With the best will in the world accidents can happen. So always make sure your First Aid knowledge is up to date!