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The survival doctor: What to do for a burn

By: James Hubbard Special to The Gazette
July 30, 2013
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photo - The Survival Doctor James Hubbard
The Survival Doctor James Hubbard 

If you get burned, it's usually a pretty simple matter to get medical help. That is, unless you're out camping or a storm has the roads closed.

No matter where you are, know the first step: Cool the burn. This soothes the pain and stops the damage.

Immediately take off any burned clothes. Even when cooled with water, many synthetics continue to be hot enough to burn skin.

Next, apply cool water or aloe vera. Don't use ice because it constricts blood flow. Never initially use greasy substances such as butter or ointments unless there's hot tar or glue stuck to your skin. Petroleum jelly can help get those off.

With large burns that involve the face or neck, you should get to a doctor quickly, even if that means an airlift, because of potential swelling of the airways. Do the same for extensive burns that involve large areas of the skin.

When it comes to the smaller ones - the ones that are not immediately life-threatening - there are three common complications.

1. Pain - Cooling the area, applying aloe vera and using over-the-counter pain medications can control pain from most first-degree (sunburn-like) burns. But if the pain is too much, you'll have to get professional help.

2. Swelling - Along with the danger of life-threatening swelling to the face or neck if you get burned in that area, there's the danger of a tourniquet effect from a burn that encircles an arm or leg if it swells enough to cut off circulation. Swelling is also the reason you should remove rings or other constrictive jewelry or clothes right away.

Applying cool compresses on the injured area and elevating a burned extremity to heart level or higher can help decrease the swelling.

With larger second- or third-degree burns - say 10 percent or more of your skin (your palm equals about 1 percent of your skin surface area) - the burns can cause so much swelling that you become severely dehydrated. You will need a lot of intravenous fluids.

3. Infection - Anytime there's a crack in the skin, infection becomes a possibility. The more skin surface that is involved and the deeper the damage, the higher the risk. Keep all burns clean with soap and water.

Blisters are the calling cards of second-degree burns. The ones that stay intact act as sterile dressings and help the burn heal. But if they start leaking, infection becomes a risk. As a rule, blisters an inch or more in diameter, or that are on a palm, are more likely to start leaking. If you can't get to a doctor, consider puncturing these and cutting away the dead skin with sterile instruments. Then keep the area clean and apply antibacterial ointment.

Third-degree burns damage all skin layers, including the layer that regenerates your skin. The only way these can heal is for the uninjured skin edges to grow over the area. This takes a while, and the skin can only grow over an inch or two. Until you can get expert help, keep the wound clean and apply antibiotic ointment. If the burn is more than a couple of inches wide, you'll likely need a skin graft.

Remember, these tips are for only until you can get professional medical help.

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Family doctor James Hubbard teaches how to survive during disasters or any time you can't get expert medical help at TheSurvivalDoctor.com

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