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Guest Post: Wilderness First Aid: Burns (Alex Estra, MD)

ashes-300x200Burns are serious injuries that frequently happen whether you are in the city or on the trail. Although first and second degree burns may seem superficial or trivial, these burns have a tendency to get infected and the results potentially catastrophic. It is always best to seek professional medical opinion if you or someone you know experiences a burn. In this article we are going to have a short talk on burns and how to provide first aid, prior to seeing a medical professional.

Now there are several ways for you to sustain burns, these are: Friction, Light, Chemicals, Electricity, Heat, and Radiation. Direct exposure to these factors is what commonly gives you a burn. How bad your burn turns out is always categorized depending on the depth of the burn. There are four degrees of burns with the first degree being the less severe, and the fourth degree being the most severe. So basically you have 1) First Degree Burns, 2) Second Degree Burns, 3) Third Degree Burns, and 4) Fourth Degree Burns.

1st Degree

1st Degree

First degree burns: These burns involve the surface layer of the skin or “epidermis”. These types of burns make the skin red and can be quite painful. A mild sunburn is a good example of a first degree burn.

2nd Degree

2nd Degree

Second degree burns: These are burns that affect the surface layer of the skin called the “epidermis”, and the immediate underlying layer or the “dermis”. Like first degree burns the skin is often red and painful. These types of burns however, tend to form blisters. A blister represents a break in the skin and is therefore prone to infection.Second degree burns are usually the most common burns sustained.

Third degree burns:  Now third degree burns burn through the epidermis and dermis, this means the entire thickness of the skin, or what is also called a full thickness burns. These are severe burns and can look pale, charred, or obviously burnt. Third degree burns can be painless due to the nerve endings being burned as well. It can also be painful if the surrounding tissues do not suffer the same third degree burn. Third degree burns are prone to infection and may eventually develop into scars, contractures or adhesions.
Fourth degree burns: The most severe burn involving the muscle and the bone. It is painless and prone to infections. Most of these types of burns may eventually end up with gangrene and need amputation.

Assessment and Treatment of Burns
If you ever need to administer first aid, we have always been taught to first secure the patient’s airway, breathing, and circulation or ABC’s. This usually applies for patients who are conscious. Unconscious patients without a heartbeat have the order change to circulation, airway, and breathing or CAB’s. However, in this article we will assume all our patients are conscious and relatively stable.

The first thing to remember during burns is to remove the source of the burn from the affected area, and then administer early cooling to prevent aggravation of the burn and further tissue loss. Relief of the pain is also prime concern.

Wash the burn – Cool the burn by holding it under cool and clean running water for 10 to 15 minutes or until the pain disappears. Holding it under cool running water not only prevents swelling and further tissue injury, it also relieves pain and also helps to wash out debris in loose dead tissue that may cause infection. Take note that water should be cool and not cold. Never apply ice to the burn, as this may cause more tissue burn.

hand-wrappingCover the burn – The next step is to cover the burn with a sterile gauze bandage. Never use cotton or other material as lint might get into the wound. Remember to wrap the gauze around loosely and without any pressure. This will serve to protect burns and blistered skin.

Pain Relief – You can give any over the counter oral pain reliever such as ibuprofen, acetaminophen, or aspirin, which the patient is not allergic to. Be aware however, that aspirin is not recommended for young children and teenagers even if they are not allergic. Take note as well that most over the counter pain relievers need to be taken on a full stomach or else it might cause stomach pains.
Minor burns such as first and second degree burns usually heal without further treatment. However, it is still wise to have a medical professional see the burn area even if it appears minor. Remember to watch out for any potential signs of infection or complications such as increased swelling, redness, pain, fever, or pus and blistering. Seek immediate medical consult if these things happen, do not attempt any home treatment. Large burns eventually lead to dehydration and infection. This burns need immediate medical consult otherwise it may be fatal. Do not apply any lotion or worse “butter” to the affected area. A burn is a wound and not bacon or toasted bread. Butter is oil and this will aggravate the burn further. Most first degree burns can also be treated with Aloe Vera for pain relief and to keep it moist. You can also apply sterile gauze soaked in sterile 0.9 Sodium Chloride to keep the burn cool, moist, and relieve pain.

Remember every good Survival Kit, has a first aid kit in it!

Alex Estra, MD is a doctor of Podiatric Medicine.  He has an avid interest in survival/wilderness preparedness including survival food and is a regular contributor to Dan’s Depot. Make sure to check out the Survival Kits over at Dan’s Depot.


Check out Dan’s Depot Blog, lots of free tips, free preparedness training and tons of great preparedness supplies.

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