Burns are something that you can come across in many different areas. It might be a temperature burn where someone’s touched something very hot, it could be flames, it could be steam, or even sunburn or chemical burns.
Now, the general rule for burns will be to run a burn under cold water or pouring water for at least 10 minutes. The idea of this is too cool the burn. What we don’t want to do is get someone to have a burn and the leave it for less than that, because it will carry on burning. We need to make sure that the skin is fully cooled. It might well be that you’re in a situation where you haven’t got access to running water, and that’s where the burns kits come in. They’ll come in different sorts of cases, different sizes. You commonly see them in kitchens or areas where burns are high risk, sometimes in factories. Inside there are different types of dressing that you’re likely to need. The actual dressings themselves are a gel-based dressing, so when you take them out, they’ll go onto the skin. They’ve got a liquid gel on them and they’re cooling. Also, they won’t stick to the burn, ‘because the big problem with any burns would be clothing or something like that that sticks onto the burn. And if you then pull that clothing off, you can make it a lot worse.
The other big problem with burns is infections. A lot of time in first aid, we don’t worry so much about infection of a wound because we’re dealing with a serious bleed, but with burns, the skin has been removed, therefore, the barrier’s been removed, so it’s important to try and keep that burn very, very clean.
The other thing with burns is they can be painful. There are different levels of burns. We have superficial burns, where the outer layers of skin have been burnt. These can be through various different things. You have partial thickness burns. This is where it’s a deeper burn. It’s commonly shown with blistering. Sometimes even something like a severe heat burn or a sunburn can be at this level. Another one would be full thickness burns, this is where the burn has gone straight through the layers of the skin. Now, these sometimes can be painful, other times not because all the nerve endings would’ve been removed. But you also get a mixture of them, so you might have a full thickness burn in the middle and then as it goes out to superficial around the outside.
The first thing you need to do with them is to observe the area, have a look at the area, and find out what the because of the burn was. And other things that can vary would be things like the age of the patient. If they’re very young or very old, the skin’s going to be much thinner, therefore more prone to be a more severe burn. Also, the location of the burn. It may well be certain areas of the body that have been burnt that would be more important. For example, around the respiratory system, that could give a major problem, because it can affect someone’s breathing. We then do a size assessment of the burn. This is typically called the Rule of Nines. The body is then divided up, so roughly speaking, the size of their hand will be 1% surface area. The head is 9%, the front of the body is 18%, the back of the body is 18%, legs are 18% each and arms are 9% and 9%.
What we’re dealing with that is giving a rough idea of how bad the burn is and whether we need to turn to the emergency service, and also, we can give a better indication when the emergency services arrive. Around here, some different equipment we’ve used with burns. The first one would be cling film. We’ll show this in a separate video of how to put this on, but the idea here is it’s a cling film or burns film, they work the same and very, very good, so they provide a good layer over the burn and they don’t stick. If you’re using standard dressings on the burn, you’ll find they can stick and then have to be removed. They can be very painful and do more damage. The key thing with this is always take off the first few rolls of it so that you can make sure it’s clean. While we’re talking about cleanliness, the important thing with dealing with any burn is you must make sure that you keep yourself clean as well and you’re wearing gloves, so when you’re dealing with these examples, make sure you do wear your gloves.
Inside the burn kit here, there are different things. There are sachets of gel and also burn dressings. And these burn dressings come in different sizes. You can also get them for covering the face, which leaves gaps in them for breathing through the nose or through the mouth. We’re going to look at these dressings in a bit more detail. We’re going to actually open them up. They’ve all got a tear mark to make sure it’s easy to rip them open. They will have expiry dates on them as well. And you need to make sure you keep the packaging nice and clear, so putting them in a kit like this is great. If you just keep one loose in the workplace, what’ll eventually happen is you’ll find, like this, that damage can happen around the burn dressing, and even when it’s in date, you might find the dressing starts to dry out.
With these, you just tear the top and open up the dressing, and then inside the dressing is the burn pad itself and also the gel. Once you lay that onto the skin, you can then even pour the spare gel on top to keep it cool. And these won’t stick. Other things inside the kit are a variety of different sizes, so here we’ve got the larger ones in this particular kit. And on the other side, there are some bandages. Now, these aren’t for that area the skin. They’re really to hold any dressings you’ve got or pads in place, and the cling film, things like that, in place. Also in here are some scissors. These are for cutting away clothing. You wouldn’t peel off the clothing from where the burn is, but you might well cut it. If there’s a burn here and the clothing is stuck to it, you can just cut it around the outside. Leave that bit on, but just cut the rest off, so when they move their arm, they’re not going to be pulling that burn over the burn itself.
Other things in a burns kit are a spray or a liquid that come in different forms and you can apply that directly to the burn to act as cooling. Lots of different things available. There are different brands available as well. It’s a good idea to make sure you’ve got a burns kit in your workplace or wherever, in kitchens, things like this. And you’d need to base that kit on the risk assessment that’s been done. If you’re working in the kitchen, a small one, they may have one size and others would have a larger. Finally, the other thing you might well have when on the burn side are bottles of saline solution. These are quite good to wash over a burn if you haven’t got water available at the time. And also, if you work in remote areas, you need to start thinking about how could you cool burns off. It may be on the outdoor side or camping and things like that and you get a burn off a gas stove.