This is the third post of our 3-part series on burns. Read part one for more on chemical burns or part two for more on electrical burns.
Nearly half a million people in the US go to the emergency room with burn injuries every year. The most common type of burn injury is a thermal burn.
Thermal burns occur when the skin comes into contact with something hot, like boiling water, a hot stove top, or steam from an iron. Children, especially toddlers, are prone to scalding from liquids or flames. About a quarter of all annual burn injuries in the US occur in children under the age of 15.
Here is more about thermal burns, their causes, treatment, and when to go to the nearest emergency room.
Defining Thermal Burns
Thermal burns occur when you make contact with a heated object, either dry sources like flames or hot metal, or wet or gaseous sources like smoke, steam, or superheated air. Scalds can also occur in your airways, making it difficult to breathe.
You can identify potential airway burns by looking for the following:
- Burned lips and mouth
- Burns on the face, head, neck, eyebrows, or nose hair
- Coughing
- Changes in the voice
- Shortness of breath or wheezing
- Dark, black-stained mucus
Thermal burns range from first to third degree.
First-degree burns involve the top layer of the skin and darkening it or turning it red or pink. The burn is painful and warm to the touch, but there are no blisters or sloughing skin.
Second-degree burns appear moist, reddened, and painful to the touch. They involve the first two layers of skin, the epidermis, and the dermis. The burned area blanches or turns pale when you touch it and can develop blisters.
Sometimes second-degree burns can develop into third-degree burns, or you can have both in the same area.
Third-degree burns are the most serious and involve all layers of the skin and advance into the underlying tissues.
A third-degree burn can appear dry, tight, leathery, waxy, tan, or pearly white and will not blanch at the touch. The capillaries cannot be refilled due to tissue damage. The burn is relatively pain-free because of nerve damage and typically does not blister.
Some third-degree burns are so severe that the skin and tissues char and the burn can reach the bone or tendons.
Causes of Thermal Burns
Most people have experienced one or more thermal burns in their lifetime. The causes of thermal burns are everywhere.
The National Fire Prevention Association (NFPA) says about half of all injuries involving grills are thermal burns. Cooking, in general, is a common way for people, especially children and pets, to sustain thermal burns, and microwaves introduce new ways to get hurt. The FDA says microwave injuries most often occur due to overheated foods, exploding liquids, and hot containers.
Other appliances can be a source of thermal burns. Personal heaters, especially older ones, can cause burns and fires. Heating pads and electric blankets can burn the skin if misused, and clothes dryers cause more than 2,900 fires annually, which could result in thermal injuries.
Candles and fireworks are common causes of thermal burns and fires. December is the peak month for candle burns, with three times as many candle and incense fires occurring on Christmas Day than any other.
Mishandling fireworks or improperly discarding hot debris is often responsible for thermal burns to the hands, legs, or head.
The pavement in summer can cause thermal burns to unprotected feet and paws. Asphalt, artificial grass, and concrete can become so hot that they will blister any skin in contact with it.
Thermal Burn Treatment
Though many day-to-day activities can result in burns if you’re not careful, there are ways to treat them.
First of all, never use butter, lotions, oil, or grease to treat a burn. If you must, you can use petroleum jelly or aloe vera if the burned area is clean and affects only the first layer of skin (a superficial or first-degree burn).
For all burns, stop the burning by putting out the fire or removing contact with hot liquid, steam, or other hot materials. If necessary, help the person stop, drop, and roll to smother the flames.
Remove any smoldering material from the person and remove any hot or burned clothing unless it sticks to the skin. In that case, cut or tear the fabric around it. Remove or loosen constrictive clothing because burns swell. Take off jewelry, belts, and other tight wearables. If the skin is blistered, avoid breaking or bothering the blisters to avoid infection.
Call a doctor for the following:
- First or second-degree burns larger than three inches
- Burns on the face, hands, or feet
- Burns on the buttocks, groin, or joints
- Any burn that encircles a limb or digit (finger or toe)
- Burns accompanied by any other symptoms, such as fever, difficulty breathing, or confusion
Treat first-degree burns by cooling the area with cool, not cold, running water or using a cold compress until the pain eases. Protect with a sterile, non-adhesive bandage or a clean cloth, and treat the pain with over-the-counter medications. See your doctor if you see signs of infection, redness, swelling, increased pain, fever, or oozing.
Treat second-degree burns similarly to first-degree burns. Cool the burned area in running water for 10 to 15 minutes or use a cool compress. Do not use ice or break blisters. Protect with a sterile, non-adhesive bandage and use shock prevention measures. See a doctor to determine burn severity and for antibiotics and pain medication.
What’s the difference between an ER and an urgent care facility? Here’s what you should know.
When to Get Emergency Treatment
A third-degree burn requires emergency treatment. Protect the burned area by covering it loosely with a non-stick sterile bandage or a large sheet or other material that will not leave lint in the wound. (No blankets or towels.)
Don’t soak the wound in water or apply any ointments. Separate burned fingers and toes with dry sterile dressings. Use shock prevention measures, avoiding pillows under the patient’s head if they have airway burns and sitting them up if they have facial burns.
Severe third-degree burns require emergency treatment at a hospital where they can debride the wound, supply IV fluids, dermal grafts, and blood transfusions.
Get emergency help for the following:
- Extensive second-degree thermal burns on the body
- Any third-degree burns
- Difficult breathing due to a facial burn (it might indicate an airway burn)
- Heavy exposure to smoke in a closed area
- Unconsciousness
- Burns penetrating all layers of the skin, if the skin is charred and leathery, with white, brown, or black patches
- Burns on an infant or elderly person
With burns, it’s always better to be safe than sorry. Visit your nearest emergency room to have a healthcare professional assess the burn and treat it.
Visit Family First ER
Family First ER’s highly trained staff can assist you with thermal burns 24 hours a day, 7 days a week. We can provide the first stages of emergency treatment and prepare the patient for the hospital if needed.
Burns that break the first layer of skin require immediate treatment, and severe burns need the services of experienced healthcare personnel.
Don’t hesitate to call or come to Family First ER with your thermal burn wounds.