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Burns, like most injuries, have very varied degrees of severity. After your first response, (which would be shouting expletives) get the injured area cooled off. Cold water is the best. Ice can be so cold as to cause further damage to the tissues. If you use ice, be sure to have a layer or two of paper towels or cloth between the ice pack and your skin.

Steam burns can actually be worse than hot liquids because the steam is hotter than hot water; so hot is vaporized off. Hot liquids onto clothing can cause a delayed burn so get the hot fabric off your skin as quickly as possible. Oil burns can be considerably hotter than steam burns and may be difficult to rinse off.

Chemical burns can come from acids or bases. Either way, rinse them off IMMEDIATELY. Acids can be neutralized by putting a base, like baking soda on the area. Basic chemical burns, like lye, just have to be rinsed and rinsed and rinsed.

A first degree burn means that the skin turns red. A second degree burn means that there are blisters. Third degree burns means there is full thickness damage to the skin and fourth degree burns, the worst, may involve muscle or bone. Third and fourth degree burns may not even hurt because the nerves are destroyed. As the tissues heal and the nerves come back, it can cause an incredible amount of pain. (Under most circumstances, people with third and fourth degree burns have a lot of pain because of other areas with lesser degree but more painful burns.)

The body surface area (BSA) is estimated by the medical professionals in cases of serious burn to estimate intravenous fluid requirements during burn resuscitation. There are charts they go by to make the estimate, roughly 1% is equal to the size of the palm of the hand of the patient.

For most of us, we just want to know what to do at home with a burn from cooking or an iron. (Let me just interject here that I strongly believe that cooking and cleaning are extremely hazardous undertakings and should be handled only be adequately trained professionals. Did that work? No? I still have to do all this stuff around the house? Darn!)

So first, cool it off. Keep it cool for a long time; as long as it takes to stop burning. That may take half an hour or more. You will, of course, notice that when you take your cool compress or cold water away, it hurts a lot. That would be an indication to keep cooling the area. Take an anti-inflammatory drug, like ibuprofen (Motrin), naproxen (Aleve), or aspirin.

Do not put butter, lard or any greasy product on a fresh burn. It doesn’t help and can even trap the heat a bit and make things worse.

I think every house should have an aloe plant in it. Aloe plants provide an excellent topical anti-inflammatory. Just take a leaf and split it open and put the gel inside onto the burned area. If your plant is getting too big or unwieldy, whole leaves can be wrapped in plastic wrap or foil and kept in your freezer. They thaw quickly or can even be applied as your cold compress.

If a burn is so bad that you think you can’t handle it at home, please call your doctor. They might see you or send you to the emergency room. If the burn is to a specialized area, like around he eye, that is much more of an emergency and should be seen in an emergency care setting immediately. If you’ve burned your finger, take any rings off as soon as possible so that any subsequent swelling won’t cause problems.

After you’ve got things cooled off, you’re left dealing with damaged skin. Cold compresses, aloe and oral medicines can all help. Leave blisters intact as long as you can. They provide the best sterile moist environment for healing. If the blister pops, you can leave the deflated skin in top of the wound. If there is a raw area, do not leave it open to the air. Put a layer of Vaseline or Bacitracin over the open area and cover it. Your body naturally puts a moist dressing on burns with the formation of blisters, so it makes sense to try to replicate that environment. If allowed to dry, the raw area can crack and that lets germs in to cause infection.

Make sure you are up to date on your tetanus shots. Watch for signs of infection like an increase in redness or pain after the first couple of days. Get a doctor to look at it if you’re not sure. Burns scar and there isn’t much to do about that. As the skin heals, keep rubbing it to keep the scars as soft and flat as possible. Silicone dressings prescribed by doctors can help too.

Burns can hurt for a long time. Be patient. Keep the healing skin supple and moisturized.



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