Burn Injury Management
As we wrap up Fire Prevention Week, an important topic to discuss is the proper treatment of burns, whether in the workplace or at home. 🔥⚕️
To start things off, there are four different degrees of burns:
• 1st degree is superficial and only affects the epidermis (like most mild sunburns)
• 2nd degree is a partial thickness burn that goes down to the dermis, signified by increased redness, blistering of the skin, and may be swollen and painful. (NEVER pop the blister!)
• 3rd degree (full thickness) burns involve all three layers of the skin, and may look white or blackened and charred. This is a medical emergency and should be treated in an emergency room.
• 4th degree burns extend down to the muscle and bone. Since the nerve endings are destroyed, there is no feeling in this area (however, you will still feel the 1st, 2nd, and 3rd degree burns surrounding the 4th degree burn). This is a medical emergency and should be treated in an emergency room.
The main thing you want to do when you are burned (or when helping someone else who is burned) is STOP the burning process. If you're able to get to the burn quickly after it happend (<5 minutes or so), then immerse the affected body part in cool (not cold) water for about 10-20 minutes to limit the depth and extent of the burn. If it's been more than ~5 minutes since the burn occurred, water immersion will have little benefit except pain relief. Note that with burns from tar, asphalt, paraffin, or oils that retain heat (or when melted fabric adheres to skin), cooling may help for a longer period of time.
• If cooling for pain relief, do not cool or moisten >10% of the total body surface area (TBSA - look up the "Rule of Nines") at any one time to avoid hypothermia.
• Remove any clothing and jewelry from the affected body part(s) and distal to the injury. If the clothing is melted or otherwise stuck to the skin, cut around it to avoid pulling the skin off or simply leave it and let medical professionals do it.
• In burns OVER 10% TBSA, apply dry sterile dressings, and keep the patient warm to lessen the chance of hypothermia.
• In burns LESS THAN 10% TBSA, apply moist dressings (e.g., burn dressings or saline-soaked gauze, both available over-the-counter).
• NEVER use ice to cool a burn! It is extremely cold and can cause additional damage to the skin, as well as increase your risk of infection or frostnip. It also decreases bloodflow to the area, therefore stopping the body's healing process.
Comments (10)
This is coming into not only Fire Prevention week, but the wonderful time of year where people think it is great to superheat oil over an open flame and then put a turkey into it with out completely thawing it.
Cooking Safety to help prevent burns to the little running around outside and in kitchen.
Great information. Thanks for sharing.
As you know I have lots of lots of WC experience!
In my experience major burns are THE MOST EXPENSIVE INJURIES there are by far, not even close! Major amputations you are talking $100K to $500K depending on limb and degree of loss. Major MDS surgeries, like a Rotary Cuff Rebuild of a Shoulder, my worse case was $500K and I once had a elbow and wrist case that went almost that high! Heck even a fatality your are talking a few thousand in hospital bills and 10 years of full WC benefits to the family or estate (in most states). If you max weekly WC benefit is $1250 a week X 52 X10 = $650K (tax free). (Usually the WC weekly benefit is 66.7% of an employees last 52 weeks of average weekly wages to a State Max, in WI it is currently $1250 a week - the employee would have to average $1800 per week in wages). So even a high income employee the max cost to the employer for a fatality is about $750K.
But if you are talking major burn cases where the employee is sent to a major trauma burn center (usually at a university medical center) you are talking easily costs in the several million dollars for a 6-month stay (an many are much longer). Back in the 80s I had an electrician that was in the University of Michigan Burn Unit for one year. I left the company three years post accident and we were at the $7,500,000 dollars expended with $2,000,000 more reserved (total cost was over $9.5 Million and still going).
When I present a case to an employer on whether they need to comply with the NFPA 70E requirements to comply with labeling their boxes. Some balk at the $35,000 cost for an average sized plant for an Arc Flash Study. I always point out that should they have an arc-flash injury the $35,000 is peanuts if the have a major burn case! If it happens to an employee your Mod Rate will BLOW UP! If we are talking an injury to a contractor your WC is not affected! But because of insurance subrogation your talking company liability in the MILLIONS!