Thermal burns can result from construction activities like welding or cutting, maintenance or cleaning tasks, and commercial kitchen and restaurants operations. Thermal burns are very different from electrical burns and must be treated accordingly. This handout will address thermal burns in some detail and provide background information and guidance on treatment of these injuries. Knowing these facts can help when faced with a burned employee.
There are three burn classifications, these are: first, second, and third-degree burns. The severity and recovery time from the burn increases as the classification increases. In first-degree burns only the outermost layer of skin (epidermis) is affected. The skin will be red, mildly swollen, and slightly painful to touch. A mild garden-variety sunburn is a first-degree burn. With second-degree burns the heat passes through the epidermis and affects the second layer of skin known as the dermis. Second-degree burns are characterized by a higher level of pain and swelling – and they are always accompanied by blistering. Both first and second-degree burns are termed “partial-thickness burns”. Third-degree burns reach into the underlying fat and muscle tissue and are termed “full-thickness burns”. With third degree burns the skin will appear charred and leathery; it will be numb to touch – for all intents and purposes it is dead. Much like a piece of wood in a campfire – a single thermal burn on the body can exhibit characteristics of all three classifications simultaneously.
Proper response to a thermal burn will vary according to the size, location, and severity of the burn. Burns to the face, neck, hands, feet, genitalia, and buttocks are considered most serious. Facial burns can cause serious damage to the respiratory system. Burns encircling a body part or the trunk (circumferential burns) can have an effect on the body similar to a tourniquet. Severe burns or burns that involve much of the body will require hospitalization and specialized treatment if the victim is to survive. These severe burns can result in “burn shock” where the damaged capillaries allow blood serum to leak into the burned tissue. This fluid loss translates into drop in blood volume sending the victim into shock not unlike a major bleeding episode. People with severe burns require massive amounts of fluids to survive and these are most commonly administered intravenously.
How to Deal with a Burn
Pour clean cold water over the area immediately to stop the burning. Remove burned clothing and jewelry before swelling begins. To decrease the pain smaller partial thickness burns will benefit from being wrapped in a towel drenched in ice water; or from submersion in cold clean water. Like any wound, a burn should be kept clean and free from debris. Second and third-degree burns should be covered in a thin layer of antibiotic ointment. Cover the area with a sterile non-stick dressing and bandage. If the burn oozes wash the area with warm water daily and replace the dressing and bandage. Use of aloe vera to prevent blistering and ibuprofen for pain are the typical countermeasure for first and second-degree burns. Burn victims should be encouraged to drink plenty of fluids since dehydration is common. If third degree burns are suspected the victim should be taken to the hospital or clinic immediately.
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