Burn with boiling water, what to do?
Content:
- Depth of defeat
- First aid for burns with boiling water
- What to do if you get burned with boiling water?
- Treatment of severe burns with boiling water
A boiling water burn is a type of thermal damage to the skin and mucous membranes caused by the traumatic effects of boiling or hot liquids and their steam. It occurs most often in everyday life, being the main cause of temporary disability among all types of burn injuries. The mechanism for obtaining them can be represented by placing a limb in a boiling liquid or spilling it on the surface of the skin.
Most often, boiling water burns proceed favorably and do not cause serious consequences. It all depends on the volume and depth of skin lesions. They, in turn, depend on a number of factors:
- Hot liquid temperature and composition. Clean water is less damaging than syrup or brine;
- Boiling water volume and skin contact area;
- The speeds and pressures under which the contact occurred;
- The time of exposure to a boiling liquid with a burnt surface;
- Features of the structure and resistance of the affected areas to high temperatures.
There is a clear pattern - the hotter the liquid is and the time it contacts the skin, the more severe the consequences will be. This fact determines the volume of activities that must be carried out without fail in such situations.
Most often, the upper limbs (hands and forearms), less often the feet, thighs, lower leg, abdomen and chest are exposed to boiling water burns. Fortunately, small areas prevail over large ones. With regard to the severity of the burn, superficial damage occurs in 85% of cases. Among other features of this type of burn injury, the best prognosis for recovery can be noted. The exception is burns in children, especially young children. Due to the small surface area of the skin, a significant part of it is affected.
There are no peculiarities regarding the degree of damage in case of burns with boiling water. The classification, which uses 4 degrees (1-2-3-4), is quite understandable and quite convenient. The first is characterized by the appearance of reddened areas. For the second, bubbles with a transparent liquid. The third is characterized by the appearance of either wound surfaces with moderate bleeding, or blisters with a sacred fluid. The fourth degree is the defeat of the entire thickness of the skin and deep-lying tissues (almost never occurs with burns with boiling water). The most common are damage of 1 and 2 degrees. The burn area is determined by the rule of the palm (palm = 1% skin), or nines (each body segment = 9 or 18%).
Depth of defeat
Before proceeding with the treatment of a burn, it is necessary to determine its degree and the area of the affected area. For first and second degree burns, treatment can be carried out at home, while for third and fourth degree burns, the help of a doctor is needed.
- Grade 1 - the surface layers of the epithelium are damaged, swelling and redness, painful sensations, burning sensations appear. Such burns usually heal on their own after a few days without additional intervention.
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2 degree - the depth of the lesion is greater, it captures not only the surface layers of the skin, but also part of the tissues that lie deeper. The painful sensations are stronger and more prolonged; second-degree burns are characterized by the formation of thin-walled blisters filled with liquid. After two weeks, they heal on their own without scarring, medical help may be needed only in case of infection.
- Grade 3 - damage to superficial and deep-lying skin tissues. Third-degree burns are additionally classified into grades A and B. A-grade is characterized by the formation of blisters with thick walls and scabs. Tissue regeneration occurs due to the surviving epithelial cells, secretory glands and hair follicles. Grade B is characterized by severe damage with tissue necrosis and purulent inflammation, a moist wound is formed, after which a scar remains.
- Grade 4 - with skin lesions in areas where the layer of subcutaneous fat is thin, black scabs and charring are formed.
If the healing of a first and second degree burn does not occur within two weeks, the inflammatory process intensifies, and signs of infection appear, you should consult a specialist. Treatment of burns of the 3rd and 4th degree of severity is carried out only in a hospital setting.
In addition, if burns of the first or second degree of severity occupy a significant area of the body (from 30%), there is a danger to the patient's life, such a situation requires medical intervention. Burns of the 3rd and 4th degree are life-threatening if they occupy more than 10% of the skin area.
How to independently correctly determine the area of skin lesion?
- Wallace's Method or the Rule of Nines - each body part corresponds to 9 or 18% of its area. The area of one arm is taken as 9%, one leg is 18%, the head, back and front surface of the body is 18%, the groin area is 1%.
- Glumov's method or the rule of the palm - the area of one palm is taken as 1% of the total area and the affected area of the body is measured with the palms.
First aid for burns with boiling water
First aid measures must be truly urgent. The timeliness of their delivery will determine the severity of the process and its consequences. Do not panic, whoever this trouble happens to. Only a clear sequence of actions can help in the fight against the prevention of severe complications.
Other activities include:
- Elimination of direct or indirect contact of a boiling liquid with the skin surface. For this, the heat source must be removed from the burnt surface. In the same way, all objects that were on the skin at the time of the burn (clothes, rings, bracelets, etc.) are removed;
- Creation of hypothermic conditions for the burn surface. This is necessary in order to cool overheated tissues, which maintain a high temperature for a long time after the burn, aggravating the severity of the primary injury. For these purposes, it is necessary to place the affected segment in cold water (like a cold bath, or running). The duration of hypothermia should continue for at least half an hour. After this time, the limb can be removed. If there is a burning sensation, the procedure is repeated. Cooling can also be achieved with ice or cold objects.
- The imposition of limiting dressings on the burned surface. They can be presented either dry, or wet-drying, or ointment on a water-soluble basis. At the prehospital stage, you should not waste time looking for various special means. You need to use what is at hand or in the first aid kit. It would be correct to include antiseptic solutions (furacilin, dioxidine) and local anesthetics (lidocaine, novocaine) in the dressing, which will have an analgesic and antibacterial effect, which will prevent infection of the burn surface.
- For large or deep burns, accompanied by severe pain syndrome, pain relievers are indicated.
Related article: Providing first aid for burns, both medical and pre-medical
What to do if you get burned with boiling water?
What can not be done with boiling water burns:
- Apply medicinal ointments to the skin immediately after the burn - first, the affected area must be cooled;
- If a bladder forms during a burn, in no case should it be pierced - this increases the risk of infection and can slow down healing;
- It is impossible to use alcohol-containing agents (iodine, brilliant green, tinctures of medicinal plants), toothpaste, vinegar and urine for the treatment of burns, since these substances irritate the skin and aggravate its condition. Sea buckthorn oil enhances tissue regeneration and promotes wound healing without scarring, but it is not recommended to use it for the first time after a burn. The oils close the pores, creating a film on the skin and preventing it from breathing.
- If the affected area is covered with clothing, it should be removed immediately. Tissue adhering to the wound surface should be carefully cut at the edges.
- To wash the wound immediately after the burn, use pure water, and not slightly alkaline or acidic liquids (solution of soda or citric acid, kefir). Acid irritates the skin and complicates its healing, increases painful sensations, and fermented milk products, in addition, also increase the risk of infection.
What you need to do in case of a burn with boiling water in the first place:
- Stop exposure to the factor that caused the burn immediately. If boiling water gets on the skin covered by clothing, it must be removed immediately before it sticks to the wound.
- The thermal effect on the skin and nearby tissues does not stop immediately after the removal of its source, so the affected area should be cooled under running cold water for fifteen minutes or a compress with ice should be applied to it.
- For first-degree burns, the best remedy for relieving pain and accelerating wound healing is sprays containing dexpanthenol, which have a healing and anti-inflammatory effect - panthenol or its analogs Pantoderm and Bepanten. It is applied to the burn surface directly from the bottle, without touching the skin, and left until absorbed.
- To treat second-degree and heavier burns, a bandage is applied after washing the wound. A bandage is not used on the face; a thick layer of petroleum jelly is applied to the affected area.
- A victim with deep burn injuries of tissues must be warmed up, given tea, provided with plenty of water or alkaline drinks (herbal or green tea, lemon water). In case of severe pain, it is necessary to inject an anesthetic and continue treatment on an outpatient basis.
What to do if you get burned with boiling water at home?
There are two methods of treating burns - open and closed, when closed, an aseptic bandage is applied to the affected area, and with open treatment, only external agents are used, and the bandage is not applied.
For first-degree burns, you can apply the bandage yourself. Bepanten or an antiseptic ointment is applied to the wound, after which it is closed with a dressing material, which can be used as a cotton cloth. It is not recommended to use gauze and bandages as a dressing, as they stick to the wound and injure it when changing the dressing. The bandage is changed every 3-4 days. If the wound has healed by the time the dressing is changed, then it is not necessary to dress it again.
For burns of the second severity, the doctor applies a bandage, carrying out the primary treatment of the affected area. Change the dressing in two days on your own, following the doctor's instructions.
The procedure for the closed treatment procedure:
- The patient is anesthetized;
- The skin around the wound is treated with an antiseptic;
- From the surface of the burn, adhered tissue and dirt, dead epithelium are removed;
- Large burn blisters are cut from the sides, fluid is released from them, leaving the upper part intact to protect the wound from mechanical damage;
- Apply a bandage treated with a bactericidal agent (streptomycin, levosulfamethacaine).
Treatment of severe burns with boiling water
Third and fourth degree burns are treated only in a hospital. Immediately upon admission, the patient undergoes anti-shock therapy, injections of painkillers.
For the treatment of burn injuries in the face and perineum, where the skin is especially thin and sensitive, only the open method is used (without the use of a bandage). Antiseptic ointments and petroleum jelly are used, which are applied to the affected areas three times a day.
Surgical treatment of severe burns (degrees 3 and 4B) is aimed at excising necrotic tissue and correcting the defect, after which plastic surgery is performed. The main tasks in the treatment of burns are to remove toxic substances, prevent suppuration and inflammation in the wound area, accelerate healing and remove dead areas.
See also the article: How to get rid of a burn at home?
The author of the article: Volkov Dmitry Sergeevich | c. m. n. surgeon, phlebologist
Education: Moscow State University of Medicine and Dentistry (1996). In 2003 he received a diploma from the Educational and Scientific Medical Center of the Presidential Administration of the Russian Federation.
