How Do I Treat a Burn Blister?

Burns and burns are more common situations in life, and they can happen to people at any time. The lighter will cause pain to the patient, and the severer will endanger the patient's life and cause lifelong harm. Therefore, it is important to understand the relevant knowledge of burns and scalds.

Basic Information

Visiting department

Emergency Department

Common causes

Damage caused by high temperature substances

Common symptoms

Local pain, redness, swelling, blistering, and damage to the skin

Burns and burns classification

Common burn

Ordinary burns are also known as thermal burns or thermal burns, and refer to injuries caused by high-temperature substances to people. Heat sources above 45 ° C can cause skin burns. High-temperature materials include fire, hot air, hot liquids and solids, etc. This is the more common burn in our lives. Burns caused by hot liquids are called scalds.

2. Special burns

Burns are often not caused by temperature differences, they fall into three categories:

(1) Chemical burns Chemical substances such as acids, alkalis, phosphorus, and chemical weapons cause harm to people.

(2) Electrical burns refer to local skin burns caused by high resistance when current passes through the human body.

(3) Radioactive burns refer to burns caused by radioactive materials such as X-rays and nuclear leaks.

Burns and scalds occur and progress

Occurrence and progression of burns

It is important to understand the occurrence and progress of burns. It is closely related to our self-rescue after burns.

In most cases, the burn hurts the skin first. The skin is an important organ of the human body. In terms of volume and quantity, the skin is the largest organ of the human body. The skin has the functions of excreting waste and poisons in the body, regulating body temperature, and feeling external stimuli. More importantly, the skin covers the human body's surface, which is the body's natural barrier against foreign pathogenic microorganisms.

The skin can be divided into several layers. The most superficial skin is called the epidermis, and the epidermis can be divided into two layers, namely the superficial epidermis and the deep epidermis (the deep epidermis is also called the germinal layer). Under the epidermis is the dermis, which can also be divided into superficial and deep layers. Under the dermis is the subcutaneous tissue. Further down are the fascia and muscles (pictured). After a burn, the skin is damaged first. First the epidermis, then the dermis, which in turn penetrates deep. In severe cases, the subcutaneous tissue, fascia, muscles and even internal organs under the skin can be burned.

Regardless of the type of burn, the damage first hurts the skin, and then gradually spreads to the deep. Therefore, after the burn occurs, measures can be taken quickly to remove the cause of the injury, which can stop the development of the burn and greatly reduce the burn injury. Important.

Judgment of Burn and Scald

Judgment of degree

The severity of the burn depends on factors such as the burn area, depth, location, and the presence of multiple injuries.

1. Estimate of burn area

There are several methods, such as 9 points in Fahrenheit, 9 points in China, and so on. Here is only one of the simplest methods-palm method: patients with five fingers close together, his own palm is 1% of the whole body area. The size of the burned area can be determined by comparing the area of the burn with the area of the palm of the patient.

2. Judgment of Burn Depth

The depth of burn is medically divided into 3 degrees.

(1) First-degree burns are also called erythema burns. Only the superficial epidermis was injured. The skin of the burn area was red, feverish, slightly swollen, dry on the surface, and free of blisters. The patient had only local pain and burning sensation. All symptoms of a first-degree burn usually disappear after 2 to 3 days, leaving no scar on the skin.

(2) Second-degree burns are also known as blister burns, which are divided into two types: Superficial second-degree burns injured the deep layer of the epidermis and the superficial layer of the dermis; If no infection occurs, the wound can heal after 7-10 days without scarring. Deep second-degree burns hurt the deep layer of the dermis, and the wound vesicles are small. The patient only feels mild pain, which usually heals after 20-30 days, and the skin may leave scars.

(3) Third-degree burns are also called burns. The entire layer of skin and subcutaneous tissues and even muscles and bones are injured. The affected area is pale, yellowish or blackened (charred), the surface is dry or leather-like, and there is no pain. Wounds often heal after skin grafting for several months, leaving scars and even deformities.

3. Overall Evaluation of Burn Degree

(1) The total area of mild burns is less than 10%, and the depth does not exceed two degrees;

(2) The total area of moderate burns is within 10% to 30% or the area of third-degree burns is within 10%;

(3) The total area of severe burns is more than 30% or the area of third-degree burns is 10% -20%. Although the burns of some patients have not reached the above area and depth, one of the following cases is also a severe burn: the burn is accompanied by other compound injuries, shock or poisoning; the respiratory tract burn caused by inhalation of hot air; the bones and joints are deep , Internal organs and burns of the head, neck and perineum.

Burn and scald manifestations and diagnosis

Clinical manifestations and diagnosis

The patient has a cause of injury, such as being burned, scalded or corrosive to the skin. Depending on the nature, extent and location of the burn, the patient may have local pain, redness and swelling of the skin, blisters, and damage. Severe patients may have charred skin wounds to form scorch, and may have difficulty breathing, shock, and coma.

Emergency self-rescue for burns and scalds

Emergency rescue at the scene

1. Quickly stop continuing burns

Regardless of thermal or chemical burns, the damage starts with the skin surface damage, and then gradually develops into the deep skin and subcutaneous tissue. Therefore, if measures can be taken to stop the progress of the burn in time after the burn, the damage can be minimized. The time at this time is calculated in fractions of a second, so you should race against time to take measures to stop continuing burns. Conversely, if left untreated, serious injury may result.

(1) Chemical burns When strong acids (such as sulfuric acid, nitric acid, hydrochloric acid, etc.) and strong alkaline solutions are spilled on the skin, they should be immediately rinsed with water, quickly, in large quantities, repeatedly, and washed away and reduced the corrosiveness of strong acids. Can avoid severe burns. Even if a burn has been caused, the extent of the burn can be reduced! Neutralizers can also be used for chemical burns, such as strong acid burns with mildly alkaline baking soda or alkaline soapy water, and strong alkaline burns with vinegar and water, but if there is no neutralizer nearby, do not take time to go Look for it and rinse with water as soon as possible.

(2) Thermal burns are also the same for thermal burns. After being burned and burned, the skin temperature of the affected area must be quickly reduced. Because heat is conducted inward from the skin surface, it gradually causes damage. The epidermis was injured first, causing a degree of burn, then the superficial dermis, deep dermis ... while we learned that the burn was continuing, the burn was continuing to penetrate deep into the skin, and heat was still being transmitted from the outside to the inside. If immediate action is taken at this time, the burn can be stopped at the initial state. On the other hand, if panic is beyond our control, then the burn will certainly continue to develop, with far more serious consequences! The best way is to quickly soak the affected area in cold water, or rinse the wound with tap water. If there is no water around, we can use all harmless and available liquids, such as milk, juice, canned drinks, and even we can use urine! Remember! The value of time at this moment is calculated in seconds or even a fraction of a second. The results of cooling measures a second earlier and a second later are very different!

(3) Other measures In case of a fire, you should quickly evacuate from danger. Those who are on fire should not run with the fire, quickly take off the fire clothes, lie down on the ground, and slowly roll to extinguish the fire. If the body is covered with gasoline or alcohol, etc. Flammable substances, when rolling is difficult to extinguish the fire, cover with a quilt, etc., and use a fire extinguisher to extinguish the fire if possible.

2. Protect burn wounds

Protecting wounds is an important part of first aid and self-rescue at the scene of a burn. It directly affects the further treatment of patients after admission, and has a direct relationship with whether the patient can recover sooner. Its main points of attention are:

(1) Do not pick the blister by yourself. Small blister can be absorbed by itself. Leave the large blister to the doctor for treatment, otherwise it may cause wound infection. Once infected, the course of the disease will be extended several times.

(2) For small area burns and scalds within 2 degrees, do not bandage large wounds, only cover with clean sheets or cloth, and also use clean plastic food bags or kitchen plastic wrap to reduce Secondary pollution. For heavily polluted wounds, you can first rinse with clean water (such as tap water, bottled drinking water, etc.).

(3) Applying scald medicine If there is no skin damage on the burned area, you can apply any commercially available medicine for treating scald, such as green ointment, eye ointment, various burn ointments, and mink oil, egg white, etc. People with damaged skin are strictly prohibited from applying any medicine by themselves, especially those with color! Such as purple potion and red potion. Applying these drugs is not only useless, but also covers the condition, which brings great trouble to the doctor's follow-up treatment.

3. Give patients life support

Whether or not a severely burned patient can be rescued depends to a large extent on whether the injured can be properly treated as soon as possible after the burn. According to statistics, if the burned area reaches more than 50%, the death rate can be reduced by 50% if it can be correctly rescued within 1 hour. For every hour later, the mortality rate doubles! Giving patients life support is the first step to rescue the wounded before going to the hospital. The main measures include:

(1) Remove the patient's ring, necklace, watch, etc., so as not to be difficult to remove after swelling.

(2) For conscious patients, give 400 ~ 500 ml of saline or sugar saline slowly as soon as possible (note: do not let the patient drink plain water), the sooner you drink, the better for the patient. Otherwise, the patient will have a large amount of plasma extravasation, which will cause blood concentration and decrease in circulating blood volume, which will be extremely unfavorable to the patient. For unconscious persons, an infusion channel should be established as soon as possible, and the infusion should be performed quickly and taken to the hospital while infusion.

(3) For patients with facial, oral cavity, larynx, neck burns and respiratory tract burns caused by inhalation of hot air, do not make any delays at the scene. Race against the clock and quickly send the patients to the hospital. If you have transportation, you should use your own transportation The tool quickly sends the patient to the hospital without having to wait for an ambulance. Because burns in these areas can quickly cause inflammatory swelling in the affected area and block the respiratory tract. Patients are at risk of suffocation at any time.

(4) Other measures: prevent respiratory tract obstruction in patients, quickly stop bleeding in patients with major bleeding, fix fractures, and perform cardiopulmonary resuscitation in patients with cardiac arrest.

4. Quickly send the patient to a burn specialist hospital

The hospital for rescuing patients with severe burns is very professional. If the patient is sent to a small hospital without the ability to rescue, it may cause illness and need to be transferred, which will waste precious time and be extremely unfavorable to the patient. Therefore, patients with severe burns should be sent to hospitals capable of treating burns as soon as possible, usually large general hospitals and burn professional hospitals.

Burn and scald treatment

Treatment after admission:

After the patient's admission, the treatment generally includes wound cleaning, treatment and prevention of infection, anti-shock, maintenance of water and electrolyte balance, supportive therapy for each organ, and subsequent skin grafting and functional rehabilitation therapy.