How to treat a burn injury

Nurse: Burns are one of the most common household injuries, especially among children. Now, tell me, how you would define a burn?

Trainee: Generally, a burn is tissue damage caused by heat, electricity, chemical products or sunlight.

Nurse: And how is a burn injury classified?

Trainee: They are referred to as first-degree, second-degree and third-degree burns.

Nurse: And how can they be diagnosed?

Trainee: First-degree burns are red and painful. They swell a little, turn white when you press on the skin, and the skin over the burn may peel off after one or two days. On the other hand, second-degree burns have blisters and are more painful. The skin is very red or splotchy, and it may swell a lot. But a third-degree burned skin looks white or charred. It may cause little or no pain because the nerves in the skin have been damaged.

Nurse: Excellent! But what about pain assessment, then?

Trainee: We would use the usual pain scale from zero to ten.

Nurse: And how would you deal with this?

Trainee: I’d ask the patient to try and situate his pain on this scale. And according to the level of pain that he estimates, I would think of a specific painkiller, with a dose adapted to the intensity felt by the patient.

Nurse: Very good! So now how can burns be taken care of?

Trainee: It depends on the burn.

Nurse: Ok. Let’s say that a patient is admitted to emergency with a first-degree burn, for example. What would you do?

Trainee: I’d soak the burn in cool water, then treat it with a skin care product like aloe vera cream or an antibiotic ointment.

Nurse: Would this be all?

Trainee: No. I would also protect the burned area by using a dry gauze bandage and give the patient an over-the-counter analgesic such as ibuprofen in order to help relieve his pain.

Nurse: What would you do if it’s a second-degree burn?

Trainee: The procedure would be more sophisticated. I’d soak the burn in cool water for about 15 minutes. If the burned area is small, I’d put cool, clean and wet cloths on it for a few minutes every day. I’d then use an antibiotic cream, or other creams or ointments prescribed by the doctor. I’d cover the burn with a dry, nonstick dressing that I’d hold in place with gauze or tape and check with the doctor to make sure the patient is up-to-date on tetanus shots. I’d also check the burn every day for signs of infection, such as increased pain, redness, swelling or pus.

Nurse: And what about third-degree burns?

Trainee: I wouldn’t take off any clothing that is stuck on the burn and I’d cover it with a sterile bandage or clean cloth until I receive medical indications from the doctor.