The useful things to do immediately after a not serious burn, at home:

1- We cool (not ice) hit the wall with fresh water, soaking it in a bowl or placing it under running tap slight, for at least 10 minutes.

2-  Above apply a generous layer of gel made from plants (Melaleuca alternifolia, Aloe, etc) refreshing for a few hours.

3-  We apply later to silver sulfadiazine ointment and cover with cotton / linen clean and clear.

4-  In case of unavailability of the previous products, used handkerchiefs or scraps of cotton / linen clean and light in color, moisten with fresh tap water and place them on the wound until further medical advice.

DOMESTIC BURNS: WHAT TO DO

• WHERE AND HOW The kitchen is the most dangerous place in the house, recent data show that 65% of the contracted burns occur at home in the kitchen; also those most affected are children between the ages of 1 and 4 years. Of course, the skin temperature can fluctuate widely even for short periods, but even a modest increase for long periods may cause functional alterations of the cells; if, however, following the action of a thermal agent, the skin temperature reaches too high values and the thermoregulatory activity fails to disperse the accumulated heat, leading to structural alterations, sometimes irreversible, of the skin mantle.

Where do the “hot” pitfalls hide in the kitchen? A pot boiling on the stove, unattended by an adult, would be a serious danger to a child, especially if the handle is protruding and height of the child does not reach the level of the kitchen; an iron with a hot plate and left unattended on a table, is a considerable danger.

A hot oven, at child height, containing a sweet cooking is a real danger if the mother is engaged in other activities at home. The agents able to cause burns, therefore, can be of various types: solid, liquid and gaseous; also a very hot steam may be adversely affecting our skin and mucous membranes, just think when we breathe hot air…

If we have learned about the agents, two words we have to reserve to the mechanism that produces the burn: the very hot liquids cause a contact burn whose extent and severity will depend on the height of the fall and its temperature, the oil is able to reach higher temperatures than water and therefore it is more detrimental to the skin.  

SPECIFIC BURNS : HOW TO ACT

THE THERMAL BURNS

Burns from liquids (scalds) are the most frequent (65%) in the kitchen and in majority of cases concerning children; if the latter of lower stature compared to the hob spilling upon the contents of the pot, they burn with a topographical distribution different depending on their height and their reflections; as mentioned are not only hot liquids to constitute a danger in the kitchen but also the hot surfaces represent a pitfall, less obvious but equally harmful. The soleplate of the iron metal or the interior of the oven are agents that transmit high temperatures for contact; an, unprotected, dish extraction from the oven or just the curiosity to taste the food being cooked on the inside, are two dynamics conducting frequent high temperatures in a very short time, sometimes with serious burns.

The burn, in fact, could result small for the speed with the subject escapes the hand from the heat source, but usually deep especially if interesting the back of the hand, typical location in the event of lack/ incongruous use of the oven glove . The handles of a pot on the turned on stove are important as thermal agent, in this case is the palmar surface of the hands to be concerned: in this anatomical location the thickness of the skin mantle is remarkable and the burn, equally painful, is usually less deep. Another serious burn is by direct contact with open flame, it seems an impossible even touching the fire yet it happens to both adults and children; adults can happen to underestimate the devastating effects of flammable liquids used to fuel the fire of the barbecue while children can happen to get too close to the flame of the stove or play with lighters carelessly left by their parents.

The flame, burning skin and overlying tissues quickly, often triggers the fusion of leather and synthetic clothes especially. In case of a localized burn, it has to be immediately choked with water or covered with non-flammable fabric; in no case incinerated clothes have to be removed from the skin tissue, you only need to soak the affected area in a basin of cold water, taking care to replace it when its temperature is raised or, if tolerable, put the burned part under tap water with a smooth flow and wait at least 15 minutes. Subsequent operations will be similar to those described below for the other types of burns. The burn from flame, usually deeper than the other types, needs, after performing cooling and coverage, medical evaluation in the hospital (preferably in the burn center).

The distinction between superficial and deep burns has importance not only from a diagnostic point of view, but especially from the therapeutic and prognostic, in this context, however, it is appropriate to simplify the evaluation for the sole purpose of guiding whom assists the burnt immediately on what to do at home and actions to be taken later. A useful indication emerges by examining the lesion: the domestic superficial burns are painful, the surface of the skin is red, the local sensitivity is increased and often form the blisters or the “bubbles” on the skin containing clear liquid.

Deeper domestic burns usually are less painful, blisters are rare and the surface of the skin appears dark red, sometimes whitish already just after the thermal contact with the agent, the sensitivity of the skin is decreased.

–       What to do

The local treatment of the burn in the golden minutes after the incident is still important and sometimes decisive for the evolution of the burn itself; In fact, the thermal effect on the skin mantle, by a solid / liquid at high temperature, is in part reversible, the readiness and preparation of the caregiver or the same hit are therefore crucial in the minimization of the thermal effects of the agent. To understand the meaning of reasonable virtually immediate relief, you can make use of an example: the effect of the launch of an undisturbed rock in calm water is the multiplication of the impact in concentric circles, more and more large, on the surface of the water.

The ability to stop the spread of the wave concentric (just touch the surface of the water) coincides with the arrest of the phenomenon and therefore the movement of water is restricted to the point of contact with the rock; this explains the mechanism by which we can stop the propagation distance of the heat, from the point of application of the agent heat.

How can we therefore oppose the propagation and to best treat a domestic burn limited to the hand or the arm? The rules are few and simple, but essential.

–       Cool the affected part

Do not use ice (natural or synthetic), but use the fresh running water straight from the tap (if it does not cause discomfort / pain on contact) or in a bowl, submerging the burn; treatment with fresh water should be continued at least for 15 minutes in order to both hinder the diffusion of the thermal effect which reduce the pain. You absolutely must avoid rushing to the emergency room immediately, then eventually cool down before moving. As previously explained a possible waiting to PS – Before being assisted- in the queue to major cases, lead to the enlargement of the burn and the continued pain. At this point it is worthwhile to point out the futility of some “remedies” popular: toothpaste, potato peel, olive oil and even cobwebs are not effective for reducing pain nor to stop the burning process, so best to avoid them…

–       Protect the burn

If you have in your home sterile gauze cotton, you can moisten with saline or fresh tap water and place them directly on the burn, a light and soft bandage will be the next step; if you have not provided any of the above, use a white towel or white patches of cotton smooth cotton / linen to be placed on the lesion and long and narrow towel to wrap gently. Only at this point you can decide whether to get a burn center, an emergency room or call your family doctor for further treatment advice.

It is desired to remember, however, that there are some anatomical-based rules about the place where to go for medical cares: for instance if the lesion involved the face or neck, hands or feet or pubic region, it will be necessary to refer to a burn center; whether they are interested in other parts of the anatomy will be enough so circumscribed the emergency room of the nearest hospital or see a general practitioner.

The second scenary, if it is not possible to reach either the emergency room or talk to a doctor, it is possible, pending further medical contacts, to use local advanced dressings at home; I’d advice to always keep at home (who does not have at least one box of aspirine o paracetamolat home?) gauze or hydrogel-based spray with soothing plant extracts (Aloe, Melaleuca alternifolia) and antiseptic ointments with silver sulfadiazine. Hydrogel and gauze (there is also a kit for home) for a few hours after cooling the part, and then a thick layer of antiseptic ointment, are an excellent home topical treatment, waiting for a medical consultation.

 CHEMICALS BURNS

The kitchen is a dangerous place, not only because it can come in contact with thermal agents but also because it is the place most frequently handling chemicals searing the skin; these substances readily available in supermarkets and intended for domestic use, must be used with great caution by adults only with proper protection – as suggested in the instructions for use – because they are highly toxic to touch (and vapors) on skin and mucous membranes (eyes).

The Caustic Soda (contained eg. Products aids, drain in paint removers and aerosol oven cleaner), chlorine (present in bleach) and muriatic acid (contained in descaling) are substances that are very harmful to the skin and mucous membranes; act even after a short-time contact, determine deep burns and sometimes serious and exert a progressive action which lasts until the moment in which the chemical agent is inactivated by the tissues themselves or by an external action.

–       Remove the toxic substance from the skin

as for thermal burns, the first thing to do is wash the burn under fresh (not frozen) tap water ; it is necessary to keep the affected area at least 20-30 minutes under the tap water to remove the chemical agent and prevent the burn deepening process. Contact with mucous membranes (eg. eye) makes removal more difficult and requires urgent medical attention: as first aid can instill saline or tap water with a sterile syringe, without needle, holding the eye open with the fingers; the maneuver must be repeated many times.  The chemical burns represent an event that requires, after first aid at home, a medical intervention by a specialist in a burn center, regardless of the location of the burn; it is therefore useless to try antidotes or buffer substances if you are not really experts on their use, locate the burn center closest to your home is certainly more useful!

–       Protect the burn

You can put on the same rules that apply for home improvised coverage of thermal burns.  

ELECTRICAL BURNS

Separate analysis deserve burns from domestic electricity: at home, adults and children can run into injury from low voltage (<1000 Volts) that are limited to the point of contact or in close proximity. So it is not frequent, at home, having to attend the dazzled with rescue breathing or external cardiac massage, because the low voltage usually does not cause damage to the heart or respiratory muscles. The crossing of the organism by the electric current causes two kinds of pathological consequences:

1- Direct damage by the electricity;

2- The electrothermal burn caused by the release of heat to the passage of the current. Electrothermal burns are usually not extensive and localized to the palmar surface of the hands (eg. child playing with electrical wire); however they are deceptive because apparently limited burns can mask deep damage.

The particular nature of the burn must be countered by a series of actions:

–       Stop the electrical contact

Quick decision if it is more convenients switch off the electricity of the house or remove the victim from the source of electricity (sometimes it remains attached to the electrical outlet …) with a non-conductive body such as a broom handle or a piece of wood. ABSOLUTELY MUST NOT TOUCH THE ELECTROCUTED trying to help him leave the power cable or at least the source of the electrical discharge; This imprudent action could be very dangerous as we would become burned ourselves.

–       Cool and protect the burn.

The same procedure described for thermal burns is suitable.

–       Carry the victim.

The medical examination should be performed at the burn center or at the nearest hospital emergency room, reporting precisely the event, in order to provide for the transfer to the appropriate clinical place.