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Burn

By Bjarne Lühr Hansen PhD, MD and Philipp Skafte-Holm MD, Mentor Institute

Burns are a frequent accident. Half of all burns occur by scalding of boiling water, hot coffee or warm food along with hot plates – in short, in the kitchen. Another frequent cause of burns is open fire.

The temperatures at scalding are surprisingly low. Water 54 degrees warm cause deep burns in the matter of 30 second. However, also water only 44 degrees warm can at longer exposure harm the skin.

Burns are divided into degrees depending on how deep the injury is:

1st degree burn.

Only reaches the upper part of the skin. Appears by redness and pain. A typical example is sunburn.

2nd degree burn.

Reaches through the entire skin. Appears by pain, redness, swelling of the skin and blisters. The blisters are cavities filled with liquid right beneath the skin – like bubbles on the skin. A typical example of scalding is warm coffee or tea.

3rd degree burn.

Reaches beneath the skin – into fat and muscle. Appears by a crust that is either white or brown and that covers a deep wound. There is no redness or blisters. A 3rd degree burn does not hurt because the nerves are destroyed. A typical example is a burn from open fire or boiling water.

The 1st degree burn does not cause lengthy nuisances. Besides from smarting in the area for 1 to 2 days, there are no nuisances. A 2nd degree burn heals in 2 to 3 weeks, depending on how large and deep the burn is. The deep 2nd degree burns heal with a scare, while the more superficial heal without a scar. A 3rd degree burn cannot heal, either you have to receive skin grafts to cover the injury or the wound shrinks with severe scarring.

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Medication

To soothe the pains you can take painkilling medication (for example a gram of paracetamol) 3 to 4 times during 24 hours.

What can you do?

With every burn, you must pour with lukewarm water (20oC) for at least 1 hour. Often, 1 hour is not enough because you have to keep pouring until the pains have disappeared. Most people will testify that there are no pains as long as the burn is kept underwater but that it hurts again when there is no water covering the area. You should keep pouring water until it stops hurting even when water is not covering the burn. In the case of a burn on the hand or the foot you can put the hand or the foot into a bowl of lukewarm water. In other cases, you can pour water with a showerhead or put a cold compress on the area of the burn. If the burn is so large or deep that you choose to go to the emergency room, it is important to put lukewarm water on the burn on the way to the emergency room. Lukewarm water (20oC) or seawater is appropriate for this use. When you are finished pouring water on the burn, you must put a bandage on the burn.

Contact the doctor tomorrow

If warmth, redness, soreness and swelling arise around the burn a few days after the burn, it can be a sign of infection. If you are uncertain whether you are vaccinated for tetanus. No more than 24 hours after the accident should pass until you have a vaccination.

Contact the doctor immediately

If the burn is very big, if there are big blisters or if the skin has broken. This means in the case of all 2nd and 3rd degree burns.