Burn is damage to the tissues or cells of the skin due to dry heat.

A scald is damage to the tissues or cells of the skin due to moist heat.

The common causes of burns are:

F= Fire, due to any cause (e.g. petroleum, kerosene, etc.)
I= Irritant (e.g. chemicals like acids, alkali, boiling water, or burns from steam, or you open the car radiator when it is hot)
R= Rubbing (Friction, remember friction produces heat, which in turn causes burns).
E= Electricity (In case of electric burns, there may be two burns at the point of entry and point of exit of the current. Always remember to switch off the source of the current first. Remember electricity can "jump" over water, and therefore wear rubber shoes, if you find water near the source of the current).

Whatever the cause of the burn; as a 'First-Aider' your intervention within the first few minutes are vital. Simply remember 3 B'S and 3 C'S while handling a case of burns.

First B = Stop the burn i.e. if the victim is on fire, your first priority will be to put out the fire. Use a blanket to wrap around the casualty in putting out the fire. This will "cut off' the oxygen supply and help to put out the flame. Never use water to put out the fire; since, if the fire is due to oil, kerosene or petrol, water will only spread the fire and create more complications.

Second B = Breathing, check if the casualty is breathing or not. This is accomplished by placing the back of your two fingers or your ear against the casualty's nose. A blast of warm air, will be felt on your finger or ear. In case the casualty has stopped breathing, immediately start Artificial Respiration. Briefly there are two methods of artificial respiration (1) Direct (Mouth to mouth or Mouth to nose) (2) Indirect (Holger-Nielson method). Use the method which is appropriate to the situation.

Third B = Examine body. Have a quick survey to see if there are burns anywhere else, or there is a fracture or any other serious problem. If breathing has stopped, then check the pulse for Cardiac Arrest. The carotid pulse is the easiest to feel. If there is cardiac arrest, then immediately start CPR (Cardio-pulmonary resuscitation). If you are alone, then the ratio of Artificial Respiration to Cardiac Massage is 2:15. In a given minute, four such cycles are needed. If you have an assistant, then the ratio is 1:5. Remember if the brain cells do not receive oxygen for 3-5 minutes they will get damaged, and therefore every minute counts. Continue administering CPR till the pulse and respiration rate returns to normal. A rough guide is to check the color of the nails, lips or face of the casualty. If they turn pink or regain their natural colour, then your efforts are proving successful.

First C = Cool the body. Remember burn is due to damage to the cells or tissues of the skin due to heat and therefore cooling the part is the treatment of choice. Use ordinary tap water.

Second C = Cover the part. Use a clean white bed-sheet or sterile gauze pieces. This will prevent dirt from setting on the burnt area. It will also prevent further loss of fluid from the body.

Third C= Carry the casualty to the nearest hospital.

A few Don'ts are also to be remembered.
 

	If the casualty is semi-conscious or unconscious do not
	give him any liquids to drink, because of the danger of causing Asphyxia.
	Do not apply any oil, petroleum jelly or cream to the burnt
	area. Remember oil will block the skin pores and prevent heat from escaping. This in turn will only increase the area of the burn.
	If any piece of cloth is stuck to the burnt area, do not try
	to remove it. If you do so, you may peel off the skin. Also you may cause fresh bleeding, which in turn can produce shock.
	If any blisters are formed, do not rupture them. Remember
	these blisters contain body fluids (plasma). The body will reabsorb it, in due time. Once you rupture the blisters they are lost to the body. Also there is a risk of introducing infection.
	Do not leave the casualty alone, till medical aid arrives.

Having understood, the basic principles regarding treatment of burns knowledge of degrees of the burns would help in assessing the gravity of the situation. Briefly, there are 3 degrees of burns which can be identified as follows:

First Degree burn: Here only the epidermis or top layer of the skin is burnt. This is identified by the area turning:

 

R= Red in colour

S= Swelling over the area

P= Pain in the affected part

Here all the damage is caused by heat, and therefore, cooling the part will prevent damage. Pour water over the part, till the burning sensation disappears. Any antiseptic cream, which you wish to apply, should be only after cooling has taken place. Do not use ice-cold water, as application of ice-cold water for a long time, will causes the capillaries in the area to constrict and reduce the blood supply to the part.

Second Degree burn: Here the dermis or deeper layer of the skin is involved. Three things happen: the skin turns Black in colour or is charred. Blisters are formed and the fatty layer under the skin is burnt (B.B.F.- Black, Blisters, Fat)

Third Degree burn: Here the entire skin is burnt. Nerves are damaged, and therefore this area may be painless.

Second and Third degree burns (which may also be called Deep burns) can prove fatal. "Rule of Nine" will help you to assess the gravity of the situation.

If the entire body is burnt then 100% of body is burnt.
 

If one hand is burnt	9%
Therefore both hands burnt		18%
One leg burnt	18%
Both legs burnt		36%
Chest and stomach		18%
Back		18%
Neck and face		9%
Genitals		1%
		100%

Remember hands and area of neck and face is 9% each, everywhere else 18%. Genitals are 1%. If the area of second or third degree burn is 10% or more, then it may prove fatal. There is a risk of losing blood or body fluid in quantities, sufficient to produce shock. Do not panic, remember 3 B'S and 3'C only.

Burn Requiring Medical Treatment

1) Widespread burns, including sunburns.
2) Second degree burns greater than 2 to 3 inches in diameter. Burns involving plams, soles or genitals are dangerous, even though the area involved is only1%.
3) All third degree burns.

Chemical Burns

Treatment

1) If the chemical container contains first Aid instruction, follow it.

2) Start 3B'S and 3 C'S.

3) If chemical falls on the eyes, treat it as an emergency. If chemical falls on the cornea, it may lead to permanent blindness. Do not panic, treat it as a case of first degree burns, and therefore treatment is water, water and water only. Keep splashing water till the burning sensation disappears. A sterile pad dressing should be applied later, and casualty taken to the hospital.

SUNBURNS

They generally produce first degree burns. Therefore cool compresses and simple analgesics like paracetamol are sufficient. In case of blister formation or secondary infection, medical aid should be sought for.