Dr. Josyann Abisaab

Third degree burns are the most severe. These burns involve all the skin’s layers and cause permanent damage to the tissues. Sometimes fat, muscle and even bone can be involved. If the burn is bad enough it could appear black and charred or look dry and white. There can be other toxic effects if smoke inhalation accompanied the burn and the patient might have trouble inhaling or exhaling.

Third degree burns are serious emergencies and require expert emergency care from emergency room doctors such as Josyann Abisaab. Call 911 as soon as possible, and while waiting for the ambulance be sure to:

1.    Not remove clothing, but make sure there is nothing smoldering or still burning touching the victim.

2.    Not immerse large and severe burns in cold water. Immersion in cool water could case the body temperature to drop, causing hypothermia, lowering of blood pressure, and poor circulation (shock.)

3.    Check for breathing and other signs of life such as coughing and movement. Start CPR if circulation seems to be curtailed.

4.    Try and keep the burned parts of the body elevated to a level above the heart, if possible.

5.    Cover the area where the burn is with a cool, moist and sterile bandage; clean moist cloth; or moist towels.

Second degree burns are more serious than first degree burns, but still do not always require emergency room visits. The classification of second degree burn applies when the skin has been burned through to the second layer of skin. This layer is known as the dermis, and when it is damaged blisters rise up and the skin becomes intensely reddened, with an accompanying splotchy appearance. Sever pain as well as swelling is also present.

As long as this second degree burn only takes up an area of the skin no larger than 3 inches in diameter, this can be treated as a minor burn like a first degree burn. If the burn is on the hands, feet, groin, buttocks or on a major joint or is larger than 3 inches in diameter, emergency medical care is advised.

To treat a minor burn, first cool the burn by running cool (not cold) water over the burned area for 10-15 minutes or until the pain is alleviated. Immersion is also an option, and so is the use of cool compresses. Cooling the burn reduces the swelling by taking the extreme heat away from the skin. Do not use ice.

Bandage the burn with a clean gauze loosely applied so there is no pressure which can cause pain. The gauze prevents air from getting on the burn, reduces the pain, and protects the damaged, blistered skin.

Take a pain killer to relieve the discomfort, such as aspirin, ibuprofen and other over-the-counter medications. Take care when giving pain-killers to children. Call a doctor for advice.

Do not use ice to cool the burn. Further damage to the skin might ensue. Do not apply ointments or butter to the burn. This can cause an infection in the wounded area.

Do not break blisters. Broken blisters can get infected more easily.

One reason why a person might decide to go to the emergency room is if he believed either he or someone he knows has suffered a severe burn. Burns can be caused in many ways; some of the more common sources of burns are hot substances such as boiling water, or from fire. Certain chemicals which are caustic can also cause serious burns.

How can a person decide whether a trip to the emergency room is really needed? The following guidelines in three parts should be helpful.

First-degree burns are the least serious. These types of burns only affect the outermost layer of skin, and do not penetrate further. The skin usually appears red with some swelling, and sometimes pain as well. You can treat a first degree burn as a minor burn unless there are major portions of skin involved at the hands, feet, face, groin, or buttocks. Also, if a major joint is affected emergency medical attention is in order.