The A-Z of dealing with burns, scalds

About two years ago Adelene Kwizera’s baby was badly scalded on the left arm after she accidentally hit a sauce pan containing boiling water. Her daughter’s dark scar is still visible today. “She was in terrible pain after the accident, always crying. I stayed up late in the night to try and make her comfortable,” Kwizera says. But Kwizera’s experience is not an isolated one. According to the World Health Organisation (WHO), an estimated 265 000 people die every year out of the millions that are moderately or severely burnt. WHO adds that children under 5 in Africa have almost 3 times the incidence of burn deaths than infants worldwide. Because of the magnitude of the problem, WHO dedicates one week in May every year to enlighten the world about burns – the cause, preventive measures and treatment. This year, the World Burns Awareness Week ended last week. What are burns and scalds? Burns and scalds are damage to the skin caused by heat. A burn is caused by dry heat, and this for example can be caused by an iron or fire. On the other hand, a scald is caused by something wet, such as hot water or steam.Burns can be very painful and can cause blisters and charred, black or red skin. According to Anita Ahayo, the director of Injuries and disabilities at Rwanda Biomedical Centre (RBC), children below the age of 10 are most vulnerable to burns and scalds. She points out that heat accidents do not only cause injury, but also come at a huge financial cost in treatment sometimes. “Treatment of a simple scald usually does not go below Rwf10, 000, but treatment for serious burns that require plastic surgery for instance costs as much as Rwf 4million,” she says. Hot drinks such as cups of tea, coffee, boiling water in containers, hot food solids, lighters, matches, fat and hot cooking oil, steam and vapour are the commonest sources of scalds and burns, according to medics. First Aid Stopping the burning process as soon as possible should be the first thing to come to mind, and this may mean removing the person from the area, dousing flames with water or smothering flames with a blanket. It is also advisable to remove any clothing or jewellery near the burnt area of skin. However, don’t try to remove anything that is stuck to the burnt skin because this could cause more damage, says Alfred Gatabarwa, a general practitioner with Abbey Family Clinic, Remera. “Cool the burn with cool or lukewarm water for 10 to 30 minutes, ideally within 20 minutes of the injury occurring. Never use ice, iced water or any creams or greasy substances such as butter,” Gatabarwa explains. Children must be kept away from fire to avoid accidents. (Solomon Asaba) He points out that one should keep themselves warm, using a blanket or layers of clothing, but avoid putting them on the injured area, as this will surely prevent hypothermia, a situation where a person’s body temperature drops below 35ºC (95ºF). Gatabarwa mentions that a patient should be taken to hospital if they have large or deep burns, if the person has cold clammy skin, sweating, rapid shallow breathing and weakness or dizziness. Paracetamol or ibuprofen may help to ease pain for small burns. A doctor may give stronger painkillers, if required. Dr Ahayo says that keeping children away from any sources of heat is an important precaution one should take. “It’s best to keep your toddler out of the kitchen, well away from kettles, saucepans and hot oven doors – you could put a safety gate across the doorway to stop them getting in,” Francine Mukankubito, a physician with Medplus Clinic, Remera cautions against pricking any blisters. He says it is better to leave them intact, to lessen the risk of infection. “Do not apply creams, ointments, oils, grease, exception is for mild sunburn. A moisturiser cream may help to soothe this,” she says. Mukankubito again warns against putting on an adhesive, sticky, or fluffy dressing. Prevention tips Blow out candles and store matches out of reach, keep candles at least 12 inches away from anything that can burn, and always blow them out when you leave the room or before you go to sleep. Make a habit of placing matches, gasoline and lighters in a safe place, out of children’s reach. Avoid novelty lighters or lighters that look like toys. Childproof your electrical outlets and appliances, keep appliance cords out of reach of children, especially if the appliances produce a lot of heat. Check to make sure the water temperature is just right. With everything going on, it is likely that the water heater is the last thing on your mind. But a small change can give you one less thing to worry about. To prevent accidental scalding, set your water heater to 120 degrees Fahrenheit or the manufacturer’s recommended setting. Engage older kids in cooking, teach older responsible kids how to cook safely. It will make your life easier if your kids can cook some of their own meals (and maybe yours, too). Teach them never to leave the kitchen while they are using the stove or oven. Don’t forget that the number one cause of home fires is unattended cooking. editorial@newtimes.co.rw ***************** WHY Burn Injuries ARE So Dangerous Burn injuries are among those that pose some of the greatest dangers. Depending on several factors, including the source of the burn and its location, burn injuries can involve both immediate and prolonged medical attention. They can also require a lengthy recovery time. So, why are burn injuries so dangerous to the human body? Severity of the burn When heat or chemicals come into contact with your skin, damage is done to its chemical and cellular makeup. Depending on how hot your skin gets, how long it is exposed to the source and the physical location of the burn, medical professionals are able to diagnose the severity a burn. Essentially, burns that are larger and more severe are harder to recover from. They not only cause excruciating pain, they can wreck your immune system and result in the permanent death of your body tissues. Burns vary in their severity and they are classified using the following scale: First degree burns These burns affect only the epidermis layer. They are painful to the touch, however, they usually heal within about one week and have no further complications. Second degree burns Burn injuries of the second degree can reach the upper layer of your dermis, causing possible infections at the burn site and taking up to three weeks to heal. The most severe second degree burns can extend to the deeper layer of dermis and take months to heal. They can cause scarring and even require skin grafting before healing properly. Third degree burns Burns of the third degree extend completely through the dermis. They kill nerve endings, taking away all sensation and sense of touch. These burns make the skin appear dry, tough and leathery. Third degree burns require tissue removal or even amputation. Fourth degree burns These burns extend beyond all three layers of skin and deep into the muscle tissue or bone. Fourth degree burn injuries often cause a complete loss of function in the burned area. They require tissue removal or amputation and can even lead to death. Dangers of severe burns Severe or large burn injuries can pose some serious problems. Some of the most common dangers are: Infection: Burn injuries leave your skin open and susceptible to infection. Without healthy skin, you have no defense against bacterial infections. Burn injuries also increase your risk of sepsis, which is a life- threatening infection that rapidly travels through the bloodstream. Sepsis can cause shock and organ failure. Low blood volume: Burn injuries damage your blood vessels, causing fluids to escape the body. This can result in low blood volume, known as hypovolemia. A severe loss of fluid and blood can prevent the heart from pumping enough blood through your body. Breathing difficulties: One of the most common dangers that accompany burn injuries is the inhalation of smoke or hot air. This can burn your airways, making it difficult to breathe. Smoke can permanently damage your lungs and lead to respiratory failure. Problems with bones, joints: Deeper burns can limit any kind of movement for bones or joints. Burn injuries form scar tissue once healed and can cause contractures. When the skin is burned, surrounding skin starts to pull together, resulting in a post-burn contracture that prevents movement. Agencies