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Burns

First degree burn; Second degree burn; Third degree burn

Burns commonly occur by direct or indirect contact with heat, electric current, radiation, or chemical agents. Burns can lead to cell death, which can require hospitalization and can be fatal.

Images

Burns
Burn, blister - close-up
Burn, thermal - close-up
Airway burn
Skin
First degree burn
Second degree burn
Third degree burn

Presentation

Minor burn treatment - run under cool water

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Considerations

There are three levels of burns:

Burns fall into two groups.

Minor burns are:

Major burns include:

You can have more than one type of burn at a time.

Major burns need urgent medical care. This can help prevent scarring, disability, and deformity.

Burns on the face, hands, feet, and genitals can be particularly serious.

Children under age 4 and adults over age 60 have a higher chance of complications and death from severe burns because their skin tends to be thinner than in other age groups.

Causes

Causes of burns from most to least common are:

Burns can be the result of any of the following:

You can also burn your airways if you breathe in smoke, steam, superheated air, or chemical fumes in poorly ventilated areas.

Symptoms

Burn symptoms can include:

You may have an airway burn if you have:

First Aid

Before giving first aid, it is important to determine what type of burn the person has. If you are not sure, treat it as a major burn. Serious burns need medical care right away. Call your local emergency number or 911.

MINOR BURNS

If the skin is unbroken:

Minor burns will often heal without further treatment. Make sure the person is up to date on their tetanus immunization.

MAJOR BURNS

If someone is on fire, tell the person to stop, drop, and roll. Then, follow these steps:

You will also need to prevent shock. If the person does not have a head, neck, back, or leg injury, follow these steps:

Continue to monitor the person's pulse, rate of breathing, and blood pressure until medical help arrives.

Do Not

Things that should not be done for burns include:

When to Contact a Medical Professional

Call 911 or the local emergency number if:

For minor burns, call your health care provider if you still have pain after 48 hours.

Call a provider right away if signs of infection develop. These signs include:

Also call a provider right away if symptoms of dehydration occur with a burn:

Children, older people, and anyone with a weakened immune system (for example, from HIV) should be seen right away.

The provider will perform a history and physical examination. Tests and procedures will be done as needed.

These may include:

The outcome will depend on the type (degree), extent, and location of the burn. It also depends upon whether internal organs have been affected, and if other trauma has occurred. Burns can leave permanent scars. They can also be more sensitive to temperature and light than normal skin. Sensitive areas, such as the eyes, nose, or ears, may be badly injured and have lost normal function.

With airway burns, the person may have less breathing capacity and permanent lung damage. Severe burns that affect the joints may result in contractures, leaving the joint with decreased movement and a reduction in function.

Prevention

To help prevent burns:

References

Christiani DC. Physical and chemical injuries of the lungs. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 94.

Singer AJ, Lee CC. Thermal burns. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 56.

Voigt CD, Celis M, Voigt DW. Care of outpatient burns. In: Herndon DN, ed. Total Burn Care. 5th ed. Philadelphia, PA: Elsevier; 2018:chap 6.

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Review Date: 4/10/2020  

Reviewed By: Ramin Fathi, MD, FAAD, Director, Phoenix Surgical Dermatology Group, Phoenix, AZ. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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