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Burns and Scalds


Cooks get burnt. It's a fact of kitchen life.

Thankfully most incidents are simply superficial burns which will heal in a few days and require very little attention.

However it is essential you understand the nature of burns and what needs to be done immediately, especially in the case of very young children and adults over the age of 60.

It's equally important that you understand what not to do.

The three degrees

You are probably already familiar with the terms first, second and third degree burns - but what do they mean?

Contrary to popular belief, these categories have nothing to do with the size of the area affected by the burn. They refer to the depth of the injury in terms of damage done, as outlined in the following:

First degree

This refers to a superficial burn in which only the upper layer of skin is affected. It's the kind you get from grabbing hold of a hot pan, for example. There is usually pain associated with this type of injury and the skin is red and dry.

Healing time is around 5 days and there is usually no scarring.

Second degree

Also known as a partial-thickness burn, this involves both layers of skin and is characterized by red, weeping skin and blisters. The affected area often looks mottled and may swell. Healing time is around 25 days and some scarring may occur.

Third degree

A full-thickness burn which destroys both layers of skin and any or all of the underlying tissue. They tend to have a charred appearance with the underlying structure sometimes appearing white. There may be extreme pain or none at all if nerve endings have been destroyed.

All third degree burns of any size must be treated as life threatening!

There are a number of reasons for this. Open burns mean that the body rapidly loses fluid and may go into shock. This in itself is a life threatening condition and you need to know how to treat it.

You should also be aware that these burns are highly likely to become infected and it's vital that you seek medical assistance immediately.

Critical Burns

While it's apparent that third degree burns require professional treatment, this is by no means the only time that medical help should be sought.

For example, a superficial burn to a large area of the body, such as may occur from scalding, may become a critical burn because of the potentially large fluid loss leading to the onset of shock

As a guide, always call an ambulance if confronted by one or more of the following conditions:

· The victim is having difficulty breathing
· More than one body part is affected
· Second or third degree burns in an infant or person over 60
· Burns to head, neck, hands, feet or genital area
· Burns resulting from chemicals, an explosion or electricity.

Treatment

It's important to understand that tissue continues to burn even after the original source of heat has been removed. So the first thing to do is to cool the injury down as rapidly as possible - and for that you use water. Nothing else, and especially NOT such things as butter and honey!*

And you keep cooling it using running water, a bucket, wet towels or whatever until you can feel that the undamaged tissue surrounding the burn has returned to normal body temperature. This will help to relieve pain and reduce the chance of infection.

This will take up to thirty minutes or more, depending on the severity of the burn. Don't attempt to shorten this process.

Once you have the cooling down process under control, assess whether or not you need further expert help.

*Both butter and honey are often tipped as natural healing products and they do have an initial soothing effect. Honey in particular is known to be a mild antiseptic and slightly analgesic. However it is also a sugar and quickly adopts the heat of the burn, thereby exacerbating and prolonging the damage. Butter behaves in a similar fashion. DO NOT use either!

Scalds

Because they are caused by hot water, scalds often manage to have two victims; the person directly involved and the one who goes to the rescue.

That's because the natural tendency is to grab hold of the victim through their clothing, which of course is still drenched with hot liquid.

This clothing will need to be removed, but either cool it first (using water) or protect your hands in some way. There is nothing to be gained by ending up a patient yourself.

Once you have the clothing out of the way continue the cooling process and treat in exactly the same way as any other burn.

Incidentally, a great many domestic hot water burns could be avoided simply by turning down the thermostat in the hot water tank. If you live in a household where cold water needs to be added to the sink/bath/shower before you can use it, you should consider this seriously.

Chemical burns

While these are not common in the kitchen, you need to be aware that they can be caused by such things as household bleach and drain cleaners. Once again those most at risk are the very young and the over sixties because their skin is thinner.

Chemicals will continue to burn for as long as they are in contact with the skin, so the obvious thing to do is to remove them and once again the treatment is water - nothing else.

However remember that some chemicals, such as dishwasher crystals, are activated by water, so as much as possible should be brushed off first.

Help the victim remove affected clothing and keep flushing with water for up to 30 minutes. If an eye is affected, keep flushing until the ambulance arrives.

Electrical burns

Do not touch, or even approach, the victim of an electrical burn until you are certain that the power has been turned off and there is no danger of you becoming an additional casualty.

Remember that with electrical burns what you see is often not what you get. They are deceptive and can often be deep with both an entry and (sometimes concealed) an exit wound. These may appear superficial while concealing deep tissue damage.

Watch for these signs:

· Loss of consciousness
· Breathing difficulty
· Weak, irregular or absent pulse
· Burns on the surface of the skin
· Entry and exit wounds (check hands and feet)

Don't hesitate. Call for an ambulance immediately. Then treat for burns by cooling, cover with sterile dressings, watch for symptoms of shock and treat accordingly.

Do's and Don'ts
When faced with a burn of any nature remember to:

· Cool it, preferably with cool running water
· Remove any rings or jewelry as soon as possible
· Cover it with a dry, sterile dressing
· Watch out for - and treat - shock

Do Not
· Use any kind of oil or ointment on severe burns
· break blisters
· touch burns with anything except sterile dressings
· apply ice directly to the burn
· try to remove clothing over burns - cut it away instead
· attempt to remove anything sticking to the burn
· try to clean a full thickness burn
· use cotton wool or similar material on the burn.

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