We’ve all burnt ourselves. Taking food out of the oven, accidentally spilling boiling water on ourselves or after lying in the sun for too long. Burns occur when heat, fire, radiation, sunlight, electricity, chemicals or boiling water causes damage to the skin. Burns are common and clients will visit you to treat their burns and to find out about first aid for burns.
Types of burns There are three main types of burns:
First-degree burns: These are red and painful. The area usually swells and may turn white. The skin may also peel during the recovery process. These burns normally heal after three to six days.
Second-degree burns: These are deeper burns. The skin blisters and is painful. The skin is normally also red and swollen. These burns take two to three weeks to heal.
Third-degree burns: These are very serious burns incorporating the full thickness of skin and even below. They are not painful as there are no skin receptors remaining. The burned area is normally white or charred and skin may be flaking off. These burns usually require surgery to heal.
Role of pharmacy staff
You can help treat clients with first degree burns and educate clients on burns’ first aid. You also play a pivotal role in identifying burns which need urgent medical attention. Sometimes the most important thing you can do is refer one of your clients to casualty.
Referrals
You should refer to casualty any client:
- With burns on the face, over joints (such as the knee), feet and genitals
- With second or third degree burns
- With a burn which is greater than six to seven cm in size
What treatment can I recommend for a first-degree burn?
Recommend your clients take basic first aid steps first i.e. soak the burn in cool water for at least five minutes. This will help reduce swelling and pain. Chemical burns require copious washing of the area with running water. Advise clients not to place oil or butter on burns. Do not break blisters over the burn.
Burn treatments: There are numerous over-the-counter treatments which can soothe burns. Burnshield®, SeptiCare®, Flamazine® are some of the non-stick burn dressings which can ease the swelling and pain and prevent infection. Aloe vera cream with gauze over it is also an effective burn treatment. For moderate sunburn a mild 1% topical steroid such as Stopitch®, Procutan®, Dilucort® or Biocort® can ease the burn and speed up recovery.
Analgesics: Pain in first- and second- degree burns can be severe. For mild to moderate pain recommend paracetamol (e.g. Panado®, Tylenol®, Empaped®) up to 600mg for adults in daily divided doses. For moderate to severe pain you can recommend an anti-inflammatory such as mefenamic acid (e.g. Ponstel®, Ponstan®, Ponac®),Naproxen (e.g. Synflex®, Nafasol®, Aleve®), ibuprofen (e.g. Brufen®, Nurofen®, voltaren), Meloxicam (e.g. Melflam®, Coxflam®, Loxiflam®) and Aspirin (e.g. Disprin®, Bayer-Aspirin®). Don’t recommend anti-inflammatories if your client has gastritis, a hernia or renal impairment. Advise your client to continue treatment until the pain subsides.
Clients should wash the burn area gently with soap and water once the pain has settled. Your client should also consider going for an anti-tetanus shot if they have burns with blisters.
Client advice for burn prevention
Every year thousands of South Africans become injured and die from burns. Children are particularly vulnerable to becoming burn victims. Clients can take the following steps to avoid burns:
- Don’t leave children unattended near boiling water, kettles or toasters. Ensure children are supervised around candles, paraffin lamps or stoves.
- All electrical appliances should be safely earthed and wall plugs secured with child-proof covers.
- Any household chemicals should be kept out of reach of children
- Always use flame-proof materials for bedding and clothing
- Make sure your geyser is set to 50 degrees Celsius or lower
Being prepared for burns
It is vital that clients keep first aid treatment for burns in their first aid kits at home, at work and in the car. If your client requests assistance with putting a first aid kit together for burns, you can advise them to have:
- Water for cleaning and cooling burnt areas
- Burn dressings (e.g. Burnshield®) or gauze and aloe vera
- Mild topical steroid cream
Beating burns
Burns are unexpected but common. Burns are at best painful and unpleasant and at worst, life-threatening and debilitating. Make sure you know which clients to refer to casualty for urgent attention. Educate your clients on what not to do if a burn occurs and do provide them with over-the-counter dressings and pain relief
Dr Karen Koch (MBChB)
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