February 7, 2018

What You Need to Know About Burn Injuries

By Jonathan Damashek

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According to the American Burn Association, 3,275 Americans died from fire and/or smoke inhalation in 2016. Of these, 2,745 of the fires occurred in homes, 310 in vehicle crashes, and 220 in other locations, such as the workplace. The ABA estimates that a civilian fire death occurs every two hours and 41 minutes.  Many Americans are at risk of burn injuries on a daily basis.

In the same year, approximately 486,000 Americans were admitted to hospital emergency rooms for some type of burn injury. Over 40,000 of these injuries were severe enough to require hospitalization, 30,000 of them in a burn center. Forty-three percent of these admissions were from fires, 34 percent from scalds, nine percent from contact with a hot object, four percent from electrical burns, and three percent from chemical burns. Male admissions outpaced female admissions by a two to one margin.

Burn Injury Types

Columbia St. Mary’s Regional Burn Center reports that burns fall into the following four major categories:

  1. Thermal burns caused by the flames or heat of an actual fire, explosion, or by contact with a hot object
  2. Scald burns caused by hot liquids, usually water or cooking oil
  3. Electrical burns caused by such things as a downed power line or a malfunctioning electrical appliance
  4. Chemical burns caused by the skin coming into contact with a caustic substance

Advanced Tissue, a nationwide supplier of specialized burn wound products, adds that radiological burns sustained by cancer patients receiving radiation therapy are a fifth category of burn injuries.

Children and the elderly are particularly susceptible to scalds, while industrial workers are most at risk for receiving a chemical burn. However, such things as household cleaners and swimming pool chemicals also can cause chemical burns. Electrical burns are especially serious since they can result in death by electrocution, heart attack, or extremely serious internal injuries.

One kind of electrical burn that is becoming more prevalent is that of technological gadgets exploding. The Samsung Galaxy Note 7 smartphone, the Fitbit step-tracking watch, and hoverboards all are known to explode without warning. Often the explosions are caused by the faulty lithium ion batteries inside them.

Burn Injury Categories

Per HealthLine.com, burn injuries are divided into four categories depending on their severity. From least serious to most catastrophic, these categories are:

  • First degree burns
  • Second degree burns
  • Third degree burns
  • Fourth degree burns

First degree burns, such as superficial sunburns and frostbite, cause the least amount of skin damage and usually heal within a week or so without scarring. The skin usually becomes red, may swell, and often the top skin layer will peel off. Minor sunburns are more of a nuisance than a danger, but more severe sunburns can cause a good deal of pain and may need medical attention. In addition, as WebMD cautions, repeated sunburns can lead to the skin cancer known as melanoma. As for frostbite, minor occurrences usually cause nothing more than a temporary numbing of the affected areas of skin. In more severe cases, however, blood vessels, nerves, muscles, tendons and bones can be permanently damaged. In the most severe cases, amputation of the affected areas, usually fingers and/or toes, may be necessary.

Second degree burns go deeper than the top layer of skin. The skin always blisters and some of the blisters may pop open, causing weeping and the risk of infection. Second degree burns generally take at least two to three weeks to heal, but usually there is no scarring, although the victim may have permanent pigment changes at the site(s) of the burn.

Third degree burns extend through all skin layers, invading underlying tissues and organs. Surprisingly, these burns often do not cause excessive pain, but the reason is sinister: the victim could have nerve damage. Third degree burns usually require surgery to have any possibility of healing without scarring. Even surgery, including skin grafts, however, does not guarantee that the victim will not have permanent disfiguring scars. Fourth degree burns are deep enough to damage the victim’s tendons and bones.

Burn Injury Complications

In addition to the damage caused by burn injuries themselves, sustaining a burn injury can result in any or all of the following complications:

  • Infection
  • Tetanus
  • Blood loss
  • Hypothermia; i.e., excessively low body temperature
  • Hypovolemia; i.e., decreased volume of circulating blood in the body
  • Shock; i.e., low blood pressure that can cause rapid, shallow breathing; rapid, weak pulse; cold, clammy skin; dizziness, fainting, and/or weakness
  • Death

Burn Injury Prognosis

The prognosis for first degree and lesser second degree burns is good. In many cases victims will have no lasting evidence or effects of such burns. Prognoses are poorer, however, for serious second degree burns and all third and fourth degree burns. Scarring, often disfiguring, is a distinct possibility. In addition, victims often will need some or all of the following:

  • Surgery
  • Rehabilitation
  • Physical and occupational therapy
  • Lifetime assisted care

All burns are serious and victims should receive immediate medical attention. This is especially true of electrical burns that often show minimal skin damage that masks the possible damage to underlying tissues and organs.