Heat Injuries

Burns, heat cramps, heat exhaustion, and heat stroke are the injuries most commonly caused by exposure to extreme heat. Although burns caused by contact with acids, alkalies, and other chemicals are not true heat burns, they are discussed here.

BURNS. \To provide the proper emergency treatment for a burn, you must determine the type of burn, the depth of the burn, and how much of the casualty's body is burned.

Three types of burns are covered here: thermal, chemical, and electrical. A thermal burn is caused by exposure to heat from sources such as fire, hot objects, hot gases, hot liquids, or explosions. A chemical burn occurs when a person comes in contact with a caustic chemical. An electrical burn occurs when a person

comes in contact with a live wire or is struck by lightning. It is important to distinguish between these types of burns because the treatment is different for each.

You can visually examine a burn to determine how deep it is. Burns are classified according to their depth as first degree, second degree, and third degree as shown in figure 13-15.

First-degree burns are the mildest, producing a redness of the skin's outer layer, increased warmth, tenderness, and mild pain.

Second-degree burns extend through the skin's outer layer to involve the deeper layers. The skin reddens and blisters, and the casualty experiences severe pain.

Third-degree burns destroy the skin and may destroy underlying tissue and bone. The casualty may not experience severe pain, because all the nerve endings in the burn area may have been destroyed. The color of the third-degree burn may vary from white and lifeless to black.

To determine how much of a casualty's body is burned, use the rules of nine (fig. 13-16). According to this method, each of the following areas of the body represent 9 percent of the body's surface, with the genital area representing 1 percent.

Figure 13-15.\First, second, and third degree burns.

Figure 13-16.\Rules of nine.

The head and neck

The front of each leg

The back of each leg

The chest

The abdomen

The upper back

The lower back and buttocks

As a general rule, all third-degree burns should be regarded as serious, as should first-degree and second-degree burns that cover more than 15 percent of a casualty's body. All facial burns should also be regarded as serious.

A casualty with a serious burn will usually be experiencing shock, and the patient's life may be in danger. The casualty must receive emergency treatment immediately. You should then get medical assistance or transport the casualty to an aid station as soon as possible.

Thermal Burns.\If a casualty is suffering from a serious thermal burn, you should take the following steps:

1. Ensure there is an open airway.

2. Treat to prevent infection.

3. Treat for shock.

Ensure there is an open airway. Hot gases or smoke may have caused the casualty's airway to swell shut. Tilt the casualty's head to the chin-up position. If the casualty is not breathing, apply artificial ventilation. If the casualty is breathing but has facial burns, place the casualty in a sitting position if this makes breathing easier.