Burn injuries are the second leading cause of accidental death in the United States, and children under four are the most vulnerable. The majority of burn accidents occur in the kitchen and bathroom, with scalds being the leading cause. Other causes of burns are heat, fire, radiation, sunlight, electricity, chemicals, hot objects or hot liquids.

Not too many years ago, treatment for a burn was usually some type of oily dressing, but now the usual first aid for minor burns is cool water. This change derived from findings that people who had fallen in snow directly after suffering burns in a fire had a smaller degree of burn damage and fewer complications than other people in the same situation who did not have this contact.

The skin acts as a barrier that protects the body from heat, cold and chemical agents. It prevents loss of body fluids, so when large areas of skin are destroyed by third-degree burns, the situation can quickly become life threatening due to leakage of fluids, shock, or bacterial invasion.

Burns are described according to the depth of the wound. Thin or superficial burns (first-degree burns) are on the surface and cause the skin to turn red. Thicker burns, called superficial partial-thickness and deep partial-thickness burns (second-degree) are deeper and result in splitting of the skin layers or blistering and are painful. Full-thickness burns (third-degree) destroy all layers of the skin and extend into the deeper tissues. The burned skin looks white or charred and may cause little or no pain if nerves are damaged.

The American Academy of Family Physicians’ and The Mayo Clinic’s recommendations for a first-degree burn are:

• Apply cool packs for five to ten minutes, repeating until the pain ebbs. Then treat it with a skin care product such as aloe vera, Aquaphor or petroleum jelly (Vaseline).
• Do not use butter, oil, ice or ice water; you might cause more damage to the skin.
• Place a dry, loose sterile gauze bandage over the burn to protect the burned area (non-stick pads such as Telfa are good). Bandaging reduces pain, protects blistered skin and keeps air off the area.
• Use acetaminophen (Tylenol) for pain.
• Seek medical help quickly if the burn covers a large area, or is on your
  face, hands, feet, groin or buttocks. Additionally, see your physician if pain continues for more than two days, there are signs of infection, or increasing pain, redness or tenderness, or the area becomes increasingly swollen. To be on the safe side, I would see a physician anytime blisters are present, and the burn area is larger than two to three inches.
• Drink plenty of water and avoid breaking blisters. Do not remove clothing that is stuck to the burn.

Electrical burns often cause serious injury inside the body and may not show on the skin. These patients should go to the hospital immediately.

A chemical burn should be washed with large amounts of cool water, and any clothing that has the chemical on it should be removed. Nothing should be put on the burn area and seek medical help.

It is claimed that 50 percent of burns can be prevented. Some suggestions are:

• Keep children away from hot liquids, hot irons, space heaters, wood stoves, fireplaces and outdoor grills.
• If your child is older than six months, use a sunscreen with an SPF of 15 or greater.
• Burn accidents frequently occur when parents or caregivers are in a hurry, angry or under a lot of pressure.
• Scald and steam burns are often associated with microwave oven use.
• Keep hot foods and drinks away from the edge of tables and counters. Do not put them on a tablecloth that little hands can pull.
• When cooking, keep your child away from the stove. Turn pot handles toward the back of the stove, and if possible, use rear burners.
• If you’re holding something hot, don’t hold your child too.
• Watch for dangling appliance cords.

The good news is that the number of deaths from severe burns has dropped by more than half over the past 4 decades.