What is the first action the medical assistant should take when he she determines there is a fire?

A burn is tissue damage from contact with:

• flames
• very hot water (scalding)
• corrosive chemicals
• electricity
• radiation (including sunburn)

The first step in treating a burn injury is determining whether the burn is a minor or major one. That determination will direct action and treatment. Read on to learn the difference and how to treat both types.

Major burns can be recognized by four primary characteristics:

• deep
• result in dry, leathery skin
• larger than 3 inches in diameter or cover the face, hands, feet, buttocks, groin, or a major joint
• have a charred appearance or patches of black, brown, or white

Minor burns are recognized by the following characteristics:

• less than 3 inches in diameter
• surface redness (like a sunburn)
• skin blistering
• pain

The first step in treating a major burn is to call 911 or seek emergency medical care.

Steps to take until emergency arrives include:

1. Make sure you and the person who’s burned are safe and out of harm’s way. Move them away from the source of the burn. If it’s an electrical burn, turn off the power source before touching them.
2. Check to see if they’re breathing. If needed, start rescue breathing if you’ve been trained.
3. Remove restrictive items from their body, such as belts and jewelry in or near the burned areas. Burned areas typically swell quickly.
4. Cover the burned area. Use a clean cloth or bandage that’s moistened with cool, clean water.
5. Separate fingers and toes. If hands and feet are burned, separate the fingers and toes with dry and sterile, nonadhesive bandages.
6. Remove clothing from burned areas, but don’t try to remove clothing that’s stuck to the skin.
7. Avoid immersing the person or burned body parts in water. Hypothermia (severe loss of body heat) can occur if you immerse large, severe burns in water.
8. Raise the burned area. If possible, elevate the burned area above their heart.
9. Watch for shock. Signs and symptoms of shock include shallow breathing, pale complexion, and fainting.

Things not to do

• Don’t contaminate the burn with potential germs by breathing or coughing on it.
• Don’t apply any medical or home remedy, including ointment, butter, ice, spray, or cream.
• Don’t give the burned person anything to ingest.
• Don’t put a pillow under their head if you think they have an airway burn.

1. Cool down the burn. After holding the burn under cool, running water, apply cool, wet compresses until the pain subsides.
2. Remove tight items, such as rings, from the burned area. Be gentle, but move quickly before swelling starts.
3. Avoid breaking blisters. Blisters with fluid protect the area from infection. If a blister breaks, clean the area and gently apply an antibiotic ointment.
4. Apply a moisturizing lotion, such as one with aloe vera. After the burned area has been cooled, apply a lotion to provide relief and to keep the area from drying out.
5. Loosely bandage the burn. Use sterile gauze. Avoid fluffy cotton that could shed and get stuck to the healing area. Also avoid putting too much pressure on the burned skin.
6. Take an over-the-counter pain reliever if necessary. Consider acetaminophen (Tylenol), ibuprofen (Advil), or naproxen (Aleve).