What is a Thermal Burn? Treatment Plans & Severity

Thermal Burn Definition: Thermal burns occur by directly contacting heated objects—hot water, steam, cooking oil, grease, hot surfaces and fire. At Burn and Reconstructive Centers of America, 85% of all burn injuries treated are thermal burns.

What is a thermal burn?

Thermal burns fall into six categories, including scalds, thermal contact burns, electrical burns, chemical burns, radiation burns, and burns caused by fire. Treatment plans for a thermal burn vary depending on the kind of burn sustained and the severity of the burn.

What is a thermal burn, and how can it be caused?

Grilling

According to the National Fire Prevention Association (NFPA), roughly half of the injuries involving grills are thermal burns. Propane and charcoal grills should only be used outdoors. Grills should be placed a safe distance from the home, deck railings and overhanging tree branches. Always make sure the grill lid is open before lighting it and never leave any grill unattended. Once grilling is complete, be sure to shut off the propane to reduce gas leaks and let the hot coals from charcoal grills completely cool down. Did you know that propane tanks can expire? Don’t worry; each propane tank is stamped with information like when it was manufactured or last certified. From there, you can figure out if your tank is still good to use!

Cooking

Always keep loose items away from the stovetop. If you have children or pets in the home, make sure they are kept well away from the stove-top or oven. Never leave a stovetop unattended. According to the U.S. Food and Drug Administration (FDA), most microwave injuries are thermal burns from hot containers, overheated foods or exploding liquids. Only use approved microwave safe products and do not heat food in metal or plastic containers as they may melt, damage the microwave or spark a fire. Always allow the food to cool before removing it from the microwave.

Candles

According to the National Fire Protection Association (NFPA), U.S. fire departments respond to an average of 7,610 house fires as a result of candles each year and December is the peak month. In fact, three times as many candle and incense fires occur on Christmas day. Always keep burning candles or incense within sight and make sure to extinguish both before leaving a room or going to sleep. Never burn a candle or incense on or near flammable objects. Keep both candles and incense out of reach of small children and pets and be sure to burn them in a well ventilated area

Fireworks

The mishandling or misuse of fireworks, along with improperly discarded hot debris, are among the most common hazards when it comes to thermal burn injury to the hands, legs, or head.

WHEN HANDLING FIREWORKS REMEMBER TO:

• Set up the firework on a flat surface to reduce the risk of tipping over.
• Educate children on proper firework etiquette: don’t get too close and don’t touch.
• Closely monitor children when they have sparklers.
• Avoid re-lighting, leaning over, or picking up a “dud.” The firework is still live and has the potential to go off.

Can Water cause thermal Burn Injury?

Bath time can be a very relaxing experience, but thermal burn injury can happen in seconds if the bath water is too hot. To be safe, test the temperature of the water before use. Instead of feeling the water with your hand, put your elbow in it. If the water feels hot on your elbow, the temperature is too hot. If you find that your bath water is too hot, you can add cold water to cool it down or wait until it naturally cools. According to the CDC, bathtub temperature should not be higher than 104°F

Coffee is often served at 175 °F, making it high-risk for causing severe thermal burns. Use a lid or thermos to reduce the risk of spilling. Also, make sure to keep it out of reach of children. If you suffer a hot beverage burn, soak the burn in cool water for about five minutes, which can help reduce swelling by pulling the heat away from burned skin. Then, treat the skin with antibiotic ointment and wrap it loosely in a dry gauze bandage.

Can Appliances Cause Thermal Burn Injury?

Personal heaters can be thermal burn injury and fire hazards, especially old ones. Most new heaters should turn off if they get tipped over, but many old ones do not and can catch flammable materials on fire. Make sure you place your heater at least three feet away from you and anything flammable. Before leaving the house or the office, turn off and unplug your heater. And always plug your heater directly into the wall outlet. Never use an extension cord or power strip.

According to the Electrical Safety Foundation International (ESFI), heating pads and electric blankets are responsible for causing approximately 500 fires each year in the U.S. Always inspect the electrical heating device before use for cracks or frays in the electrical cord. Do not place or allow anything on top (pets, other blankets, etc.) of a heating pad when in use.

According to the U.S. Fire Administration, more than 2,900 fires occur each year as a result of home clothes dryers. Annually, this results in an estimated 5 deaths, 100 injuries and $35 million in property loss/damage. Be sure to consistently empty the lint trap before use to avoid risk of fire. Additionally, make sure to check the outside vent to ensure proper airflow. If possible, try to run the dryer when home and keep an eye on it.

Can Pavement Cause Thermal Burn INjury?

Surfaces such as pavement, asphalt and artificial grass can become searingly hot, causing blisters or thermal burns on the skin. When walking on hot pavement, make sure you have proper foot protection to help prevent thermal burns! Small children should also be kept off of hot pavement to eliminate the chance of thermal burn injuries. And remember, if it’s too hot for you, it’s also too hot for pets!

After a toddler burned their feet walking on a patio, Augusta’s WJBF Channel 6 reached out to BRCA’s Chief Clinical Officer, Beretta Craft-Coffman, for an interview on burn safety, prevention tips and awareness of the dangers of severe thermal burns from hot surfaces.

Watch the interview here.

What is a thermal burn, and how severe is it?

If you are in uncontrollable pain, have second-degree thermal burns larger than your palm or anything that looks charred, dry or is painless, seek immediate medical care. Additionally, you may need to call 911 for emergency medical transport, including:

• Extensive second-degree thermal burns on the body
• Any third- or fourth-degree thermal burns on the body
• Difficulty breathing due to facial burns
• Large smoke exposure in a closed room
• If the injured person is unconscious

WHAT IS A THERMAL BURN’S RECOVERY TIME?

What is a thermal burn injury’s average time to recovery? The severity of a thermal burn injury can range from superficial to deep. The time it takes for a thermal burn to heal can vary wildly depending on various factors, including what caused the thermal burn and how quickly treatment or medical attention is sought.

Now you have a firm understanding of what a thermal burn is and what causes it, it’s also important to understand how long these injuries might take to heal. Here are average treatment times for the four different levels of thermal contact burns.

First-degree thermal burn

First-degree, or superficial burns, are contained within the epidermis, and the nerve endings remain intact. There is typically no need to access a healthcare center, as these burns can heal within three to five days with minimal intervention.

Second-degree thermal burn

The thermal injury definition of a second-degree burn is one that partially damages the nerve endings and leaves thickness burns. These burns may appear more advanced, but they can heal within 10 to 15 days based on average healing times.

Expect minimal scarring under the right conditions. However, changes to your skin pigment may occur. Again, formal medical intervention is typically not required, but it is considered best practice to consult your doctor for an examination.

Third-degree thermal burn

Known as full-thickness burns, understanding what can cause a thermal burn of this nature can enable you to seek immediate medical attention to control the damage and minimize any risk to your health.

These burns cause significant scarring and require long healing times. It can take months for these burns to heal.

Fourth-degree thermal burn

Any article on this subject will tell you that these are the most severe burns involving subcutaneous fat, muscle and bone and require an immediate trip to a hospital. Treatment will focus on preserving the patient’s health before moving to debridement, dermal autografts and possibly even blood transfusions and amputations.

If you sustain a fourth-degree thermal burn, permanent scarring should be expected, along with a long recovery path.

For more information on thermal burns or how to treat them, contact Burn and Reconstructive Centers of America at 855-863-9595. If you’re a healthcare provider looking to refer a patient, check out our referral process and how we’re able to assess and create a care plan in minutes.

Burns and scalds – Complications

Burns and scalds can sometimes lead to further problems, including shock, heat exhaustion, infection and scarring.

Shock

After a serious injury, it’s possible to go into shock. Shock is a life-threatening condition that occurs when there’s an insufficient supply of oxygen to the body.

It’s possible to go into shock after a serious burn.

Signs and symptoms of shock include:

• a pale face
• cold or clammy skin
• a rapid pulse
• fast, shallow breathing
• yawning
• unconsciousness

Dial 999 and ask for an ambulance if you think someone who’s been seriously injured is going into shock.

While you wait for the ambulance:

• lay the person down (if their injuries allow it) and raise and support their legs
• use a coat or blanket to keep them warm, but do not cover their face or the burnt area
• do not give them anything to eat or drink

Heat exhaustion and heatstroke

Heat exhaustion and heatstroke are 2 heat-related health conditions that happen when the temperature inside your body rises to 37 to 40C or above.

Both heat exhaustion and heatstroke can be very serious. They’re often caused by being exposed to too much sunlight or heat.

Symptoms of heat exhaustion and heatstroke include:

• extreme tiredness and lack of energy
• dizziness or fainting
• feeling sick or vomiting
• rapid pulse
• headache
• muscle pain
• irritability
• confusion

If a person with heat exhaustion is taken quickly to a cool place, given water to drink and has their clothing loosened, they should start to feel better within half an hour.

If they don’t, they could develop heatstroke. This is a medical emergency and you’ll need to call 999 for an ambulance.

Read more about what to do if someone has heat exhaustion or heatstroke.

Infection

Wounds can become infected if bacteria get into them. If your burn or scald has a blister that’s burst, it may become infected if it’s not kept clean.

Seek medical attention for any burn that causes a blister.

Your wound may be infected if:

• it’s uncomfortable, painful or smelly
• you have a high temperature of 38C or higher
• you have signs of cellulitis, a bacterial infection that causes redness and swelling of the skin

Contact your GP or get help from NHS 111 if you think your burn has become infected. An infection can usually be treated with antibiotics and painkilling medication, if necessary.

In rare cases, an infected burn can cause blood poisoning (sepsis) or toxic shock syndrome. These serious conditions can be fatal if not treated.

Signs of sepsis and toxic shock syndrome include:

• a high temperature
• dizziness
• vomiting

Scarring

A scar is a patch or line of tissue that remains after a wound has healed. Most minor burns only leave minimal scarring.

You can try to reduce the risk of scarring after the wound’s healed by:

• applying an emollient, such as aqueous cream or emulsifying ointment, every day until the burn is no longer dry or itchy. This could take 3 to 6 months
• using sunscreen with a high sun protection factor (SPF) to protect the healing area from the sun when you’re outside

Psychological impact

Burns and scalds, especially severe ones, can cause long-lasting distress.

After a burn or scald, some people report experiencing:

• feelings of anxiety and stress
• low mood and depression
• a lack of confidence and self-esteem

Some people recovering from a burn may also develop post-traumatic stress disorder (PTSD), which can cause symptoms such as flashbacks, nightmares, and unwanted and intrusive thoughts.

If you experience any of these emotional issues, you should speak to the staff at the burns care service.

They can arrange an appointment with a psychologist with experience of treating people recovering from burns and scalds.

Page last reviewed: 23 June 2022
Next review due: 23 June 2025

➤ Thermal Burn First Aid – Thermal Burn Degrees – August 2022

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A thermal burn is a burn resulting from exposure to a heat source. It can be a fire, a hot liquid or steam, a solid object of high temperature. Both adults and children experience thermal burns. According to statistics, in 84% of cases the cause lies in the fire.

Prognosis directly depends on the degree of tissue damage and the chosen treatment strategy. With extensive injuries and burns of III-IV degree, there is a risk of death, especially in the absence of timely medical care.

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Symptoms and degrees of thermal burns

In medicine, burns are classified into degrees depending on the nature and depth of damage. Symptoms directly depend on the degree of burn:

1. I degree . It is characterized by superficial tissue damage. There is redness and swelling. A person is worried about pain and burning. Symptoms persist for 2-3 days and then gradually disappear.
2. II degree. Blisters are added to the listed symptoms, which are formed as a result of prolonged exposure to a heat source or short-term high temperature.
3. III degree . Differs in tissue necrosis. Depending on the cause of the burn, cell necrosis may look like a yellow weeping jelly-like mass, or the skin remains dry, but becomes dark red or even black. A burn is accompanied by severe pain and can cause serious suffering to a person, especially with a large area.
4. IV degree . Necrosis concerns not only the surface epithelium, but also tissues located under the skin. In some cases, damage reaches the bones. Affected areas become dark, red-black. Several large bubbles merge into one huge blister. Due to severe pain, there is a high risk of developing pain shock. In addition, there may be signs of intoxication: weakness, tachycardia, pallor of the skin. This is the most severe degree of thermal burns, in which there is a risk of death.

Stages of burns and first aid for burns

Burns are usually diagnosed by visual inspection. The severity of tissue damage is determined depending on the external manifestations and the depth of the burn. When determining the area of ​​damage, the rule of the palm is used, when it is conventionally considered that the area of ​​the palm is 1% of the entire body.

First aid for thermal burns: basic steps

It is important to immediately and correctly provide first aid for thermal burns, since the recovery of the patient, and sometimes even the chances of life, directly depends on this.

Observe the following rules and guidelines:

1. Extinguish the fire on the person immediately. Cover with a thick cloth or use other methods such as water, sand, earth, etc.
2. Remove any remaining smoldering cloth from the affected person, provided that it does not touch the wound. In no case should you tear off the adhered tissue from the body.
3. Run cold water on the burn for 10-20 minutes to reduce soft tissue temperature. You can lower the damaged parts into a container of cold water. But ice should not be used because of the risk of frostbite.
4. Apply an anti-burn ointment or gel to the affected area. Then apply a sterile or at least clean bandage. Don’t use cotton. Bandages, gauze and other fabric materials will do. For first-degree burns, you can do without a bandage.
5. It is strictly forbidden to use various folk remedies, lubricate wounds with oil, sour cream, apply aloe leaves, etc.
6. If a person suffers from severe pain, give an anesthetic.
7. Resuscitate if cardiac or respiratory arrest occurs.
8. If a large area of ​​the body is affected and symptoms of intoxication, pain shock are observed, let the patient drink a lot to speed up the removal of toxins from the body.
9. Call an ambulance immediately or take the patient to the hospital yourself. The first option is preferable because burns are not treated in all hospitals.

It is important not to panic and calm the injured person.

Thermal burns: how is it treated?

If a person has a thermal burn, treatment should be comprehensive. The measures taken are usually aimed at eliminating the disorders that have appeared in the body. The complex of procedures and drugs is selected individually, taking into account the degree and depth of tissue damage, concomitant diseases, general condition and other factors.

In a specialized hospital or department, the wound is toileted first. Anesthesia is required to avoid pain shock. The wound is washed with a mild soapy solution, particles of melted substances are removed. Then they are treated with antiseptics. In case of severe contamination, the wound is washed with hydrogen peroxide.

If an open treatment is chosen, an anti-burn agent is applied to the wound. The bandage is not used. With the closed method, after applying the ointment or emulsion, a not very tight bandage is applied, but it should not move. Leave it on average for 7 days until the epithelium layer is restored.

Doctors differ on whether blisters should be opened. Some believe that they should not be touched, since the blisters serve to protect tissues from infection. Other experts argue that the contents of the bubbles are not sterile, so they need to be opened. In this case, a small incision is made in the lower part of the blisters and all the liquid is removed, gently pressing on the bubble with a cotton-gauze swab.

IV degree burns require not only competent treatment, but also skin grafting. This is especially true in cases of tissue damage over a large area.

Author:
Andrey Zhernov
Plastic surgeon

2022 © Andrey Zhernov

Development: Medmarketing

90 000 Thermal burns – GBUZ “Bryukhovets Central District Hospital” MZ KK

Thermal burns

Thermal burns – these are burns with a flame, hot steam, hot or burning liquid, boiling water, from contact with hot objects, sunburn. Flame burns are the most common, burns with liquids are recorded in second place, electric burns and burns with an electric arc flame are in third place. Burns caused by other factors are observed in isolated cases.

In modern conditions of intensive industrialization, the ever-increasing use of thermal energy sources in production and at home, there is a tendency to increase the frequency of burns. According to the World Health Organization, burns rank third among other types of injuries. Burns are often fatal, and many of those who recover remain disabled.

The severity of a burn injury largely depends on the area and depth of tissue damage. In our country, the following classification of burns has been adopted:

• 1st degree burns are manifested by redness and swelling of the skin;
• · 2nd degree burns are characterized by the appearance of blisters filled with a clear yellowish liquid. Under the exfoliated layer of the epidermis, an exposed basal layer remains. With burns of the I-II degree, there are no morphological changes in the skin, which is how they fundamentally differ from deeper lesions.
• III degree burns are divided into two types: III A degree burns – dermal – damage to the skin itself, but not to its entire thickness. At the same time, viable deep layers of the skin or appendages (hair bags, sweat and sebaceous glands, their excretory ducts) are preserved. With burns of the III B degree, necrosis of the skin occurs and a necrotic scab forms.
• IV degree burns are accompanied by necrosis not only of the skin, but also of deeper tissues (muscles, tendons, bones, joints).

The severity of the burn also depends on the area of ​​the affected tissues. It is expressed as a percentage relative to the area of ​​the entire surface of the skin. When estimating a burn, the so-called “rule of the palm” is used: the area of ​​\u200b\u200bthe human palm is equal to one percent of the body area.

In severe cases, a thermal burn can be complicated by a burn disease, during which it is customary to distinguish periods:0003

– acute toxemia (the second period of burn disease, occurring 2-3 days after injury and lasting 7-8 days; characterized by a predominance of severe intoxication due to the effect on the body of toxic products coming from the affected tissues and bacterial infection),

– septicotoxemia (a period conditionally starting from the 10-12th day of the disease and characterized by the development of infection, putrefactive processes in wounds and the penetration of microbes, their toxins and products of autolysis of dead tissues into the bloodstream; staphylococcus, Pseudomonas aeruginosa and Escherichia coli usually grow in the burn wound, proteus and their associations),

– recovery (or convalescence).

First aid for thermal burns

1. The first thing to do as soon as possible is to extinguish the flames (if any) on the victim’s clothing and skin. It is necessary to throw off burning clothes from a person or throw a cloth over his body in order to stop the access of air to the fire.

2. Try to calm the victim and the people around him.

3. Carefully remove smoldering remains of things from the injured person that did not get into the wound. Never peel off clothing stuck to the burn. Also, you can not touch the burnt body with your hands.
4. If it is a sunburn, you need to move the injured person to the shade.
5. Hold the affected part of the body for 10-20 minutes under a stream of cold running water (you can lower it into a container with cool clean water). This must be done so that the heated wound does not deepen and expand. In addition, it activates the blood circulation in the wound. However, ice should not be used to cool the burnt area in order to avoid the possibility of another injury – frostbite.
6. Apply any available anti-burn agent (ointment, gel) to the affected surface, apply a sterile (if possible) dry bandage on top. You can not use cotton wool, only gauze, bandage – fabric materials. It happens that there is neither an anti-burn agent nor sterile bandages at hand, then any dry, clean bandage should be applied to the wound. You can not apply any folk medicines to the burn: vegetable oil, vodka solutions, kefir, sour cream, etc. You can also not apply Kalanchoe or aloe leaves and other “miracle remedies” to the burned skin. With a first-degree burn (if neither extensive damage to the skin nor blisters is observed), the bandage can not be applied at all, only an anti-burn gel can be applied.
7. If there are extensive burns of the extremities, it is necessary to carefully fix them with a splint (any improvised means), lifting the burnt arms (legs).
8. If a large area of ​​the body is burned and there are signs of burn shock (the person is weak, pale, he has increased anxiety, tachycardia and pressure drop are observed, cold sweat appears, breathing and heart rhythm are disturbed), you should give him as much liquid as possible to drink – juice , compote or plain clean water. Due to the intake of fluid into the body, intoxication will decrease, which has arisen due to the penetration of decay products of burnt tissues into the blood.
9. If the victim complains of pain, then in order to avoid pain shock, you should give him any available painkiller (spasmalgon, analgin, etc.).
10. In the absence of cardiac and (or) respiratory activity, cardiopulmonary resuscitation (artificial respiration, chest compressions) should be performed.
11. In case of severe burns, call an ambulance to hospitalize the victim.

In case of superficial thermal burns of more than 10% of the body area of ​​adults (in children – more than 5%) and with deeper burns from 5% of the body of an adult (respectively, more than 2.5% of the body of a child), after first aid, mandatory medical assistance is required followed by hospitalization. Such burns lead to a violation of the general condition, threaten the life of the victim and may subsequently require surgical intervention.

In addition to these cases, victims with deep burns of the hands and feet and superficial extensive burns of the hands and feet, burns of the eyes, ears, face and perineum, as well as suspected burns of the respiratory tract due to inhalation of extremely hot air are subject to mandatory hospitalization .

At home, you can independently treat superficial small burns without infection (without red swollen edges of the wound, without purulent discharge from the wound, fever, chills, increased pain in the wound, twitching pain in the wound, etc.). Home treatment involves changing bandages twice a day with the application of an anti-burn agent. The lesion site can be treated with hydrogen peroxide (3%), the skin around the burn – with iodine or brilliant green. An ointment for thermal burns (solcoseryl, panthenol, “rescue”) and a sterile gauze bandage are applied to the wound.

The prognosis to a large extent depends on the area of ​​the lesion, the degree of the lesion and the age of the victim.