Brushing the hot edge of a grill during a shore lunch or chomping on the wrong end of a cigar in the excitement of pulling in a lanker bass exposes one to another of the minor hazards of outdoor activity, namely burns. When a hot object comes into contact with a cool skin several things happen: the blood vessels dilate, fluids leak into the area, the protein material in the cells coagulate like the white of a fried egg, and it hurts! Medically we classify burns into three types.

First degree burns are the mild ones, involving only the outer layer of skin. These produce redness and swelling but no blisters.

Second degree burns involve all the layers of skin, outer and inner, producing blistering but not deep enough damage to prevent the growth of new skin.

Third degree burns are deeper, more serious burns which destroy the tissues underlying the skin. These are beyond the limits of first aid and require skilled medical attention.

First and second degree burns usually heal well within two weeks, but certain “do’s” and “don’t” should be followed. The number one problem complicating burns of the more serious type is infection, and even for relatively minor ones the first principle is cleanliness. Here again the bottle of liquid medicated soap and the cotton should be used and the involved area cleaned with gentle thoroughness. I put this question to one of my colleagues who specializes in the treatment of severe burn cases. “What kind of first-aid do you prefer to see in those patients who come into your office with burn injuries?” his immediate answer was “soap and water.”

After the area is thoroughly clean there are several things that can be done. There is increasing evidence that the use of cold water will favorably affect the progress and healing of a burned area and it certainly helps ease the pain. If your portable ice box and a bucket are available, make a chilled pail of ice water and immerse the burned area in it. If it is an area that cannot comfortably be submerged, use cold wet packs and change them frequently.

If the skin is unblistered, a light application of one of the many anesthetic-antibiotic ointments may be spread over the involved area. A tube of this medicine may be obtained from your pharmacist and should be a part of your emergency medical kit. A sterile dry gauze dressing should then be applied and no complications need be expected.

With blistered second degree burns, one of the most important DONT’S is to leave blisters alone. Do not open them because this is a job for your doctor. An open blister is an open door for wound infection, and this operation should be carried out under sterile conditions not likely to be available in the field. Should the blisters break spontaneously, leave it intact, do not (as many first-aid books recommend) attempt to trim it. The skin of the blister is in itself an excellent dressing material.

Another DON’T – never use a greasy or oily material on a second or third degree burn. Cleanse them thoroughly as soon as possible and use a dry sterile dressing until more specific measures can be taken. Leave the ointment in the first-aid kit.

DO – Clean thoroughly with liquid soap and water. Immerse in cold water, or use cold wet packs to the area. Use light application of an anesthetic antibiotic ointment to first degree burns. Cover with dry, sterile dressing.

DON’T – Open a blister. Cover a blister with an oily or greasy material (including butter).

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