First Aid for Burns

Written by DAN Staff

A serious burn — even a sunburn — can bring a quick end to an exciting dive trip. You can take steps to reduce the risk of burns, but you can’t always prevent them. On a busy dive boat, accidental contact with a hot compressor or stove, or someone just spending too much time in the midday sun can occur. Knowing how to address injuries and keep divers comfortable can make the difference between a minor hiccup and a ruined vacation. Brush up on your first aid skills for burns and keep your customers happy on your next trip.

Types of Burns

Burns occur when tissues are subjected to more energy than they can tolerate. This energy can come from chemicals, heat, radiation or electricity.

• Chemical burns, for example, are caused when a caustic chemical touches the skin. If the chemical is dry, assist the victim in brushing off the substance and consult a Material Safety Data Sheet (MSDS), which can often be found on the back of the chemical’s container. Otherwise, flush with copious amounts of water unless the MSDS indicates otherwise.
• More common in diving scenarios are thermal burns resulting from contact with heaters, hot water or fire, but even these pale in comparison to the number of radiation burns divers experience.
• Sunburns are the most common burns seen among divers. They result from radiation from the sun, rather than heat, and represent the single largest source of burns faced by outdoor enthusiasts of all kinds.

First Aid

After safely removing the source of a burn (caustic chemical, unprotected skin under the hot sun, electrical current or source of significant heat), the first step is to assess the injured diver’s airway, breathing and circulation. Barring any medical emergencies this assessment uncovers, the next step is to douse the burn with cool water (either fresh or salt) for at least 15 to 30 minutes. It can be difficult to cool deeper tissues after a burn, and spending a significant amount of time dousing the area in water can prevent further injury. Clothes, boots or shoes, and jewelry or accessories in the area of the burn should be removed while dousing the wound.AOnce a burn has been cooled, begin wound assessment and dressing. Burns are typically classified as superficial, partial thickness or full thickness.

• Superficial burns can be identified by redness, warmth and minor swelling around the site of the burn.
• Partial-thickness burns involve deeper layers of tissue and often have blisters and cause severe pain.
• Full-thickness burns are the most serious and affect all layers of the skin, destroying nerves and fatty tissue. Full-thickness burns may appear either black and charred or white and waxy, and are sometimes described as painless due to the nerve damage caused by the burn, but are almost universally surrounded by areas of partial-thickness burn that cause intense pain.
• Superficial burns can be identified by redness, warmth and minor swelling around the site of the burn.
• Partial-thickness burns involve deeper layers of tissue and often have blisters and cause severe pain.
• Full-thickness burns are the most serious and affect all layers of the skin, destroying nerves and fatty tissue. Full-thickness burns may appear either black and charred or white and waxy, and are sometimes described as painless due to the nerve damage caused by the burn, but are almost universally surrounded by areas of partial-thickness burn that cause intense pain.

You can treat a superficial burn by gently washing it with clean, soapy water, rinsing it thoroughly and patting dry. The wounds can be cleaned up somewhat, but avoid breaking any intact blisters. Take care not to irritate the wound further before dressing with a nonadherent dressing and double-antibiotic ointment. Change dressings daily.

Small partial-thickness burns can be treated in the same way, but any substantial partial-thickness or full-thickness burns should be evaluated and treated by a physician. These burns can be difficult to manage in the field and present a risk of significant fluid loss and infection. In the case of partial-thickness burns covering more than 15 percent of a person’s body or a full-thickness burn, immediate evacuation to advanced medical care may be indicated.

For more information on treating burns and other injuries, visit DAN.org/Health