The right action for burns
Burns can have different causes
Burns or scalds are damage to the skin and deeper tissues caused by heat. Burns can be caused by both obvious hazards (welding, hot materials, steam, hot water) and hidden hazards (electricity, frictional heat, radiation).
The causes of combustion can be divided into six categories:
- dry-thermal: flames, radiant heat, open fire (explosion)
- wet-thermal: Scalding, hot liquids, vapour
- liquid chemicals: Acids, alkalis, solvents, etc.
- dry chemicals: Powder (e.g. cement, lime, etc.)
- mechanical: Friction
- Radiation: Sunburn, radioactivity, ionisation
The depth of a burn is categorised into burn grades from I to IV:
| Grade I | Reddening and swelling of the skin, e.g. sunburn. |
| Grade II a | Reddening and swelling of the skin, blistering, pain due to damage to the outer skin layer, which stands out as a thin-walled blister. |
| Grade II b | Whitish pallor and swelling of the skin, blistering, pain due to damage to deep layers of the dermis. |
| Grade III | Leathery skin areas, discoloured white, grey or black, reduced pain due to destruction of the nerve endings, complete destruction of the outer skin layer and dermis as well as damage to the subcutis. |
| Grade IV | Burn extends beyond the skin into deeper layers of tissue (tendons, muscles, blood vessels), often accompanied by charring of the affected tissue. |
Workers are one of the largest risk groups due to these different causes of burns. "[...] Thermal trauma, including electrical accidents and chemical contact injuries, is one of the most common causes of accidents in the western world. In Germany, around 15,000 patients with burns are treated as inpatients every year, of which around 1,500 receive intensive medical care in the burn centres set up for this purpose. [...]"1
The severity of the burn is influenced by the temperature, the duration of exposure to heat and the type of first aid measures administered. "[...] At a temperature of 45 °C, for example, cell death occurs after one hour, at a temperature of 75 °C within 2 seconds. [...]"1
1 Ott, Alexander: The preclinical therapy of the severely burnt patient: An overview. In: Rescue Service, 33rd Vol. 2010, Issue 4, pp. 342-346.
The three different degrees of burns
First degree: First-degree burns usually show reddened skin or swelling. The external symptoms are accompanied by pain. Hole-like changes in the outer layer of skin are not yet noticeable. A doctor should be consulted as a precaution in the case of extensive burns, breathing problems and chemical burns.
Second-degree burns: Second-degree burns usually refer to skin damage that affects the epidermis and the dermis underneath. It is not uncommon for symptoms of second-degree burns to include blistering and a strong red colouring of the skin. The external symptoms are accompanied by swelling and severe pain. If the affected area is smaller than 6 - 8 cm, it can be treated as a first-degree burn. If larger areas of skin are affected and breathing or joints are impaired, medical help should be sought quickly.
Third degree: In contrast to second-degree burns, third-degree burns not only damage the top two layers of skin, but also other layers of the skin. Nerves, muscles and even bones can also be damaged. Charred areas are often visible and the affected person suffers very severe pain. However, if the nerves are damaged, the affected person may not feel any pain at all. A doctor should be called immediately.
First aid: Do not cool burns with water!
The first aid measure taught for a long time for burns was: cooling with water. However, this has been viewed critically by first aid organisations and burn specialists for many years.
Background: Running water is only suitable for cooling a burn wound to a limited extent. Instead of the burn wound, the entire affected body part is usually cooled, which can quickly lead to hypothermia in the injured person. However, hypothermia in a burn victim is considered a serious risk factor for further clinical care.
Based on clinical experience with burn victims, cooling with water has therefore been increasingly restricted in recent years (shortening the duration, limiting the body surface to be cooled, cooling only with tempered water at 15 - 20 °C).
Not cooling burn injuries poses two important problems for the injured person and the first aider: firstly, as everyone knows from their own experience, burn wounds are extremely painful. Effective cooling provides immediate relief. Secondly, it is important to prevent the so-called "afterburn": The heat energy that has penetrated the tissue continues to spread. Without suitable first aid, a second-degree burn can quickly develop into a third-degree burn, even if there is no longer any contact with the original heat source!
Based on the latest scientific findings and the current doctrine of first aid organisations, WERO recommends controlled cooling of burns with WATER JEL® instead of uncontrolled cooling with water .
How to treat burns correctly
Direct contact of the skin with ice should always be avoided. There is a risk of localised frostbite of the skin. Appropriate gels or gel-soaked compresses, such as the WATER-JEL® products, are ideal for treating burns. WATER-JEL® combines the most important basic measures for treating burns in one step:
- Elimination of the cause of the burn (extinguish flames if necessary)
- Cooling of the burn (no dangerous evaporative cooling)
- Clean wound care (no further bacterial growth)
The first aider must immediately ensure that body heat is maintained. Further information on the WATER-JEL® products and how to use them can also be found in our online shop.
However, burns are often cooled with water. There is a risk, especially in the case of extensive burns, that the affected area or even the injured person will cool down. The core temperature of the affected person decreases as a result of the cooling. The body reacts with muscle tremors to produce heat. If the core temperature continues to fall, the person's consciousness becomes clouded. Their reflexes are severely impaired and the shivering stops. If the core temperature cools further, loss of consciousness occurs. Further consequences can include respiratory and circulatory arrest.
WATER-JEL® First Responder HA
The optimal first aid for burns
WATER-JEL® FR* HA (Hyaluronic Acid) consists of over 95 % pure deionised water. Hyaluronic acid is responsible for the regeneration of the skin. It therefore accelerates and improves wound healing. The transparent gel makes it possible to visually inspect the wound at any time. This is particularly important for emergency services and doctors, as they can see the condition of the wound directly without having to remove the gel.
The patented carrier material is a sterile, woven polyester, which provides optimum wound coverage and absorbs 13 times its own weight in gel.
WATER-JEL® FR HA offers an excellent option for the treatment of burn wounds, as proven in various international studies:
Immediate pain relief.
Pain relief in particular leads to important psychological relief and reassurance for the injured person. This in turn makes it easier for the first aiders involved to proceed calmly and for professional staff to provide further care.
Controlled cooling of the burn wound
using heat transfer. The WATER-JEL® FR HA compresses absorb very high temperatures in a very short time. The gel above the wound heats up, conducts the heat to the gel surface and transfers it to the surrounding air. This prevents further penetration into deeper layers of the skin and further tissue destruction (the "afterburn").
Avoidance of hypothermia.
The controlled cooling of the burn wound drastically reduces the risk of hypothermia compared to cooling large areas with water. When covering large burns with WATER-JEL® FR HA blankets or compresses after initial treatment, care should be taken to ensure that the injured person retains heat.
No sticking of foreign bodies.
With its gel-like structure, WATER-JEL® FR HA ensures that the wound fluid does not evaporate or soak into the dressing, preventing it from sticking to the wound. Due to its watery consistency, the gel can be easily washed off in the event of clinical treatment without altering the appearance of the wound. Foreign bodies such as clothing residues can be removed more easily during clinical treatment by keeping the burn wound moist.
For first aid, it is usually sufficient to treat the burn with WATER-JEL® FR HA. Covering the WATER-JEL® FR HA dressing is only necessary if it serves to secure the dressing during transport or if it is necessary to keep the injured person warm. In the first 5 - 10 minutes, the WATER-JEL® FR HA dressing should not be covered in order to prevent heat build-up in the burn wound underneath.
Burns to the hands
are particularly common. If the fingers are bandaged together in the case of a grade IIb or higher burn, there is a risk that the burnt skin of the fingers will stick together and can only be loosened by surgery. The fingers should therefore be bandaged separately. The WATER-JEL® FR HA hand compress offers the ideal, easy-to-use solution for this.
Burns to the face
are extremely painful and can be permanently disfiguring if scarring occurs. The WATER-JEL® FR HA face dressing has special cut-outs and covers for the eyes and nose as well as an "H" shaped cut-out for the mouth. These cut-outs allow optimum treatment of the burn injury and even ensure access in the event of artificial respiration. In addition, the dimensions of the face dressing are sufficient to cover the ears, chin and neck area.
"... We are very satisfied with WATER-JEL® FR HA and can only recommend it to others. We have already used the product for scalds. The accident clinic has also praised the use of the product." Customer reference: Schäfer Mietwäsche Service GmbH
