ABOUT BURNS



The Experience: There is a physical, mental, and emotional experience associated with being burned. When a person is exposed to fire, the heat is so intense that it literally takes one's breath away. Fire grabs and feeds from oxygen, so it is nearly impossible to breathe. As a consequence, there is little or no time to react.

The human body responds remarkably to any potential threat of danger with a "fight or flight" response. When this reaction is triggered, our brain sends messages to the adrenal glands, which release chemicals into the bloodstream that cause our bodies to change. These changes include increased respirations, increased blood flow to muscles and limbs, intensified awareness, enhanced impulses, and diminished pain.

Many crash victims/survivors report recognizing the need to get out or away from the fire and after doing so, remember little else about the event. Some only remember vague details such as smells and images.

Despite removal from or extinction of the fire, the burn victim/survivor remains in immediate danger. Depending upon the size and degree of the burn injury there is now the risk of respiratory failure and shock. Shock is a physiological response to trauma and a life-threatening condition that should not be confused with the "fight or flight" response.

Shock reduces blood flow to vital organs and affects a person's blood pressure, heart rate, respirations, as well as state of consciousness. Shock may also account for a victim/survivor's inability to recall details of a crash. If you were burned as a result of a drunk driving crash you may not recall feelings of panic, fear, and anxiety often associated with burns. On the other hand, you may describe the experience as terrifying. Either way, immediately following a crash and for some time thereafter, a burn victim/survivor is faced with a potentially life threatening condition.

Types of Burns: A burn is an injury to the skin that damages or destroys skin cells and tissue. Burns are generally caused when skin makes contact with flames, chemicals, electricity, or radiation. Thermal burns are burns caused by intense external sources of heat, such as flames, scalding liquids, or steam. Burns resulting from an impaired driving crash are most likely thermal burns.

Degrees of Burns: Your skin is the largest organ of your body. It prevents infection from entering your body and it limits the loss of important fluids. Your skin "holds everything together." Once a victim/survivor with burn injuries is identified and stabilized, the burn team begins to assess and classify the burn injuries. Burns are assessed by their size in relation to the entire body and by their depth. They are rated according to how many layers of skin are damaged.

A first degree burn involves the top layer of skin called the epidermis. The epidermis is the outer most layer of skin made of flat, scale-like cells called squamous cells. Under these cells are basal cells, and at the deepest part of the epidermis lie melanocytes. Melanocytes produce melanin, which gives skin its color.

First degree burns: Are labeled superficial and the body can heal itself quickly by creating new, healthy cells in a process called epithelialization . First degree burns are often caused by sunburn or scalds, appear pink to red, can be painful with swelling, and typically leave no scarring.

Second degree burns:  Involve the epidermis and the second layer of skin called the dermis . The dermis contains blood vessels, lymph vessels, hair follicles, oil glands, and sweat glands. Second degree burns can range from superficial to partial thickness depending upon the extent of the damage.

While the body can heal from second degree burns by epithelialization and a process called contraction , scarring and thickening frequently occur and healing can take up to six months. Contraction happens when the burn is deeper and the skin cannot heal with epithelialization. The body closes the wound by drawing on the surrounding skin, or contracting. Because of these factors, doctors often recommend skin grafts for second degree burns.

Third degree burns: Involve all layers of the skin and are referred to as full thickness burns. Full thickness burns destroy all of the epidermis and dermis, as well as nerves, hair, glands and vessels. Because of the damage caused by third degree burn, the body cannot repair itself and skin grafts must be performed to prevent infection to the body. Fourth degree burns involve the damage of bone and muscle and are rare.

The severity of a burn injury is not only determined by burn classifications, but also by the victim/survivor's age, the victim/survivor's previous health status, the size of the injuries, how much of the injuries can be attributed to third degree burns, and other medical complications related to the fire. It is often difficult to accurately assess a burn at first glance as the injury may change over the first several days following exposure.




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