Burn wound progression and the importance of first aid

A burn injury is one of the most severe forms of trauma that can be sustained (National Burn Care Review Committee Report [NBCR], 2001). Burns and scalds can have a wide variety of causes such as thermal, mechanical, chemical, electrical or radiation, but all will involve coagulative destruction of the skin (Rawlins, 2011). About 250,000 people sustain burn injuries in the UK every year; 175,000 people visit A&E for treatment and almost 13,000 require admission for their injuries (NBCR, 2001). Wound severity can vary wildly (Evers et al, 2010). Flame injuries account for more than half of all burns (55%) and are often associated with inhalation injury and other concomitant trauma (Hettiaratchy and Dziewulski, 2004). Scald burns account for 40% of all burns injuries with 70% of childhood burns caused by contact with hot liquids or being exposed to hot bath water (Evers et al, 2010). Children under four years are most at risk and they make up 20% of all paediatric burn injuries. Fortunately, the majority (80%) of all burn injuries are classified as being minor and can be managed successfully by non-specialist healthcare professionals in primary and secondary care (Alsbjorn et al, 2007; Rowley-Conwy, 2012). The quality of initial management of burns can greatly influence long-term outcomes such as aesthetic, psychological, social, physical and functional outcomes (Falder et al, 2009). Therefore, it is essential for all clinicians involved in the care of patients with burn injuries to understand how interventions can affect healing and outcomes. Mortality and length of stay are no longer used as singular parameters to quantify the success of burn care. Healthcare professionals must consider success in terms of patients’ resulting satisfaction with life and physical, functional and emotional wellbeing (Stavrou et al, 2014), with the goal of treatment being to recover the patient to their pre-injury state with unaltered potential (NBCR, 2001).