water. Apply a simple sterile dressing of fine-mesh, dry
First-degree burns. A first-degree burn is the
gauze over the area to protect it from infection. Casualty
mildest. Symptoms are reddening of the skin and mild
treatment for first-degree burns needs little attention
pain.
beyond self-care.
Second-degree burns. A second-degree burn is
When emergency treatment of the more serious
more serious. Symptoms include blistering of the skin,
second-degree burns and third-degree burns is required,
severe pain, some dehydration, and possible shock.
treat the patient for shock first. Make the patient as
Third-degree burns. A third-degree burn is
comfortable as possible, and protect the person from
characterized by complete destruction of the skin with
cold, excessive heat, and rough handling.
charring and cooking of the deeper tissues. This is the
The loss of body fluids is the main factor in burn
most serious type of burn. It produces a deep state of
shock. If the patient is conscious, able to swallow, and
shock and causes more permanent damage. It is usually
has no internal injuries, you can give the patient frequent
not as painful as a second-degree burn because the
small amounts of coffee, tea, fruit juice, or sugar water.
sensory nerve endings are destroyed.
To enable trained personnel to determine the kind
Burn Emergency Treatment
of treatment required, no not apply medication to burns
during emergency treatment. Pain is closely associated
The degree of the burn, as well as the skin area
with the degree of shock and should be relieved as soon
involved, determines the procedures used in the
as possible. When available, ice water is an effective
treatment of burns. Large skin areas require a different
pain reducer. Flooding with lots of clean, cool fresh
approach than small areas. To estimate the amount of
water also helps if not too much force is used. In electric
skin area affected, use the rule of nines (fig. 1-15).
shock cases, burns may have to be ignored temporarily
while the patient is being revived.
As a guideline, burns exceeding 20 percent of the
body surface endanger life. Burns covering more than
After treating the patient for pain and shock, apply
30 percent of the body surface are usually fatal.
a compress and bandage to protect the burned area. If
a universal protective dressing is not available, use a
If time and facilities permit caring for patients with
fine-mesh gauze. Remove constricting articles of
supeficial burns, clean the burned area with soap and
clothing and ornaments, and immobilize and elevate the
burned area.
Evacuate patients with extensive deep burns to a
medical facility for treatment as rapidly as possible.
Pain should be alleviated and shock must be controlled
before and during evacuation.
Clothing that sticks to a burn maybe cut around the
burn and the adhering cloth allowed to remain until
removed by medical personnel. The area of the burn is
usually sterile; therefore, be careful not to contaminate
it.
HEARING CONSERVATION AND
NOISE ABATEMENT
Historically, hearing loss has been recognized as an
occupational hazard related to certain trades such as
blacksmithing and boilermaking. Modem technology
has extended the risk to many other activities, such as
internal combustion engines, or similar high-speed,
high-energy processes are used. Exposure to
high-intensity noise occurs as a result of either impulse
Figure 1-15.--Rule of nines.
or blast noise (gunfire or rocket fire) and from
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