Burns and Electric Shock

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Burns and Electric Shock

Topic Overview

Most burns are minor injuries that occur at home or work. It is common to get a minor burn from hot water, a curling iron, or touching a hot stove. Home treatment is usually all that is needed for healing and to prevent other problems, such as infection.

There are many types of burns.

  • Heat burns (thermal burns) are caused by fire, steam, hot objects, or hot liquids. Scald burns from hot liquids are the most common burns to children and older adults.
  • Cold temperature burns are caused by skin exposure to wet, windy, or cold conditions.
  • Electrical burns are caused by contact with electrical sources or by lightning.
  • Chemical burns are caused by contact with household or industrial chemicals in a liquid, solid, or gas form. Natural foods such as chili peppers, which contain a substance irritating to the skin, can cause a burning sensation.
  • Radiation burns are caused by the sun, tanning booths, sunlamps, X-rays, or radiation therapy for cancer treatment.
  • Friction burns are caused by contact with any hard surface such as roads ("road rash"), carpets, or gym floor surfaces. They are usually both a scrape (abrasion) and a heat burn. Athletes who fall on floors, courts, or tracks may get friction burns to the skin. Motorcycle or bicycle riders who have road accidents while not wearing protective clothing also may get friction burns. For information on treatment for friction burns, see the topic Scrapes.

Breathing in hot air or gases can injure your lungs (inhalation injuries). Breathing in toxic gases, such as carbon monoxide, can cause poisoning.

Burns injure the skin layers and can also injure other parts of the body, such as muscles, blood vessels, nerves, lungs, and eyes. Burns are defined as first-, second-, third-, or fourth-degree, depending on how many layers of skin and tissue are burned. The deeper the burn and the larger the burned area, the more serious the burn is.

The seriousness of a burn is determined by several things, including:

  • The depth, size, cause, affected body area, age, and health of the burn victim.
  • Any other injuries that occurred, and the need for follow-up care.

Burns affect people of all ages, though some are at higher risk than others.

  • Most burns that occur in children younger than age 5 are scald burns from hot liquids.
  • Over half of all burns occur in the 18- to 64-year-old age group.
  • Older adults are at a higher risk for burns, mostly scald burns from hot liquids.
  • Men are twice as likely to have burn injuries as women.

Burns in children

Babies and young children may have a more severe reaction from a burn than an adult. A burn in an adult may cause a minor loss of fluids from the body, but in a baby or young child, the same size and depth of a burn may cause a severe fluid loss.

A child's age determines how safe his or her environment needs to be, as well as how much the child needs to be supervised. At each stage of a child's life, look for burn hazards and use appropriate safety measures. Since most burns happen in the home, simple safety measures decrease the chance of anyone getting burned. See the Prevention section of this topic.

When a child or vulnerable adult is burned, it is important to find out how the burn happened. If the reported cause of the burn does not match how the burn looks, abuse must be considered and resources for help, such as social services, offered. Self-inflicted burns will require treatment as well as an evaluation of the person's emotional health.

Infection is a concern with all burns. Watch for signs of infection during the healing process. Home treatment for a minor burn will reduce the risk of infection. Deep burns with open blisters are more likely to become infected and need medical treatment.

Check your symptoms to decide if and when you should see a doctor.

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Home Treatment

Most minor burns will heal on their own, and home treatment is usually all that is needed to relieve your symptoms and promote healing. But if you suspect you may have a more severe injury, use first-aid measures while you arrange for an evaluation by your doctor.

Immediate first aid for burns

  • First, stop the burning to prevent a more severe burn.
    • Heat burns (thermal burns): Smother any flames by covering them with a blanket or water. If your clothing catches fire, do not run: stop, drop, and roll on the ground to smother the flames.
    • Cold temperature burns: Try first aid measures to warm the areas. Small areas of your body (ears, face, nose, fingers, toes) that are really cold or frozen can be warmed by blowing warm air on them, tucking them inside your clothing or putting them in warm water.
    • Liquid scald burns (thermal burns): Run cool tap water over the burn for 10 to 20 minutes. Do not use ice.
    • Electrical burns: After the person has been separated from the electrical source, check for breathing and a heartbeat. If the person is not breathing or does not have a heartbeat, call 911.
    • Chemical burns: Natural foods such as chili peppers, which contain a substance irritating to the skin, can cause a burning sensation. When a chemical burn occurs, find out what chemical caused the burn. Call your local Poison Control Center or the National Poison Control Hotline (1-800-222-1222) for more information about how to treat the burn.
    • Tar or hot plastic burns: Immediately run cold water over the hot tar or hot plastic to cool the tar or plastic.
  • Next, look for other injuries. The burn may not be the only injury.
  • Remove any jewelry or clothing at the site of the burn. If clothing is stuck to the burn, do not remove it. Carefully cut around the stuck fabric to remove loose fabric. Remove all jewelry, because it may be hard to remove it later if swelling occurs.

Prepare for an evaluation by a doctor

If you are going to see your doctor soon:

  • Cover the burn with a clean, dry cloth to reduce the risk of infection.
  • Do not put any salve or medicine on the burned area, so your doctor can properly assess your burn.
  • Do not put ice or butter on the burned area, because these measures do not help and can damage the skin tissue.

Home treatment for minor burns

  • For home treatment of first-degree burns and sunburns:
    • Use cool cloths on burned areas.
    • Take frequent cool showers or baths.
    • Apply soothing lotions that contain aloe vera to burned areas to relieve pain and swelling. Applying 0.5% hydrocortisone cream to the burned area also may help. Note: Do not use the cream on children younger than age 2 unless your doctor tells you to. Do not use in the rectal or vaginal area of children younger than age 12 unless your doctor tells you to.
  • There isn't much you can do to stop skin from peeling after a sunburn—it is part of the healing process. Lotion may help relieve the itching.
  • Other home treatment measures, such as chamomile, may help relieve your sunburn symptoms.

You may be able to treat second-degree burns at home.

First-degree burns and minor second-degree burns can be painful. Try the following to help relieve your pain:

Medicine you can buy without a prescription
Try a nonprescription medicine to help treat your fever or pain:

Talk to your child's doctor before switching back and forth between doses of acetaminophen and ibuprofen. When you switch between two medicines, there is a chance your child will get too much medicine.

Safety tips
Be sure to follow these safety tips when you use a nonprescription medicine:
  • Carefully read and follow all directions on the medicine bottle and box.
  • Do not take more than the recommended dose.
  • Do not take a medicine if you have had an allergic reaction to it in the past.
  • If you have been told to avoid a medicine, call your doctor before you take it.
  • If you are or could be pregnant, do not take any medicine other than acetaminophen unless your doctor has told you to.
  • Do not give aspirin to anyone younger than age 20 unless your doctor tells you to.

Lotions

Some doctors suggest using skin lotions, such as Vaseline Intensive Care or Lubriderm, on first-degree burns or second-degree burns that have unbroken healing skin. These skin lotions can be used to relieve itching but should not be used if the burns have fluid weeping from them or have fresh scabs. An antihistamine, such as Benadryl or Chlor-Trimeton, can also help stop the itching. Read and follow any warning on the label.

When a first-degree burn or minor second-degree burn is 2 to 3 days old, using the juice from an aloe leaf can help the burn heal and feel better. Applying the aloe juice may sting at first contact.

It is important to protect a burn while it is healing.

  • Newly healed burns can be sensitive to temperature. Healing burns need to be protected from the cold, because the burned area is more likely to develop frostbite.
  • A newly burned area can sunburn easily. Sunscreen with a high sun protective factor (SPF at least 30) should be used for the first year after a burn to protect the new skin.

Do not smoke. Smoking slows healing because it decreases blood supply and delays tissue repair. For more information, see the topic Quitting Smoking.

Symptoms to watch for during home treatment

Call your doctor if any of the following occur during home treatment:

  • Pain increases.
  • Difficulty breathing develops.
  • Signs of infection develop.
  • Symptoms become more severe or frequent.

Prevention

Most burns happen in the home. Simple safety measures decrease the chances of anyone getting burned.

Home safety measures

  • Do not smoke in bed.
  • Place smoke alarms and other fire safety devices in strategic locations in your home, such as in the kitchen and bedrooms and near fireplaces or stoves. Smoke detectors need to be checked and to have the batteries replaced regularly. A good way to remember to do this is to check smoke detectors twice a year when daylight savings and standard time change.
  • Make a fire escape plan, and make sure the family knows it (babysitters, too).
  • Keep a fire extinguisher near the kitchen and have it checked yearly. Learn how to use it. Put out food or grease fires in a pan with a lid or another pot.
  • Set your water heater at 120°F (50°C) or lower. Always test the temperature of bathwater.
  • Store cleaning solutions and paints in containers in well-ventilated areas.
  • Use proper fuses in electrical boxes, do not overload outlets, and use insulated and grounded electrical cords.
  • Keep trash cleaned up in attics, basements, and garages.
  • Be careful with gas equipment such as lawn mowers, snowblowers, and chain saws.
  • Be careful with any flammable substances used to start fires, such as lighter fluid.
  • Avoid fireworks. Think of safety first when dealing with fireworks.

Your local fire department is a good resource for more information on how to prevent fires, make a fire escape plan, use fire safety devices, and provide first-aid treatment for burns.

Child safety

Teach children safety rules for matches, fires, electrical outlets, electrical cords, stoves, and chemicals. Keep in mind child safety considerations. Prevention tips for children include the following:

  • Keep matches and flames, such as candles or lanterns, out of the reach of children. Keep small children away from stoves and ovens when you are cooking, and do not place pot handles where a child can reach them. Do not let children play with any small appliances such as curling irons, hair dryers, toasters, or heating pads.
  • Never hold a child while smoking or drinking a hot liquid, because any sudden movement by the child could cause a burn.
  • Never leave hot foods or liquids within reach of children, such as on the edges of tables or counters. Also, be cautious about leaving hot liquids on a table with a tablecloth that young children can reach and pull down.
  • Prevent electrical, chemical, friction, and heat burns in young children:
    • Keep electrical cords away from a child's reach. A child chewing on a cord could cause an electrical burn of the mouth. Cover electrical outlets so children will not stick items in the outlet.
    • Do not allow children to remove hot items from the oven or microwave. Use caution whenever heating baby bottles in the microwave so that the liquid does not get too hot. A liner may burst or a lid may not be secure, and when the bottle is tipped for feeding, the hot contents may burn the baby. For this reason, most doctors recommend that bottles not be heated in the microwave.
    • Store cleaning solutions and chemicals out of the reach of children.
    • Friction burns can cause small cuts and scrapes. Don't pull or drag your child across carpet while playing.
  • Teach children who are old enough to understand to stop, drop, and roll if their clothing catches on fire so they can help put out the flame and prevent getting burned more.
  • Buy children's sleepwear made of flame-retardant fabric. Dress children in flame- and fire-retardant clothing. Older adults need to be careful about wearing clothing with loose material that could catch on fire.
  • Keep woodstoves and fireplaces in good working condition, and use screens to keep children a safe distance away. Keep portable heaters, furnaces, water heaters, and small appliances in good working condition.

Reduce the risk of a lightning strike

In general, avoid placing camping tents under tall trees, near bodies of water, or on the highest hill in an area. Seek shelter in a covered area, such as a car, if you get caught outdoors in bad weather. If no shelter is available, lie on the ground in a ditch or take cover in a thick grove of trees, where lightning striking a single tree is unlikely.

  • Avoid handling metal or electrical objects.
  • Avoid or stop using any machines outdoors.
  • Get out of water and off of boats.

Preparing For Your Appointment

To prepare for your appointment, see the topic Making the Most of Your Appointment.

You can help your doctor diagnose and treat your condition by being prepared to answer the following questions:

  • What caused the burn?
  • What kind of material was burning (such as wood, plastic, chemical, or asbestos)?
  • When did the burn occur?
  • What is the size and location of the burn? Can you estimate the depth as a first-, second-, or third-degree burn?
  • Was there a possibility of smoke inhalation? Was the fire in an enclosed place?
  • How was the fire put out?
  • Were there other injuries?
  • What home treatment has been used?
  • Do you have any health risks?

Credits

ByHealthwise Staff
Primary Medical ReviewerWilliam H. Blahd, Jr., MD, FACEP - Emergency Medicine
Specialist Medical ReviewerH. Michael O'Connor, MD - Emergency Medicine
Last RevisedDecember 27, 2012



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