First Aid for Burns

a. Eliminate the Source of the Burn. The source of the burn must be eliminated before any evaluation or treatment of the casualty can occur. (1) Remove the casualty quickly and cover the thermal burn with any large nonsynthetic material, such as a field jacket. Roll the casualty on the ground to smother (put out) the flames (Figure 3-33).

(2) Remove the electrical burn casualty from the electrical source by turning off the electrical current. DO NOT attempt to turn off the electricity if the source is not close by. Speed is critical, so DO NOT waste unnecessary time. If the electricity cannot be turned off, wrap any nonconductive material (dry rope, dry clothing, dry wood, and so forth) around the casualty's back and shoulders and drag the casualty away from the electrical source (Figure 3-34). DO NOT make body-to-body contact with the casualty or touch any wires because you could also become an electrical burn casualty.

High voltage electrical burns may cause temporary unconsciousness, difficulties in
breathing, or difficulties with the heart (heartbeat).

(3) Remove the chemical from the burned casualty. Remove liquid chemicals by flushing with as much water as possible. If water is not available, use any nonflammable fluid to flush chemicals off the casualty. Remove dry chemicals by brushing off loose particles (DO NOT use the bare surface of your hand because you could become a chemical burn casualty) and then flush with large amounts of water, if available. If large amounts of water are not available, then NO water should be applied because small amounts of water applied to a dry chemical burn may cause a chemical reaction. When white phosphorous strikes the skin, smother with water, a wet cloth, or wet mud. Keep white phosphorous covered with a wet material to exclude air which will prevent the particles from burning.

Small amounts of water applied to a dry chemical burn may cause a chemical reaction transforming the dry chemical into an active burning substance.

(4) Remove the laser burn casualty from the source. (NOTE: Lasers produce a narrow amplified beam of light. The word laser means Light Amplification by Stimulated Emission of Radiation and sources include range finders, weapons/guidance, communication systems, and weapons simulations such as MILES.) When removing the casualty from the laser beam source, be careful not to enter the beam or you may become a casualty. Never look directly at the beam source and if possible, wear appropriate eye protection.

After the casualty is removed from the source of the burn, he should be evaluated for conditions requiring basic lifesaving measures (Evaluate the Casualty).

b. Expose the Burn. Cut and gently lift away any clothing covering the burned area, without pulling clothing over the burns. Leave in place any clothing that is stuck to the burns. If the casualty's hands or wrists have been burned. remove jewelry if possible without causing further injury (rings, watches, and so forth) and place in his pockets. This prevents the necessity to cut off jewelry since swelling usually occurs as a result of a burn.

CAUTION (081-831-1007) DO NOT lift or cut away clothing if in a chemical environment. Apply the dressing directly over the casualty's protective clothing. DO NOT attempt to decontaminate skin where blisters have formed.

c. Apply a Field Dressing to the Burn.

(1) Grasp the tails of the casualty's dressing in both hands.

(2) Hold the dressing directly over the wound with the white (sterile) side down, pull the dressing open, and place it directly over the wound. If the casualty is able, he may hold the dressing in place.

(3) Hold the dressing in place with one hand and use the other hand to wrap one of the tails around the limbs or the body.

(4) Wrap the other tail in the opposite direction until the dressing is completely covered.

(5) Tie the tails into a knot over the outer edge of the dressing. The dressing should be applied lightly over the burn. Ensure that dressing is applied firmly enough to prevent it from slipping.

NOTE Use the cleanest improvised dressing material available if a field dressing is not available or if it is not large enough for the entire wound.

d. Take the Following Precautions (081-831-1007):

• DO NOT place the dressing over the face or genital area.

DO NOT break the blisters. DO NOT apply grease or ointments to the burns. For electrical burns, check for both an entry and exit burn from the passage of electricity through the body. Exit burns may appear on any area of the body despite location of entry burn.

• For burns caused by wet or dry chemicals, flush the burns with large amounts of water and cover with a dry dressing.

For burns caused by white phosphorus (WP), flush the area with water, then cover with a wet material, dressing, or mud to exclude the air and keep the WP particles from burning.

• For laser burns, apply a field dressing.

• If the casualty is conscious and not nauseated, give him small amounts of water.