To Burn or Not to Burn, the Third Degree.

We have been talking about burns the last few weeks. First degree burns we decided were the kind of burns that are most commonly associated to Sunburns with pain, redness, swelling and illness. Not often fatal, they can make you wish you were dead, but you will be fine in most cases. Treatment most often was hydration and aloe (in other words drink a lot of water or Gatorade and moisturize the skin) and Oh, Stay Out Of The Sun For A Few Days -as my kids say… DUH!

Second degree burns were those that produced Blisters as well as pain, redness, swelling, and illness. These burns can be fatal if large areas are covered or if they become infected. Because they are a large open wound, they are prime sites for infection! Small areas were to be treated with dry sterile dressings and bandages — do not break the blisters. If they are broken, you need to apply some sort of antibiotic ointment that you aren’t allergic to and sterile dressing. We also know that large areas need to be seen and treated by professionals.

So, now we get to Third Degree burns or what is now often called full thickness burns. How do we recognize them and how do we treat them and how dangerous are they? Please be advised, electrical burns do not often show on the surface and, if there is any doubt what degree or area is affected by an electrical burn, seek medical help.

Now, how do we recognize Third Degree burns? Well, they are not painful, except maybe the edges, because they kill the nerve endings. They are often hard and white or waxy, if not they tend to be black or look charred. There are often no blisters because all the moisture has been burned out of the skin.

They need initial treatment of DRY, sterile dressings, and the patient will need to be hydrated. Most often, you will be worried only about initial treatment because these burns, unless very small, should be treated by medical professionals. When I say small, I mean like the burn I have right now on my right index finger and thumb. I am building a cooker to cook whole or half pigs in for large gatherings (family reunions or large parties). Yesterday I was welding runners on to the tray that will hold the charcoal. The welder did not “strike an arc” until I had 3 or 4 inches of wire run out. I knew I needed to break or cut off the wire. Without thinking, I grabbed onto the wire that was red hot… I now have a third degree burn on my fingers where I grabbed the wire. That is about as small as small gets. But, if you look at the picture, you will see the

thin white line, it is hard and not painful, but I am thankful that it isn’t bigger (don’t ask about the second degree burns to the right ring finger from melting plastic/paint). Like I tell my kids do as I say not as I do.

Most third degree burns of any size will require a skin graft to heal properly and will scar in most cases. So don’t mess with them, go get help. I personally get concerned with any third degree burn as big as a silver dollar for kids or as big as the palm of my hand for adults. Also, Third degree burns that effect the hands, feet or face should be seen by a doctor, no matter what the size.(Except my fingers, remember do as I say not as I do!)

Also, I want to mention that for any second or third degree burn that affects the nostrils or the eyes seeks medical help. The burns that produce singed nasal hairs or soot in the nose or mouth can indicate very hot air that might have entered the lungs, which can cause many problems. The eyes are an area that no one should be careless with.

I hope that everyone will take a second look at some of their practices around hot items and see if you can make everyone safer. Encourage children (and some adults) not to play or run near the fire. Watch handles that are in the fire — they are a prime source of third degree burns around camp, and all you need to do is have a pot holder near by.

It is usually a lot easier to prevent a burn that to take care of it… and a lot less painful!

Your Obedient Servant,

Gary Smith, Jr.