Burns and Electric Shock

Many things can affect how your body responds to a symptom and what kind of care you may need. These include:

• Your age. Babies and older adults tend to get sicker quicker.
• Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
• Medicines you take. Certain medicines, herbal remedies, and supplements can cause symptoms or make them worse.
• Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
• Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.

It can be hard to tell how deep a burn is.

• A fourth-degree burn goes through the skin and fatty tissue to injure muscle, nerves, blood vessels, and bones.
• A third-degree burn goes through all the skin layers to the fatty tissue beneath. The skin is dry and swollen and may be pale white or charred black. This kind of burn destroys the nerves, so it may not hurt except on the edges.
• A second-degree burn involves several layers of skin. The skin may be swollen, puffy, moist, or blistered.
• A first-degree burn affects only the outer layer of skin. The skin is dry and hurts when you touch it. A mild sunburn is a first-degree burn.

Some common burn patterns and common areas for burns that result from abuse include:

• Circular burns that are the size and shape of the end of a cigarette or cigar.
• Burns on the bottom of the feet.
• Burns that look like gloves (on the hands), socks (on the feet), or a large circle on the buttocks. These come from putting someone's hands, feet, or buttocks in a sink or tub of scalding-hot water.

With burns caused by abuse, the explanation for the burn may not match the size, shape, or location of the burn. But it still can be hard to tell whether a burn was caused on purpose. A burn caused by throwing hot liquid on someone may look just like a burn caused by an accidental spill.

Symptoms of difficulty breathing can range from mild to severe. For example:

• You may feel a little out of breath but still be able to talk (mild difficulty breathing), or you may be so out of breath that you cannot talk at all (severe difficulty breathing).
• It may be getting hard to breathe with activity (mild difficulty breathing), or you may have to work very hard to breathe even when you’re at rest (severe difficulty breathing).

Severe trouble breathing means:

• The child cannot eat or talk because he or she is breathing so hard.
• The child's nostrils are flaring and the belly is moving in and out with every breath.
• The child seems to be tiring out.
• The child seems very sleepy or confused.

Moderate trouble breathing means:

• The child is breathing a lot faster than usual.
• The child has to take breaks from eating or talking to breathe.
• The nostrils flare or the belly moves in and out at times when the child breathes.

Mild trouble breathing means:

• The child is breathing a little faster than usual.
• The child seems a little out of breath but can still eat or talk.

Severe trouble breathing means:

• You cannot talk at all.
• You have to work very hard to breathe.
• You feel like you can't get enough air.
• You do not feel alert or cannot think clearly.

Moderate trouble breathing means:

• It's hard to talk in full sentences.
• It's hard to breathe with activity.

Mild trouble breathing means:

• You feel a little out of breath but can still talk.
• It's becoming hard to breathe with activity.

Heartbeat changes can include:

• A faster or slower heartbeat than is normal for you. This would include a pulse rate of more than 120 beats per minute (when you are not exercising) or less than 50 beats per minute (unless that is normal for you).
• A heart rate that does not have a steady pattern.
• Skipped beats.
• Extra beats.

Pain in adults and older children

• Severe pain (8 to 10): The pain is so bad that you can't stand it for more than a few hours, can't sleep, and can't do anything else except focus on the pain.
• Moderate pain (5 to 7): The pain is bad enough to disrupt your normal activities and your sleep, but you can tolerate it for hours or days. Moderate can also mean pain that comes and goes even if it's severe when it's there.
• Mild pain (1 to 4): You notice the pain, but it is not bad enough to disrupt your sleep or activities.

Pain in children under 3 years

It can be hard to tell how much pain a baby or toddler is in.

• Severe pain (8 to 10): The pain is so bad that the baby cannot sleep, cannot get comfortable, and cries constantly no matter what you do. The baby may kick, make fists, or grimace.
• Moderate pain (5 to 7): The baby is very fussy, clings to you a lot, and may have trouble sleeping but responds when you try to comfort him or her.
• Mild pain (1 to 4): The baby is a little fussy and clings to you a little but responds when you try to comfort him or her.

Here are some ways to estimate how much of the body is burned in an adult or older child.

• The palm of the person's hand equals 1% of the body's surface area. Using the person's palm is a good way to estimate the size of a small burn.
• The total surface of the head plus the neck is 9% of the body's surface area.
• The total surface of one arm and hand is 9%.
• The chest is 9%.
• The belly is 9%.
• The upper back is 9%.
• The lower back is 9%.
• The total surface of one leg and foot is 18%.
• The groin area is 1%.

Here are some ways to estimate how much of the body is burned in a baby or young child.

• The palm of the child's hand equals 1% of the body's surface area. Using the child's palm is a good way to estimate the size of a small burn.
• The total surface of the head plus the neck is 21% of the body's surface area.
• The total surface of one arm and hand is 10%.
• The total surface of the chest plus the belly is 13%.
• The back is 13%.
• The buttocks are 5%.
• The total surface of one leg and foot is 13.5%.
• The groin area is 1%.

Symptoms of infection may include:

• Increased pain, swelling, warmth, or redness in or around the area.
• Red streaks leading from the area.
• Pus draining from the area.
• A fever.

Certain health conditions and medicines weaken the immune system's ability to fight off infection and illness. Some examples in adults are:

• Diseases such as diabetes, cancer, heart disease, and HIV/AIDS.
• Long-term alcohol and drug problems.
• Steroid medicines, which may be used to treat a variety of conditions.
• Chemotherapy and radiation therapy for cancer.
• Other medicines used to treat autoimmune disease.
• Medicines taken after organ transplant.
• Not having a spleen.

Shock is a life-threatening condition that may quickly occur after a sudden illness or injury.

Symptoms of shock (most of which will be present) include:

• Passing out (losing consciousness).
• Feeling very dizzy or lightheaded, like you may pass out.
• Feeling very weak or having trouble standing.
• Not feeling alert or able to think clearly. You may be confused, restless, fearful, or unable to respond to questions.

Shock is a life-threatening condition that may occur quickly after a sudden illness or injury.

Symptoms of shock in a child may include:

• Passing out (losing consciousness).
• Being very sleepy or hard to wake up.
• Not responding when being touched or talked to.
• Breathing much faster than usual.
• Acting confused. The child may not know where he or she is.

To clean a wound well:

• Wash your hands first.
• Remove large pieces of dirt or debris from the wound with cleaned tweezers. Do not push the tweezers deeply into the wound.
• Hold the wound under cool running water. If you have a sprayer in your sink, you can use it to help remove dirt and other debris from the wound.
• Scrub gently with water, a mild soap, and a washcloth.
• If some dirt or other debris is still in the wound, clean it again.
• If the wound starts to bleed, put direct, steady pressure on it.

If a chemical has caused a wound or burn, follow the instructions on the chemical's container or call Poison Control (1-800-222-1222) to find out what to do. Most chemicals should be rinsed off with lots of water, but with some chemicals, water may make the burn worse.

You may need a tetanus shot depending on how dirty the wound is and how long it has been since your last shot.

• For a dirty wound that has things like dirt, saliva, or feces in it, you may need a shot if:
  • You haven't had a tetanus shot in the past 5 years.
  • You don't know when your last shot was.
• For a clean wound, you may need a shot if:
  • You have not had a tetanus shot in the past 10 years.
  • You don't know when your last shot was.