Cuts,Grazes, Burns and Scalds and/or Blisters - Medtick
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Cuts,Grazes, Burns and Scalds and/or Blisters

Cuts

  • Cuts if shallow are smooth and are closed during body movement can be treated by one self, if they are deep and depending on what has caused the cut and/or if one are showing symptoms of an infection then one may need further referral.

Burns and scalds

  • A burn causes healthy skin cells to die.
  • A burn is caused by dry heat touching or exposed to something hot.
  • A scald is caused by moist/wet heat i.e hot water or steam.
  • Mild burns and scalds usually heal within a week without scarring.

There are four types of burns:

  • First-degree burns (minor)
    • Normally affects the top,layer of the skin (epidermis)
  • Symptoms include:
    • Redness and no blistering?
    • Skin becomes lighter when pressed or pinched but regains normal colour (do no do this if one does not want to touch the skin)?
    • Burns usually heal within 7 to 10 days without scarring , only the epidermis can regenerate it self , deep layers affected cannot and can lead to scarring and may also affect the skin not to return to normal function.
    • See your pharmacist
  • Second-degree burns (moderate) :
    • Affects the first and second layers of the skin (epidermis and dermis)
  • Symptoms include:
    • Blisters (small pockets of clear fluid under a layer of skin)?
    • Blood blister of red and/or black appearance (small pockets of blood under a layer of skin)?
    • Some blister may burst and open, wet or weeping skin?
    • Hot, red and swollen (inflamed) skin?
    • Skin becomes lighter when pressed or pinched but regains normal colour slowly (do no do this if one does not want to touch the skin)?
    • White and/or blotchy and/or charred skin?
    • Soft skin may develop over the wound?
    • Thickening of the skin?
    • Second-degree burns take longer than three weeks to heal
    • Most heal within two to three weeks without scarring, but often with pigment changes to the skin.
    • The worse the blisters are, the longer the burn will take to heal.
    • In some severe cases, skin grafting is required to fix the damage. Skin grafting takes healthy skin from another area of the body and moves it to the site of the burned skin.
    • Sever secondary burns can cause scarring:
      • See a healthcare professional (Medical Doctor and/or nurse)
  • Third-degree burns (severe):
    • Affects all layers of the skin (including the hypodermis and/or subcutaneous/ fatty layer where there large blood vessels and nerves, this layer also helps with temeperature regulation)
  • Symptoms include:
    • Waxy and white colour?
    • Charred (black) skin?
    • Dark brown/black coloured skin?
    • Raised and leathery texture?
    • Blisters that do not develop?
    • Widespread thickness with a white, leathery appearance?
    • Skin does not becomes lighter when pressed or pinched (do no do this if one does not want to touch the skin)?
    • One may have no pain as it has damaged the nerves?
    • Go to hospital
  • Fourth-degree burns (very severe)
    • Includes all of the symptoms of a third-degree burn and also extends beyond the skin into tendons and bones
    • Go to hospital

Rule of  9 burns

 

Referral to hospital:

All major burns and red flags should be referred to A&E (and then specialist care) for treatment.

These include:

    • Burns covering more than 2% of TBSA (Total Body Suface Area)  for children (aged under 16 years);
    • Burns covering more than 3% of TBSA (Total Body Suface Area) for adults;
    • Superficial burns to the face, neck, axillae, hands, genitalia, feet, and areas that could affect mobility;
    • Deep dermal and full thickness burns;
    • Superficial circumferential burns;
    • Electrical, chemical, frictional or cold burns;
    • Suspected non-accidental burn.

Stockdale N. Clinical guidelines burn injury. Dudley: Russells Hall Hospital; 2012.

 

Cause

  • Scalding from hot, boiling liquids
  • touching something ho i.e  hot pan, iron , hot machinery
  • Chemical burns i.e strong acids , paint thinner,lye , gasoline, cleaning agents
  • Electrical burns
  • fires, including flames from matches, candles, and lighters
  • Excessive sun exposure and/or sun beds and/or U.V radiation
  • Allergic reactions
  • Radiation i.e from x-rays
  • Abuse of solvents

Chemical and electrical burns require immediate medical attention because they can affect the inside of the body, even if skin damage is minor.

These burns can damage:

Electrical burns:

  • Electrical burns should be managed only after the patient is separated from the source of electricity. If possible, isolate the source of electricity (e.g. turn off the mains power).
  • Attempt a rescue if the source of electricity is of low domestic voltage (e.g. 110–240 volts), using a non-conductible object (e.g. a wooden stick or wooden chair) to separate them from the current.
  • Do not attempt to rescue someone who is connected to 1,000 volts or more (e.g. electrical train lines) because the risk of conduction is very high.
  • Electrical burns are usually deep and an ambulance should be called immediately.
  • Go to hospital

Chemical Burns:

  • Cool the burn with cool or lukewarm running water for an hour as soon as possible after the injury.
  • Never use ice, iced water (it can cause frost bite and slow the healing process), or any creams yet or greasy substances like toothpaste, oils, butter and eggs.
  • Identify the chemical that has caused the burn; different types of chemical will produce different burns.
  • Chemical burns are usually deep and an ambulance should be called immediately.
  • Go to Hospital

National Institute for Health and Care Excellence. Clinical Knowledge Summaries: Burns and scalds. May 2013. 

The Pharmaceutical Journal, PJ, 9/16 May 2015, Vol 294, No 7861/2;294(7861/2):DOI:10.1211/PJ.2015.20068363

 

Inhalation burn/injury:

Pulmonary oedema (caused by irritation of lung tissue by inhaling a hot source) in the airways can be fatal.

Signs that a person has sustained an inhalation injury include:

  • Burns to the face, neck, or torso;
  • Singed nasal hair;
  • Carbonaceous sputum (i.e. sputum that is black or brown) or soot particles in oropharynx;
  • A change in voice with hoarseness;
  • Dyspnoea (breathing difficulties) and stridor (breath sounds caused by a narrowed or obstructed airway);
  • Erythema or swelling of oropharynx on examination.
  • An ambulance should be called immediately.
  • Go to Hospital.

National Institute for Health and Care Excellence. Clinical Knowledge Summaries: Burns and scalds. May 2013. 

Blisters

  • Blisters (small pockets of clear fluid under a layer of skin) and are formed to protect the underlying skin allowing the skin to heal.
  • It can be moderately painful while the healing process takes place
  • Blister may occur which normally develop due to friction burns and skin allergic reactions and are normally more painful than a normal blister.
  • Blood blister of red and/or black appearance (small pockets of blood under a layer of skin) and these occur due to blood vessels are damaged.

Blood blisters

  • Blood blisters are raised pockets of skin that look like friction blisters.
  • Blood blisters appear red, purple or black because they’re filled with blood instead of clear fluid.
  • The blood starts as a light red color and becomes darker over time. Blood blisters can range in size.
  • One may feel pain or discomfort in the area of the blister due to the injury that caused it. Sometimes blood blisters can cause itching as well.

Cause

One can get a blood blister when something pinches your skin but doesn’t break it open. Instead of clear liquid, blood floods the area from broken blood vessels and damage to the lower layers of your skin.

The blood pools and forms a blister. Blisters develop to protect your damaged skin and help it heal.

  • Pinching your skin.
  • After closing a drawer on your finger or stubbing your toe on the ground.
  • Sweaty feet can cause friction against your feet and toes.
  • Severe frostbite can also cause blood blisters.
  • Certain medications for example blood thinners

Beware of blood spots around and in the mouth

  • Angina bullosa hemorrhagica can cause noncancerous (benign) condition blood blisters in your mouth.
  • Painful, blood-filled blister develops on your tongue, gums or the floor of your mouth.
  • The blister usually bursts on its own and no treatment is needed.

Blood blisters in and around your mouth may be caused by more serious conditions.

These conditions may include:

  • Mouth cancer (oral cancer).
  • Blood disorders.
  • Rheumatoid arthritis.
  • Diabetes.
  • High blood pressure (hypertension)
  • Kidney failure.

Blood blisters typically heal on their own within a week. They heal as new skin grows below the blister’s raised layer and the blood in the blister dries out.

One can use methods and treatments for cuts and grazes to help the heeling of the blood blisters faster.

Cleveland Clinic

Tattoos and Body piercing:

Factors to consider:

  • Skin infections can occur, they can range from a simple skin infection to Superficial infections (eg, impetigo), deep bacterial infections that present as cellulitis or erysipelas to serious infections such as  sepsis.
  • Most infection are caused by the bacteria S aureus, Streptococcus species, and Pseudomonas aeruginosa.
  • Jewellery piercing can lead to contact dermatitis and the most common allergic metal tends to be nickel.Sterling silver, 18- and 24-carat gold, and platinum are less likely to cause allergic reactions.
  • If one has a body piercing on their genitals and it has been infected, chlamydia and gonorrhoea testing should be considered.
  • Acute (short term) inflammatory reactions are associated with physical tissue injury and the injection of pigment, dyes, or metals into the skin. This reaction usually recedes without consequence within 2-3 weeks and is an expected adverse effect of the tattooing process.
  • If after two to three weeks the reaction continues it is most likely to be an allergy to the pigment used in the tattoo showing symptoms of  localized eczematous eruptions (bumps and rashes or, rarely, as an exfoliative dermatitis.
  • Keloids are common with body piercings i.e ear and belly button though can occur anywhere. The lesions can develop as soon as 1-3 months after the injury or piercing or as late as one year after. Most keloids tend to grow slowly over months to a year, extending past the initial area of injury.

Medscape

Symptoms

Does one have:

Minor Cuts and/or First and Second Degree Section only:
Cuts
  • Skin edges are sooth and stay together during normal body movement?
  • Cut in less than 0.5cm (1/4 of inch) deep and/or shallow?
Burns and Scalds and blisters
  • Minor inflamed (hot, red and swollen) skin?
  • One is in pain?
  • Dry, peeling skin occurs as the burn heals?
  • Skin becomes lighter when pressed or pinched but regains colour  (do no do this if one does not want to touch the skin)?
Please refer further in the programme regarding:
  • Second degree burns
Please go to hospital if have:
  • Third-degree burns (severe):
    • Affects all layers of the skin (including the hypodermis and/or subcutaneous/ fatty layer where there large blood vessels and nerves, this layer also helps with temeperature regulation)
  • Symptoms include:
    • Waxy and white colour?
    • Charred (black) skin?
    • dark brown/black coloured skin?
    • Raised and leathery texture?
    • Blisters that do not develop?
    • Widespread thickness with a white, leathery appearance?
    • One may have no pain as it has damaged the nerves
  • Fourth-degree burns (very severe)
    • Includes all of the symptoms of a third-degree burn and also extends beyond the skin into tendons and bone
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