A burn injury damages a person’s skin or deeper tissues, muscles and even bones primarily caused by heat, chemicals, fire, electricity, sunlight or radiation. While scalds from hot or flammable liquids and building fires are the most common source of burns, they are not always the most severe. The cause and severity of the burn will greatly determine the survivor’s pain levels, treatment and recovery timeline.
Unfortunately, burn injuries are quite common with more than 3 million cases per year in the United States. Globally, around 265,000 people die each year from burn injuries, most of whom live in low- and middle-income countries. Non-fatal burn injuries are also the leading cause of morbidity, according to the World Health Organization (WHO).
While most burns are associated with pain, minor burns generally heal on their own with little to no medical attention. More severe burns, however, medically ranked by degrees, require special care to prevent infection and reduce potential scarring.
Also called “superficial burns”, first-degree burns are the most common causing minor damage to the outer, or first, layer of skin. Typically from brief contact with a hot item or the sun, first-degree burn symptoms include: redness, minor swelling, pain and dry skin. The skin will begin to peel away as the burn heals, often in seven to 10 days. These burns, like sunburns, are treatable at home; however, if a large or sensitive area is affected, such as the face, a doctor may be able to help aid in the body’s natural healing process.
Generally from boiling water, extended contact with hot objects or too much sun exposure, these burns burn through the first and second layer of skin. In addition to first-degree symptoms, second-degree burns will blister and pop, giving the affected area a wet-like appearance. During the healing process, thick, scab-like tissue may also develop over the burnt area. The worse the blisters, the longer healing will take. If the burn is three inches or wider or affects the face, hands, butt, groin or feet, seek medical attention.
After extended contact or exposure with hot objects, third degree burns penetrate through all three layers of the skin. While the victim’s physical appearance will change- leathery white or black skin with undeveloped blisters- physical pain may actually not exist due to the extensive nerve damage. Third-degree burn victims should always seek immediate medical attention. Without surgery, the burns will heal with intense scarring and contracture.
Though not all organizations separate third and fourth burns, fourth degree burns are life-threatening injuries. Affecting all layers of the epidermis and below- muscles, tendons, ligaments, bones- fourth-degree burns require surgery and often leave survivors with permanent disabilities or amputations.
What: A raised scar after an injury is healed from an overgrowth of scar tissue
Appearance: Lumpy or rigid, typically larger than the injury; red or pink coloring that fades to a dark tan overtime
How Common: Very, with over 3 million cases in the U.S. annually; those with darkly pigmented skin are more likely to develop keloid scars
Side Effects: Some may be itchy, uncomfortable and tender, keloid scars are not medically harmful. However, in rare instances where keloid scars cover large areas of the body, the hardened scar tissue may restrict mobility.
Treatment: Generally for cosmetic purposes, treatments may include self-care remedies such as silicone gel sheets or professional treatments including steroids, topical medication or cryotherapy (freezing). However, keloids can re-occur after treatments.
What:Similar to keloid scars, but do not spread beyond the injury site
Appearance: Red scar tissue raised above the skin
How Common: Very common; skin pigmentation is not as great a factor as with keloids
Side effects: generally much less painful then keloid scars; the raised scar will flatten spontaneously with time
What: Tight and inflexible scar tissue usually forming over joints or muscles
Side Effects: Normal elastic connective tissues are replaced with inelastic fibers, eventually preventing normal movement of the affected area. Such tightening of the skin can affect muscles, tendons and nerves.
Treatments: Physical therapy, pressure and exercise may help lessen or control contracture scars. If these don’t work, more serious options include surgery, skin grafts, or newer techniques like Z-Plasty and tissue expansion.
Proper nutrition is essential to a healthy, full recover for sever burn survivors. Burns loose proteins through wounds, break down muscles for energy while healing and increase the body’s metabolic response more than any other disease state.
HIGH-CALORIE DIET: While the average healthy adult needs around 2,000 calories per day, a burn victim requires at least 2,500 per day on average. Any liquid dietary supplements should be consumed separately for meals to make sure their appetite is not suppressed.
HIGH-PROTEIN DIET: Proteins are essential to healing wounds and regaining and retaining muscle strength. The average burn victim uses more than 150 grams of protein per day. If the body doesn’t have enough protein, the patient may suffer from a loss of muscle mass, slower healing of wounds and a weakened immune system. Healthy high protein foods include: meat, eggs, beans, milk, yogurt, nuts, peanut butter, tofu, etc.
DON’T FORGET ABOUT CARBOHYDRATES: The body uses glucose for energy to heal wounds- eating enough carbs will ensure there’s enough glucose. Healthy carbs should be the main source of energy for burn victims, therefore reserving the proteins to promote healing. Whole grains, beans, fruit and vegetables are all great options to fulfill this need.
MONITOR FAT INTAKE: Fats are a double edge sword for burn survivors; they are essential to upping calories and the healing process but too much fatty acid consumption can weaken the immune system. Doctors or nutritionists specializing in burn patient diets should advise how much fat patients need based on their severity of injuries.
For more information on nutrition for burn injury survivors, read our blog post.
HOW ARE NUTRITIONAL NEEDS DETERMINED?
Dietitians follow two main formulas to determine a burn patient’s diet. For adults, the Harris-Benedict equation finds a patient’s base metabolic rate and then applies an “activity factor” to determine the amount of calories used per day. The Galveston formula, used for children, focuses more on body surface area as opposed to weight.
Globally and nationally, burn injury data is not monitored as closely as other accidents or injuries, such as car accidents. However, national organizations such as the CDC, American Burn Association (ABA) and the U.S. Fire Administration work to gather and analyze as much comprehensive data as possible. Below are their estimates for annual burn injuries:
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Source: NFPA Statistics – civilian injuries does not include firefighters
This annual study the National Burn Repository and the ABA gathers data from participating hospitals across the country with burn units. In 2015, 99 burn centers sent over their data, making for largest participant pool to date, but still only representative of 75% of U.S. burn units. The data below is based off their report.
Source: National Burn Repository, 2015. The data is based off burns requiring emergency room visits between 2005 and 2014.
The 7 percent for “other” burn injuries includes: unspecified burn (2.7%), non-burn (2.5%), inhalation only (1.7%), radiation (0.3%) and skin disease (0.2%). The percentages add up to 7.4, rather than seven, due to rounding of earlier numbers.
Men account for more than half of all burn victims in the United States, with 138,644 cases out of 203,422. Broken down by age group, men consistently outnumber women, as well.
Whites account for 58.6 percent of burn injuries. Following suit, white people are admitted to burn units more often than non-whites when five and older. Children under 5, however, are predominantly non-white. “This suggests that racial factors may influence the occurrence of burn injuries and/or admission to a burn center differently as a function of age,” as the 2015 National Burn Repository states. Black, hispanic and asian victims account for 19, 14 and 2.5 percent, respectively.
RACE FOR CHILDREN UNDER ONE YEAR
RACE FOR ONE YEAR OLDS
RACE FOR TWO TO FOUR YEAR OLDS
RACE FOR FIVE TO 15 YEAR OLDS
RACE FOR 16-19 YEAR OLDS
RACE FOR 20-29 YEAR OLDS
RACE FOR 30-39 YEAR OLDS
RACE FOR 40-49 YEAR OLDS
RACE FOR 50-59 YEAR OLDS
RACE FOR 60-69 YEAR OLDS
RACE FOR 70-79 YEAR OLDS
RACE FOR 80+
WHO monitors burn injuries and fatalities around the world. They classify burns as a public health problem in need of more attention.
Q. Who Can Sue?
A. Anyone who suffered a moderate to serious burn injury due to someone else’s negligence can sue for damages including, but not limited to: medical bills, loss of wages and emotional damage. Some examples include victims of apartment or public building fires, burns resulting from faulty fire alarm systems or someone exposing you to harmful chemicals resulting in burn injuries.
Q.What Damages May Burn Victims be Entitled to?
A. Past and future medical expenses, loss of income/wags, possible future loss of earning capacity due to injuries, and compensation for future pain, disability and emotional trauma
Q. Who Can be Held Responsible for my Burn Injury?
A. This, of course, depends on the circumstances of the fire and resulting injury. Possibilities may include an individual, a homeowner of property management company, or manufacturers of a product.
Q. Are Investigations an Important Part of the Lawsuit?
A. Yes. Investigations, either through police and fire reports or through the attorney’s team of investigators and expert witnesses, are always important. Property should be immediately investigated for evidence surrounding the source of the fire and resulting personal and property damages.
Q. Will There be Extra or Surprise Attorney Charges Around my Lawsuit?
A. This depends entirely on the type of attorney hired to fight for you. Before hiring a burn injury lawyer, people should research online for reviews and testimonials, check out major attorney directories like Avvo and Justia, explore the attorney’s website and utilize free consultations. Make sure to ask how their office handles payments and what may cause payments to increase throughout the court process. Expert witnesses in particular are often called to help prove negligence- which may cost money, again depending on the attorney.