When Keith invited you to his house for hamburgers on the grill, you quickly accepted. Besides liking hamburgers, Keith is a good friend, and you like spending time with him. When you arrive, his parents are not home, and he is just beginning to prepare the grill. Keith gets the coals started, but he is in a hurry to begin cooking. He decides to squirt some starter fluid on the already red coals. The fire flares up, and Keith screams as his long-sleeved shirt catches fire over his right arm and chest.

Keith has become one of 2 million people this year who will be burned. Burns and fires are the third leading cause of accidental death. For children between ages 1 and 14, they are the leading cause of accidental death in the home.

But, back to Keith. What are you going to do for him?

The first step in dealing with Keith, and any burn victim, is to rescue him from further injury and protect yourself. You must put out the fire, and you have two choices. If water is available, douse his arm and chest with water. If no water is available, use a blanket or towel to smother the flames. Before you do anything else, call for help; the number for the Emergency Medical Service (EMS) in most areas is 911.

Know Your ABCs

If Keith is unconscious, you must next remember ABC — Airway, Breathing, and Circulation. Open his airway by tilting his head back. Then look, listen, and feel for signs of breathing. If there are none, begin mouth-to-mouth resuscitation. Then check for a pulse. If you feel no pulse, CPR (cardiopulmonary resuscitation with chest compression) is needed.

Keith is awake and breathing, so your next step is to determine if he has any other injuries. He may have hurt himself if he fell. If so, severe bleeding takes priority over burns in the treatment plan. Get bleeding under control.

Relieving the Pain

Now you can relieve some of the pain. Assess the severity of the burn. Also keep watch on his breathing. In the case of facial, neck, and chest burns, the victim may have inhaled superheated air and also burned the delicate tissues of the respiratory system. This can cause swelling that will close off the airway.

Cool the burned area immediately with lots of cool water, but do not use ice water or ice. If the burned area cannot be immersed in cool water, wring out cloths in cold water and apply them to the burn. Continue to do this until the victim is comfortable without them. Once a burn has been cooled, it is usually a good idea to cover it with the cleanest thing you have available. Never use loose cotton; it sticks to the burn. Sterile gauze is best, or use clean sheets. Covering the burn reduces the risk of contamination and prevents hypothermia as well as reducing the pain when air comes in contact with burned skin.

Do not try to remove clothing that is stuck to the burn, but, if possible, remove jewelry that could act as a tourniquet as the hand and fingers swell. Metal also retains heat longer than clothing.

Do not apply ointments to serious burns that will need medical attention. If you do, they will have to be removed at the hospital and this will cause more pain. Small first-degree burns can be treated by washing and applying antibiotic ointment followed by a sterile dressing.

Do not try to clean a third-degree burn, and do not break blisters. The potential for infection in these burns is quite high.

In Case of Shock

Always treat for shock. It is especially common in third-degree burns because of the loss of fluids. To minimize shock, have the victim lie down and elevate the feet and legs. You may also elevate the burned area to lessen pain. If the victim is having trouble breathing, however, elevate the head and shoulders.

Burns are considered to be the most painful injuries we can experience. It’s smart to do all you can to prevent them.