Frequently Asked Questions About Strokes & **First-Degree Burns (Superficial):** & **Second-Degree Burns (Partial Thickness):** & **Third-Degree Burns (Full Thickness):** & **Special Burn Considerations:** & **For Minor Burns (First-Degree and Small Second-Degree):** & **For Major Burns (Large Second-Degree and All Third-Degree):** & **Chemical Burn Protocol:** & Common Mistakes to Avoid During Burn Treatment & **Critical Mistakes:** & **Dangerous Home Remedies to Avoid:** & **Call 911 Immediately For:** & **Can Treat at Home If:** & **Burns in Children:** & **Sunburn Treatment:** & **Chemical Burn Variations:** & **Scenario 2: Grease Fire Burn** & 8. Bring chemical container

Your wife's face looks "funny" and she's slurring words, but insists she's "just tired" and refuses to go to hospital.

Your Actions:

3. "I love you too much not to call"

Critical Learning:

- Override denial - Stroke affects judgment - Your quick action saves lives

> Practice This Now: > Weekly F.A.S.T. drills with family: > - Everyone practices being tester > - Time the assessment > - Practice 911 scripts > - Discuss family risk factors > - Post F.A.S.T. signs prominently

Q: What's the difference between stroke and heart attack?

A: Stroke is blocked blood flow to the brain ("brain attack"), while heart attack is blocked blood flow to heart muscle. Both are emergencies, but symptoms differ. Strokes cause sudden neurological symptoms (weakness, speech problems), while heart attacks typically cause chest pain.

Q: Can you have a stroke without knowing it?

A: Yes, "silent strokes" occur in about 25% of cases. They may cause subtle symptoms mistaken for aging or fatigue. Often discovered later on brain scans. They still cause permanent damage and increase risk of major strokes.

Q: Why can't I give aspirin like with heart attacks?

A: Unlike heart attacks (always clots), strokes can be bleeding in the brain (hemorrhagic). Aspirin could worsen bleeding strokes. Only give aspirin if doctor prescribes after determining stroke type through CT scan.

Q: What's a TIA or mini-stroke?

A: Transient Ischemic Attack—temporary blockage causing stroke symptoms that resolve within 24 hours (usually minutes). It's a major warning sign: 40% have a major stroke within a year. Always requires immediate medical attention.

Q: How fast do I need to act?

A: Immediately. Brain loses 1.9 million cells per minute during stroke. Clot-busting drugs work best within 3 hours. Every minute of delay means more permanent damage and fewer treatment options.

Q: Can young people have strokes?

A: Yes. While risk increases with age, strokes can occur at any age. Young people may have different causes: birth control pills, drug use, genetic conditions, pregnancy complications, or blood vessel abnormalities.

Q: What if symptoms come and go?

A: Still call 911. Fluctuating symptoms may indicate TIA or evolving stroke. Don't wait for symptoms to "stick around." The opportunity to prevent major stroke may be brief.

Q: Should the person lie down flat?

A: No. Elevate head and shoulders 30-45 degrees if conscious. If unconscious but breathing, use recovery position on their side. Never lay flat as this can worsen brain swelling.

Q: Can stress cause a stroke?

A: Chronic stress contributes to stroke risk factors (high blood pressure, diabetes). Acute severe stress may trigger stroke in susceptible individuals. Managing stress is important for prevention.

Q: What happens at the hospital?

A: Immediate CT scan determines stroke type. If ischemic and within time window, may receive clot-busting drugs (tPA) or undergo clot removal procedure. Time from door to treatment is critical—that's why calling 911 matters.

> Final Quick Reference Box: > Remember: B.E.F.A.S.T. > - Balance - Sudden loss of balance > - Eyes - Sudden vision changes > - Face - Facial droop > - Arms - Arm weakness > - Speech - Speech difficulty > - Time - Time to call 911 > > Also Remember: > - Note exact time symptoms started > - Don't give any medications > - Keep person calm and still > - Never drive to hospital yourself > - Stay with them constantly

Final Critical Message:

Stroke is a medical emergency where minutes matter. The F.A.S.T. test takes 30 seconds and can save a life. Don't second-guess symptoms or delay calling 911. Modern stroke treatments are incredibly effective but extremely time-sensitive. Your quick recognition and action can mean the difference between full recovery and permanent disability. Learn F.A.S.T., teach it to others, and never hesitate to call 911 when stroke symptoms appear. Time lost is brain lost—act F.A.S.T.!# Chapter 7: How to Treat Burns: First Aid for First, Second, and Third Degree Burns

The kitchen accident happened in seconds. Maria was draining pasta when the pot slipped, splashing boiling water across her left forearm. The pain was immediate and intense. Her teenage daughter, remembering her first aid training from school, immediately guided her mother to the sink and ran cool water over the burn while calling for help. That quick action—cooling the burn within the first minute—likely prevented deeper tissue damage and reduced Maria's healing time by weeks. Burns are among the most common household injuries, with over 450,000 people receiving medical treatment for burns annually in the United States. Every day, approximately 1,100 people suffer burn injuries severe enough to require medical attention. While minor burns can often be treated at home, knowing how to properly assess and treat different types of burns can prevent complications, reduce scarring, and in severe cases, save lives. The first few minutes after a burn injury are critical—proper immediate care can mean the difference between a minor injury that heals quickly and a serious wound requiring extensive treatment. Understanding burn classification, appropriate first aid, and when to seek emergency care is essential knowledge for everyone.

Burns are classified by their depth and the layers of skin affected. Recognizing the type and severity of a burn is crucial for providing appropriate treatment and determining whether emergency medical care is needed.

Characteristics:

- Affects only the outer layer of skin (epidermis) - Red, painful skin - No blisters - Skin is dry - Mild swelling possible - Blanches (turns white) when pressed

Common Causes:

- Brief contact with hot objects - Mild sunburn - Brief exposure to steam - Flash burns from brief flame exposure

Healing Time: 3-6 days without scarring

Superficial Second-Degree:

- Affects epidermis and upper dermis - Very painful - Red, moist, weeping appearance - Blisters form within minutes to hours - Blanches with pressure

Deep Second-Degree:

- Extends deeper into dermis - Less painful due to nerve damage - Red and white patchy appearance - Blisters may be present - May not blanch with pressure

Common Causes:

- Scalding liquids - Direct flame contact - Severe sunburn - Hot oil or grease - Chemical burns Healing Time: 2-3 weeks for superficial, 3-8 weeks for deep

Characteristics:

- Destroys all skin layers - May extend into fat, muscle, or bone - Painless in center (nerves destroyed) - White, brown, black, or charred appearance - Leathery texture - No blanching - Surrounded by painful second-degree burns

Common Causes:

- Prolonged flame contact - Electrical burns - Hot oil/grease immersion - Strong chemicals - Hot metal contact Healing: Requires medical intervention, skin grafting

> Quick Reference Box: > - Rule of Nines: Estimates burn surface area > - Adult head: 9% of body surface > - Each arm: 9% > - Each leg: 18% > - Front torso: 18% > - Back torso: 18% > - Genitals: 1% > - Palm size = approximately 1% of body surface

Chemical Burns:

- May not show damage immediately - Progressive tissue destruction - Require specific neutralization - Always remove contaminated clothing - Flush for 20+ minutes

Electrical Burns:

- External burns may be minimal - Internal damage can be severe - Entry and exit wounds - Cardiac complications possible - Always require medical evaluation

Inhalation Burns:

- Singed nasal hairs - Soot around nose/mouth - Hoarse voice - Difficulty breathing - Coughing - Life-threatening airway swelling

The first few minutes after a burn are critical. Follow these steps systematically for optimal outcomes.

Step 1: Ensure Safety (Immediate)

- Remove person from heat source - Stop the burning process - Remove hot clothing/jewelry immediately - Ensure your safety before helping

Step 2: Cool the Burn (Within 30 seconds)

- Run cool (not ice cold) water over burn - Temperature: 55-65°F (12-18°C) - Continue for 10-20 minutes - Or apply cool, wet compress - Start within 3 minutes for best effect

Step 3: Assess the Burn

- Determine degree and size - Check for signs of severity - Decide if medical care needed - Document time and cause

Step 4: Protect the Burn

- Gently pat dry - Apply thin layer of aloe vera or burn gel - Cover with sterile, non-stick bandage - Wrap loosely - Don't use adhesive on burned skin

Step 5: Manage Pain

- Over-the-counter pain relievers - Keep burn elevated if possible - Continue cool compresses - Avoid ice directly on burn

Step 1: Call 911 Immediately

- For burns covering >10% body surface - All third-degree burns - Burns to face, hands, feet, genitals, joints - Chemical or electrical burns - Inhalation injuries

Step 2: Ensure Safety and Stop Burning

- Remove from heat source - Smother flames if needed (stop, drop, roll) - Remove hot/burning clothing - Leave stuck clothing in place

Step 3: Initial Treatment While Waiting

- DO NOT immerse large burns in water - Cover with clean, dry sheet - Keep person warm (prevent hypothermia) - Elevate burned areas if possible - Monitor breathing and consciousness

Step 4: Special Considerations

- Chemical burns: Flush continuously - Electrical burns: Ensure power is off - Don't apply ice, butter, or ointments - Don't break blisters - Give nothing by mouth

> Practice This Now: > - Locate cool water sources in your home > - Time how long 10 minutes feels while running water > - Practice wrapping gauze loosely > - Find clean sheets for major burns > - Review location of nearest burn center

1. Safety First - Wear gloves if available - Ensure good ventilation - Identify chemical if possible

2. Remove Contamination - Take off contaminated clothing - Brush off dry chemicals before flushing - Remove jewelry

3. Flush Extensively - Minimum 20 minutes for acids - Minimum 30 minutes for alkalis - Use lukewarm water - Flush away from unaffected areas

4. Seek Medical Care - All chemical burns need evaluation - Bring chemical container if possible - Continue flushing en route

1. Ensure Scene Safety - Turn off power source - Don't touch victim until safe - Use non-conductive object if needed

2. Call 911 - All electrical burns need evaluation - Risk of cardiac complications - Internal injuries possible

3. Check and Monitor - Check breathing and pulse - Be ready for CPR - Look for entry/exit wounds - Keep person still

Many traditional burn remedies can actually worsen injuries. Understanding what NOT to do is crucial for proper burn care.

1. Using Ice or Ice Water

- Can cause frostbite on burned tissue - May increase tissue damage - Causes blood vessels to constrict - Use cool, not cold water

2. Applying Butter, Oil, or Grease

- Traps heat in tissue - Increases burn depth - Risk of infection - Difficult to remove for medical treatment

3. Breaking Blisters

- Increases infection risk - Delays healing - More scarring - Blisters protect healing tissue

4. Using Adhesive Bandages

- Sticks to burned skin - Painful to remove - Can tear healing tissue - Use non-stick dressings only

| DO | DON'T | |---|---| | Use cool running water | Use ice or ice water | | Remove jewelry immediately | Force stuck clothing off | | Cover with clean, dry sheet | Apply butter, oils, or toothpaste | | Keep person warm overall | Immerse large burns in water | | Elevate burned limbs | Break blisters | | Give pain medication | Give fluids if severe burns | | Seek medical care when in doubt | Use fluffy cotton on burns | | Monitor for shock | Apply antibiotic ointment to major burns |

Common Myths:

- Egg whites (infection risk) - Toothpaste (can deepen burn) - Tomatoes or mustard (irritating) - Petroleum jelly on fresh burns (traps heat) - Alcohol (extremely painful, damaging)

Why These Don't Work:

- Most trap heat in tissue - Increase infection risk - Make medical assessment difficult - Can cause chemical reactions - Delay proper treatment

Knowing when a burn requires emergency medical care versus home treatment can prevent complications and ensure appropriate care.

Size and Location Criteria:

- Burns covering >10% body surface area - Burns to face, neck, or airway - Burns to hands, feet, genitals, or joints - Burns that encircle a limb or torso - All third-degree burns regardless of size

Special Circumstances:

- All electrical burns - All chemical burns - Suspected inhalation injury - Burns in elderly or very young - Burns with other injuries

Concerning Symptoms:

- Difficulty breathing - Confusion or altered mental state - Signs of shock - Severe pain uncontrolled by OTC meds - White, brown, or charred skin

Moderate Burns Requiring Evaluation:

- Second-degree burns larger than 3 inches - Burns that might be deeper than they appear - Burns in people with diabetes or poor circulation - Any burn you're unsure about - Burns showing signs of infection

Red Flags After Initial Treatment:

- Increasing pain after 48 hours - Red streaks from burn - Pus or unusual drainage - Fever over 100.4°F - Foul odor from wound

Minor Burn Criteria:

- First-degree burns only - Second-degree burns smaller than 3 inches - Not on face, hands, feet, genitals, or joints - Pain controllable with OTC medication - No signs of infection

> Important Disclaimer: > Burn depth can be difficult to assess initially. Burns may appear minor but worsen over 24-48 hours. When in doubt, seek medical evaluation. Children, elderly, and those with chronic conditions have less reserve and may need medical care for smaller burns. This guide does not replace professional medical assessment.

1. 0-30 seconds: Remove from heat, start cooling 2. 30 seconds-3 minutes: Assess severity, call 911 if needed 3. 3-20 minutes: Continue cooling minor burns 4. After 20 minutes: Dress wound appropriately 5. 24-48 hours: Reassess for progression

Different populations and burn types require modified approaches for optimal care and safety.

Why They're Different:

- Thinner skin = deeper burns - Smaller body surface = less reserve - Higher risk of hypothermia - May not communicate pain well - Heal differently than adults

Modified Approach:

- Lower threshold for medical care - Any burn >5% needs evaluation - Watch temperature carefully - Use pain assessment scales - Consider child abuse if pattern suspicious

Child-Specific Rule of Nines:

- Head: 18% (larger than adult) - Each arm: 9% - Each leg: 14% - Front torso: 18% - Back torso: 18%

Special Risks:

- Thinner skin - Slower healing - More complications - May have decreased pain sensation - Other medical conditions

Adaptations:

- Seek medical care for smaller burns - Monitor more closely - Check medications (blood thinners) - Watch for dehydration - Consider home safety evaluation

First-Degree Sunburn:

- Cool baths or compresses - Aloe vera gel - Hydrate well - NSAIDs for inflammation - Moisturize after cooling

Severe Sunburn (Second-Degree):

- Medical evaluation needed - Don't pop blisters - Risk of dehydration - Possible heat exhaustion - Infection risk

Prevention Reminders:

- SPF 30+ sunscreen - Reapply every 2 hours - Protective clothing - Avoid peak sun hours - Extra care near water/snow

Unique Dangers:

- Internal injuries not visible - Cardiac arrhythmias - Muscle damage - Kidney problems - Neurological effects

Response Modifications:

- Always call 911 - Continuous cardiac monitoring needed - Check for entry/exit wounds - May need extensive testing - Delayed complications possible

Acid Burns:

- Immediate burning - Coagulation necrosis - Flush minimum 20 minutes - Usually less deep than alkali

Alkali Burns:

- May not hurt immediately - Liquefaction necrosis - Penetrate deeper - Flush minimum 30 minutes - More serious than acids

Special Chemicals:

- Hydrofluoric acid: Needs calcium gluconate - Phenol: Wash with polyethylene glycol - Dry lime: Brush off before water - Elemental metals: Cover with oil

Mental rehearsal and practice improve real-world performance. Work through these scenarios to build confidence.

Your 8-year-old spills hot soup on their hand and forearm. They're crying in pain, and the skin is red with two small blisters forming.

Your Actions:

Key Decisions:

- Size borderline for child—watch closely - If blisters enlarge, seek care - Document appearance

Your neighbor runs to you with burns on both hands from a grease fire. The palms are white and leathery, but they say it doesn't hurt much.

Your Actions:

Critical Recognition:

- Painless + white/leathery = third-degree - Both hands = major burn - Need immediate transport

Coworker splashes unknown cleaning chemical on arm. Skin is red and burning.

Your Actions:

Important Points:

- Don't waste time identifying first - Flush immediately - Continue longer than seems necessary

> Practice This Now: > - Time 20 minutes of flushing (it's longer than you think) > - Practice burn size estimation on family > - Locate non-stick gauze in first aid kit > - Find clean sheets for major burns > - Save Poison Control number in phone