Seafarers should be very cautious when handling hot pipelines, steams and fires to avoid burns and scalds. Burns and scalds are damage to the skin caused by wet heat, electricity, or chemicals; both are treated in the same way while the amount of pain that the patient feels isn’t always related to how serious the burn is. Even a very serious burn may be relatively painless.
Severity of a burn
In a burn injury, it is important to consider how deeply the burn goes into the skin and how extensive the area of skin affected by the burn is.
1st degree: The outer skin layer is affected. The treatment requires three to seven days without scarring. The symptoms are: redness which turns pale on pressure, mild swelling, tenderness and pain.
2nd degree: The deep skin lays is affected. The treatment requires seven to twenty days, usually without scarring. The symptoms are: pain, tenderness to pressure and to air blown on the skin, redness; the burn area turns pale when pressed.
3rd degree: The under dermis layer is affected. The heal takes weeks to months and the scarring is often severe. The symptoms are: possibly severe pain, from damage to nerve endings, extensive blisters which burst readily and the burn areas are weeping or waxy, dry, red or pale and not turn pale when pressed.
4th degree: The entire thickness of skin is affected; it may extend to underlying fat, muscle and bone. The burn is untreated; with skin grafting, it will heal within weeks to months and scarring is always severe.
Dos & Don’ts
- Seek medical advice in all cases expect for small superficial burns.
- Cool the heat burns as quickly as possible with cold running water (sea or fresh) for at least 10 minutes
- Try to remove clothing gently but do not tear off any clothing that adheres to skin.
- Cover the burned areas with a dry, non-fluffy dressing larger than the burns, and bandage in place.
- After cooling the burn, remove the patient to a warm cabin with a supply of clean water and dressing material.
- For pain relief in a patient with a small burn give paracetamol or ibuprofen.
x Do not treat a patient with a burn if you have any doubts about whether you can or should.
x Do not treat a patient onboard who has any other injury or a burn
Actions to be taken onboard in case of a burn injury
If the patient is going to remain on board
- Wash the burn gently with soap and potable water;
- Keep the patient warm: loss of skin makes the patient prone to hypothermia;
- Use sterile scissors to cut away loose, dead skin, including broken blisters;
- Smear the burn with honey (it helps prevent infection) and cover it, first with petroleum gauze, then with a sterile non-adherent dressing
- Cover the dressing with padding to absorb fluid leaking from the burn and hold the dressing in place with a suitable bandage
If the patient is awaiting evacuation
- Do nothing further except keep the patient warm: take care to prevent blankets from sticking to the burns.
Depending on how serious a burn is, it may be possible to treat it onboard. For minor burns, keep the burn clean and do not burst any blisters that form. More serious burns require professional medical attention. In general, seafarers can only avoid or lessen such injuries if they are cautious by wearing Person Protective Equipment when doing their work onboard ships. In addition, crew members onboard should always seek an expert’s advice regarding burns while the transfer of the patient to shore medical facilities should be priority regardless the severity of burn.