1. Bruises, Burns, Chemical Burns

2.  The pain is severe.  You can’t use or move the bruised body part.  You have signs of infection.  You suddenly start to bruise easily, or you have lots of bruises for no clear reason  After a blow to the eye: ◦ You have blood in the colored part or white part of your eye ◦ You have vision changes ◦ You can’t move your eye normally in all directions.

3.  Bruises occur when small blood vessels under the skin break or tear after a bump or fall.  Older adults and people who take aspirin or blood thinners may bruise easily.  A black eye is a type of bruise.

4.  Put ice or cold packs on the bruise for 10 minutes several times a day for the first 2 days. The sooner you use ice, the less bleeding and swelling you’ll have.  Take ibuprofen (Advil, Motrin) or naproxen (Aleve) for pain and swelling.  Keep the bruised area above the level of your heart when you can.  Rest the area so you don’t hurt it more.  If the area still hurts after 2 days, put a warm towel or heating pad on it.

5.  The burn is deeper than a blistering burn.  You have severe pain.  You are not sure how serious the burn is.  You have a burn worse than a mild sunburn on your face, ears, eyes, hands, feet, privates, or a joint.  Pain from the burn lasts longer than 48 hours.  You have signs of infection.  A child younger than 5, an older adult, or a person with a weakened immune system is burned.  There is a chance the burn was caused on purpose.

6.  The degree of the burn is based on how deep it is, not on how much pain it causes.  A first-degree burn involves only the outer layer of skin. The skin is dry and painful and hurts when you touch it. A mild sunburn is a first-degree burn. (picture on page 25)  A second-degree burn involves several layers of skin. The skin may be swollen, puffy, weepy, or blistered.

7.  A third-degree burn involves all layers of skin and may include tissue beneath the skin. The skin is dry, pale white, or charred black, and swollen. It sometimes breaks open. This kind of burn destroys the nerves, so it may not hurt except on the edges.  A fourth-degree burn extends through the skin to muscle and bone.

8.  These burns need medical care right away. Call a doctor or 911 and then, ◦ Make sure the fire that caused the burn has been put out. ◦ Have the person lie down to prevent shock. ◦ Cover the burned area with a clean sheet. ◦ Do not put any ice, salve, or medicine on the burn.

9.  You can treat most of these burns at home. ◦ Run cool water over the burn until the pain stops (15 to 30 minutes). Do not use ice or ice water, because it may further damage the skin. ◦ Remove rings, jewelry, or clothing from the burned limb. Swelling may make these items hard to remove later. And if they are left on, they may damage nerves or blood vessels. ◦ Clean burn with mild soap and water. ◦ Use antibiotic ointment such as Bacitrcin, Polysporin, or Silvadene. Do not use butter, grease, or oil. The increase the risk of infection and do not help the burn heal.

10.  If the skin breaks open, use a bandage. Otherwise, don’t cover the burn unless clothing rubs on it. If you need to cover the burn: ◦ Use a nonstick gauze pad. Make sure the tape is well away from the burn. ◦ Do not wrap tape all the way around a hand, arm, or leg. ◦ Keep the bandage clean and dry. If it gets wet, replace it. ◦ Remove the bandage once a day, clean the burn, and put on a new bandage.

11.  If blisters form, do not break them. If they break on their own, use water and mild soap to clean the area. Don’t cut off the flap over a blister; it’s a natural bandage. Apply an antibiotic ointment, and cover the burn with a nonstick gauze pad.  Do not touch the burned area with your hands or any unclean objects. Burns get infected easily.  After 2 to 3 days, use aloe to soothe the burn.

12.  A strong chemical such as acid or lye splashes into your eye.  You have swallowed a chemical that may cause burning or be poisonous.

13.  A large area of skin (more than 25 percent of any body part) or any part of the face is exposed to a strong acid, such as battery acid, or to a caustic substance, such as lye or Drano.  A burned eye still hurts after 30 minutes of rinsing with water  You eye is very red; has yellow, green, bloody, or watery discharge; or has a gray or white discolored area.  You have vision problems that do not clear with blinking.  Your skin is red, blistered, or blackened.

14.  Burns can occur when a harmful chemical, such as a cleaning product, gasoline, or turpentine, splashes into an eye or onto the skin. Fumes can also burn the eyes, the skin, and airways and lungs.  A burned eye may be red and watery and may be sensitive to light. If the damage is severe, the eye may look white.  Chemically burned skin may be read, blistered, or blackened. It depends on how strong the chemical was.

15.  Call Poison Control for specific advice. Have the chemical’s container or label nearby.  Right away, flush your eye or skin with a lot of water. Use a cold shower for skin burns.  Keep rinsing with water for 30 minutes or until the pain stops, whichever takes longer.