Assalam-o-Alaikum!

I hope that you all will be well with the grace of Allah Almighty. A few days ago, I visited new challenges and found this challenge useful for me. It is an interesting challenge for me because I am also a public health worker at a govt. Hospital as a dental assistant. Moreover, I realized that I can easily describe the mentioned questions from the medical and biological points of view. So, I tried my best to describe the questions asked in the homework.

![Cover Poster.png](https://cdn.steemitimages.com/DQmRo7Lz3ode5evYYQJQSLhTkDQY9TjPZbcaWnpsbb3i7LU/Cover%20Poster.png) ^{[Image Edited on Canva](canva.com)}

✅Question No. 1 " You witness a child accidentally spilling hot tea on their arm. What immediate steps will you take? What actions will you avoid? Include considerations for burn severity and explain your reasoning. "

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Immediate Steps Taken by Me

Suppose that I am present on the spot where a boy spills hot tea on his arms. First, I would help that boy by trying my best. In this situation, I will take the following steps:

Taking Away from Spilling

My first step is to take away the boy from the incident site. It is an important step as it can prevent the boy from further burning and there will be higher chances of minimal spilling effects. Moreover, it will also help to avoid secondary spills and the chances of a safe environment against further burn will maximize where he could feel safe.

Cooling the burn

The second step that I will take is cooling the burn. For this purpose, I will use cool water to flow around the burn. Applying gentle pressure is essential because the burnt skin may peel by the application of high pressure over the wound. Using cold water can prevent the wound from spreading and will help to slow down the burning process. Moreover, it will be helpful against further tissue damage and also reduce pain and swelling because its action will stabilize the temperature of blood vessels.

Identifying the Severity of Wound

The third thing I would do is to identify the severity of the wound. This is an important step to check the condition to analyze whether that boy needs to move to a hospital emergency or some nearby doctor's clinic. There are three to four types of burns that are classified in first-degree, second-degree, third-degree, and fourth-degree. ⬇⬇

Identification for First-degree burn These are some key points to identify first-degree burns. When these points are appeared, the burn is of first-degree. i) Redness on the burnt site ii) Pain iii) No blisters iv) Little-swelling Identification for Second-degree burn These are some key points to identify second-degree burns. When these points appear, the burn is second-degree. i) Pain on the burn site ii) Blister Formation on the burn site iii) Swelling and Decoloration

In this stage of burn, the patient feels a lot of pain because both the epidermis and dermis layers of skin burn due to nerve exposure. Moreover, this stage is more crucial than the first one and therefore, the patient must be moved to the hospital or some nearby clinic for better treatment.

Usually, the burns from hot tea and water are the burns first or second-degree, and therefore there is no need to discuss the burns third and fourth-degree.

Removing the Jewelry and clothes

If the boy is wearing any jewelry like a watch, male bracelets, or any ring, I will remove that because this may also cause the peeling of skin from the burn site and may cause problems if it remains contaminated with the skin or burn site. If the arms are not naked or covered with clothes then I will remove them if they are removed easily otherwise they may peel the wound leading to infection hazards.

Cleaning the Wound smoothly

Being a medical professional. I can remove tea from a wound by improvising cotton dry non-stick bandage to prevent the wound from dust and bacterial action because tea contains a significant amount of sugar in it and it should be removed to prevent any bacterial attack. Bacteria attack rapidly on glucose sites and the chances of fungal growth also increase. Moreover, the presence of glucose slows the healing process. Therefore, it is essential to do so. At all, the boy will be moved to the doctor for proper check-ups and treatment which is necessary in any condition.

![Picture One. png](https://cdn.steemitimages.com/DQmY2efNZPYAWS6exUeoQLAzv5Dz4NNepHBFHju2Dandi2a/Picture%20One.png) ^{These are the preventive measures that should be taken if any thermal burn happens.} ^{[Image Edited on Canva](canva.com)}

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Actions to Avoid

Avoid to applying chilled water or ice

I would avoid applying ice or extremely cold water on or around the burn. This is because the mau causes the shrinking of tissues and blood vessels and leads to vasoconstriction (shrinking of the blood vessels by a reduction in diameter of vessels and resulting in increased blood pressure) and further tissue damage.

Avoid using butter, cream, oil, and any ointment immediately

I would avoid using butter, cream, and oils because of their rapid heat-trapping ability. They trap heat because of their low specific heat capacity as compared to water which means that these substances can catch heat rapidly as compared to water to increase their temperature. Moreover, the ability of thermal conductivity enables them to pass more heat from them. The mentioned substances may cause infection if the burn victim is allergic to them.

Avoid to Brust the blisters

Blisters are the hollow dom of the epidermis. Because of the thermal burns, the small vessels of blood leak and an accumulation of water-like fluid occurs. This fluid lifts the skin and the blisters are formed. They work as a protective layer on the body as a barrier between the wound and the external environment. Moreover, the leaking fluids that I mentioned may have proteins and body nutrients to boost the healing process. Therefore, I would avoid to Brust the blisters for the mentioned reasons.

Avoid using sticky and adhesive materials

I would try to avoid using sticky and adhesive materials. Such materials might cause some problems like allergies and infection. Moreover, they can cause peeling of skin and bursting of blisters. I would avoid using cotton as its thin threads can stick to the wound causing complications.

![Picture Two. png](https://cdn.steemitimages.com/DQmQ3oG9VvP1SKWgSKNfCaTESAAJziuU8bK8pMJoUgC5TkX/Picture%20Two.png) ^{All the mentioned measures must be avoided if thermal burn happens.} ^{[Image Edited on Canva](canva.com)}

✅Question No. 2 "A worker in a warehouse suffers an electrical burn after touching exposed live wires. The burn site shows entrance and exit points, with damage to the skin and underlying tissues. What are the immediate first-aid actions you should take, and what critical steps should you avoid? How does this differ from treating thermal burns?"

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Steps to Take

The following steps should be taken in the case of an electrical burn. Ensurance of Safey

The first step that I think should be taken by everyone is to ensure safety. It is prioritized because the electrical burn not only harms the victim but it may also affect the helpers too. The victim's body may have electric charges in it for a long time and any other person directly touching the body may face another problem. Here are points to ensure the safety of the scene of the incident.

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Removing the metals from nearby

It is also a restrictive action but should be explained in this segment to ensure safety. If any metallic object is in touch with the body, the most essential step is to remove that from the surroundings to avoid any complexity. The metallic objects may increase the severity of electrical shock because of their ability of conductivity. Moreover, their ability to resist heats them quickly and this may cause another burn if the metallic object remains in the touch with the body. The explanation of this point is too long to make this segment interesting but the overall conclusion is to remove the metallic object from nearby. However, non-conducting materials like wood or rubber should be used to touch the nearby conductors.

Avoid to touch the body directly

It is a restrictive point but carries the best position for description. Another important safety measure is to avoid direct contact with the victim's body. It is a well-known fact that is proved from physics too that the human body works as a conductor and the body's tissues and nerve impulses produce an electrical current of milli volts as I studied in my biology books, years ago. When any external current passes from the body, the body's electrical current also disturbs and leads to prolonged effects. Therefore, any wooden stick and other non-conductor material such as plastic and rubber should be used to touch the body.

CPR Action (If no Response observe)

Another important step that should be taken by me is to give CPR to the victim. CPR stands for Cardiopulmonary resuscitation and it is a life-saving technique that you have seen on television if someone is not professionally related to medicine. If the burn victim is unconscious, It is a useful technique in which the victim is given breath from outside and it must be done. The chest of the person is compressed and after 30 compressions two rescue breaths are given as I learned during my emergency treatment training session, a few years ago. If the victim is not responding then the CPR method is used to continue the breathing process. However, a safety precaution is that the victim's body should not carry any electrical current. Moreover, if the chest and the other compressional parts of the body are burned (including the face from where breath is inhaled in the body), then avoid CPR to prevent another wound. The mentioned ratio was recently revised by WHO about some years ago.

Checking of Entrance and Exit point to note the severity of wound

Let's understand it first. The entrance point is the point where the electrical shock enters the body. It has a significant appearance on the body but the burn area is small. Usually, tissues appear to be damaged at this point and the severity of this point can provide efficient information about the internal tissue damage. On the other hand, the exit point is the point where the electrical current leaves the body. Usually, feet and legs are the exit points in most of the cases because they remain in touch with Earth. Any point that is in touch can be an exit point. Here the wound could be more severe as compared to the entrance point because electricity affects more badly on exit points than entrance points.

Significance of these points

These points carry a significant importance. They can inform us about the damaged internal organs. Suppose the entrance point is present on the left shoulder and the exit point is located on the left side under the heart, then we can conclude that the heart might affect the electrical chock.

![Picture Three. png](https://cdn.steemitimages.com/DQmULQj34KyBMoRPngpb2HZRJQoQwBaTCogkYkETV635bw2/Picture%20Three.png) ^{The following points should be followed in the case of electrical burns.} ^{[Image edited on Canva](canva.com)}

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Steps to Avoid

The following steps must be avoided in the case of electrical burn. Avoid using Water

I would avoid using water. We have studied that water is the best conductor of electricity, and salted water effectively conducts electrons. Water that is present around us for drinking, has a significant amount of nutrients in it that conduct electrons more effectively. Therefore, I will avoid using fresh water to clean the wound. When the hazard of electrical shock in the body is minimized, the wound could be washed with water. Moreover, using ice and water may also cause excessive complications, and therefore, I will surely avoid it.

Avoid giving Food to Victim

The people living in remote areas usually try to give food and other nutrients to the victims especially when they are unconscious. It has a bad impact on the health of the victim. During this stage, the food may enter the respiratory tract and improper choking may also have a bad impact on the health of the victim.

Avoid using Normal Saline

We must avoid using Normal Saline. At my workplace, I usually note that many newcomer trainers make the mistake of putting NS on the burn wound on electrical shocks. One of my seniors cleared it a few months ago. Using NS directly on the burn can impact badly if it is available around the incident.

Avoid delaying in seeking medical treatment

An important thing that I will do is to avoid delay in seeking medical treatment. No doubt, it is important in any accidental case, but in this case, it has significant importance in this accident because of its severity.

![Picture Four. png](https://cdn.steemitimages.com/DQmU4kR8iTPAj3MipNAGRztvDCb1gmnYAGNCwYhX1MH8tiZ/Picture%20Four.png) ^{The following steps carry importance. They must be taken for medical or non-medical persons.} ^{[Image edited on Canva](canva.com)}

✅Question No. 3 "A worker in a factory accidentally spills a strong acid on their arm, causing immediate pain, redness, and blistering. A colleague tries to wash it off with water but notices the burn spreading." a. Identify the type of burn. b. What went wrong during the initial first aid? c. Propose the correct first aid steps and explain why each step is important.

Answer A
a. It is a chemical type of burn because it involves chemicals in it.

Answer B

It is interesting and seems to be a scenario-based question. A worker spills a strong acid accidentally and his colleague washes it with water. But the burn spreads. If the burn spreads, it means that the spilled acid is probably such kind of acid that can react with water like H₂SO₄, Phenol, HNO₃, H₃PO₄, etc. These are strong acids that react highly with water. Therefore, if the burn from such chemicals is washed from water, it spreads due to the reaction of those chemicals.

Answer C

Some of the correct aid measures are given below. Use Soil or Sand Immediately

I think it is one of the best replacements of water to avoid any further reaction because the soil has an alkaline nature and works to neutralize the effect of acid. Moreover, It may also protect the further spreading by absorbing acid. A good thing about soil is that it is easily available around any incident site but some precautions should be taken like the soil should not include too much dirt to infect the wound or it should not be acidic to spread the wound.

Removing the Clothes

If the arm of that person is not naked and there is any covering on it, then it is important to remove that immediately and safely because by contaminating it with acid, they can other parts of the body.

Cover Area to Prevent the spread

After putting enough alkaline soil, the area of the wound must be covered to avoid any further spreading. Before covering, it is important to ensure the cleaning of body parts around the wound is perfect.

Protection from inhalation of acidic fumes

The victim would be moved away from the scene because the fumes may enter to nose of the victim causing difficulty in breathing and the risk of other respiratory complications may increase.

Immediate Medical treatment

An important step is to seek medical treatment immediately for further detailed treatment that can prevent the victim from any major confusion.

![Picture Six.png](https://cdn.steemitimages.com/DQmQn3vRVnBPQTKmMiSMt7gm7VjAkjMNQ5T4cYX9kpshiEb/Picture%20Six.png) ^{[Image edited on Canva](canva.com)}

✅Question No. 4 " You are a first responder in a rural area. Two people are injured in a house fire: * Person A has a large area of third-degree burns but is conscious and calm. * Person B has second-degree burns on both legs and is in severe pain. You can only help one person immediately due to resource constraints. Whom do you prioritize, and why? Support your decision with medical and ethical reasoning."

It is interesting to answer as it involves a situation and is a scenario-based question. Answering such questions is logical because answers to such questions should be based on logical points of view. Therefore, it is important to understand the situation first.

Situation of Person A
Person A has a large area of third-degree burn and is conscious & calm. Reason Behind Calmness of Frist Person

A third-degree burn involves damage to the nervous system of the part of the body where the burn occurs. Nerve cells are messengers to transfer signals from other parts of the body to the brain and if they are damaged then there are no chances of transferring messages. Therefore, the person with the third degree of burn feels no pain. The person in the given case has third-degree burns, therefore he is not feeling pain anymore and is calm and conscious.

But has: i) Damaged his nerves ii) More crucial than person B Situation of Person B
Person B has second-degree burns on both legs and is in severe pain. This is because of the exposure of nerve cells that transmit signals to the body and they have been more sensitive in second-degree burns. The person is feeling pain and might be crying for help.

Explanation of Triage management system

A quick and right decision is a must in the situation of low facilities. Any wrong decision can even lead to the death of the person or both. A triage management system enables one to decide quickly to make a productive and helpful decision.

There are four triage band categories. 🟥Red Band: * It is tagged when injuries require immediate treatment otherwise victim may lose his life if late. 🟨Yellow Band: * It means the victim is serious but the treatment can be delayed. Injuries are not fatal. 🟩Green Band: * The green tag stands for the safe zone. The injuries are minor and can be treated by clinical methods. ⬛Black Band: * It refers to the high severity of injury or death and if the injured victim is treated, there are minor chances for survival. ### Selection of Person to be treated first I would select Person A to treat first. The medical, ethical, and perspective reasonings are below. ### Medical Reasoning Person A🟥

Person A has a burn of this degree involving the burn of all the layers of the body and underlying tissues. Even though he is calm and conscious he has more damage than person B. Moreover, there is a high chance of this fact that the delay in the medical treatment may lose his life, and the risk of dehydration, infection, and shock is higher in person A. He is calm but any condition can be turned into a critical condition.

Person B🟨

Person B is no doubt crying in pain and may be out of his senses. But, he has less damage on his body and the risk of dehydration and shock is less in person B. Pain management is important but the life-threatening risks are less to this person.

### Ethical Reasoning

Ethical reasoning is the process of making decisions of right and wrong. It involves ethics of beneficiary, virtuosity, and care. In short, it consists of the reasoning of who should be helped first, based on the fact of actual benefit to the victim and beneficiary compromise with the other person for the well-being of a first-person. From this point of view, Person A carries a 🟥Red band which means to be helped first, and Person B carries a 🟨Yellow tag to be helped later. This order is a beneficial order for both persons because pain management is easier then shock and infection management.

✅Question No.5 Create an infographic on burn management. Include the following: a. Types of Burns and Their Causes (Electrical, Thermal, etc) b. Different types of burns (1st, 2nd, and 3rd degree) c. First aid steps for minor and major burns d. What NOT to Do During Burn First Aid." Use visuals and short explanations for each point."

A) Types of Burns and Their Causes (Electrical, Thermal, etc)

![Infograph Types or Burn. png](https://cdn.steemitimages.com/DQmcvJs3GRhqPWMdy6pHYiWb4pKPRgmptDsrJTukBEq1GxG/Infograph%20Types%20or%20Burn.png) ^{All the types of burn and their causes have been described in the above infographics with brief descriptions.} ^{[Image Edited on Canva](canva.com)}

A) Different types of burns (1st, 2nd, and 3rd degree)

![Stages of Burn. png](https://cdn.steemitimages.com/DQma2fVciUTCMSUjEsJLDSAnSbCohdMdXHQEYETVHnJ42R6/Stages%20of%20Burn.png) ^{Types of burns and a brief description.} ^{[Image Edited on Canva](canva.com)}

Answer C) First aid steps for minor and major burns

![Minor Burns.png](https://cdn.steemitimages.com/DQmaqebT7RBTJKphweRPcTp7Vg5WK1dRngtWCLJbE2sQ162/Minor%20Burns.png) ^{First Aid methods for minor burns with brief descriptions.} ^{[Image Edited on Canva](canva.com)}

![Major Burns. png](https://cdn.steemitimages.com/DQmPYzndgWSqwCq9s3iDpfGvLJfXdQXyozhRHr6o2sZyuKa/Major%20Burns.png) ^{Infograph of major burn first aid method with a brief description.} ^{[Image Edited on Canva](canva.com)}

Answer D) What NOT to Do During Burn First Aid." Use visuals and short explanations for each point."

![Things to Avoid in Burns.png](https://cdn.steemitimages.com/DQmbSu6yricmBnLQtQjZVAyJW9x3AYwqHCEWqpm3Cp3LhtL/Things%20to%20Avoid%20in%20Burns.png) ^{The infograph for measures to avoid in burns.} ^{[Image Edited on Canva](canva.com)}

* Avoid Ice: Ice should not be applied to any burn to avoid vasoconstriction. In severe it may cause cardiac arrest. * Avoid Butter and Oils: They trap energy on heating. Due to this, these may cause hyperthermia. * Avoid Popping Blisters: Popping blisters may cause a decrease in protection. Moreover, the chances of bacterial and fungal attacks increase. * Avoid Removing Stuck Clothes: Stuck clothes may cause peeling of the skin and expansion of wounds. * Avoid Cotton: Due to thin threads, it may stick to the wound. * Avoid Direct Sunlight: Sunlight may impact badly due to ultraviolet rays and cause other diseases. In severe cases, cancerous cells may born in the body. * Avoid Toothpaste: Toothpaste contains certain chemicals which are harmful to wounds. * Avoid Peeling Dead Skin: Dead skin also works as a protective layer. Peeling dead skin means removing a protective layer. * Avoid Scrubbing: Similarly scrubbing may cause peeling of skin. * Avoid Adhesive Bandages: They have a sticky nature and victims may be allergic to such bandages.

^{Brief Description of preventive measures.}

Thank you very much for reading this blog. In the end, I would like to invite @humaidi, @afzalqamar, and @damithudaya to participate in this contest. #### By: @bhaiaslam