How could a burn impact your character? What challenges might they face with burn prevention? What are the four types of burns? What is a fourth degree burn? Find out on this episode. Welcome to Writing Rural with Alley. I'm Alley and this is Episode Number 27, Burns 101. Today we are going to talk about burns. Let me start by adding a disclaimer. I am in no way, shape, form or more fashion a doctor or medical person. This is not a medical or treatment advice and I am not telling you what to do or not to do. This is solely for the purposes of inspiring ideas for writing about burns in a fiction story and nothing else. Now that that is out of the way, let's get into this. This week I will focus on burns and next week I will focus on burn treatment. We have all dealt with burns at one time or another in our lives and our characters will be the same. There are four types of burns. Thermal burns, chemical burns, electric burns, and radiation burns. Thermal Burns are burns caused by contact with heated objects. They fall into one of six categories. Scalds, thermal contact burns, electric burns, chemical burns, radiation burns, and burns caused by fire. I know some of these have their own categories. However, thermal burns are categorized by how a person comes in contact with heated object and that can overlap with other categories. Scolding involves things like boiling water, scorching bath water, and steam. I once dropped a pot of boiling tea on my hand and wrist. Nothing helped the pain for days, and it was only a first degree burn. I do not recommend. Chemicals can sometimes burn when the chemicals are mixed together and generate heat. Electric burns sometimes turn thermal when the body converts electric current going through it into heat. Another example is when electricity lights the clothes on fire. Burns by fire are fairly self explanatory. Fire happened to the skin. Thermal contact burn is being burned by a hot object, pot, pan, or a slide in the summer sun, a hot sidewalk, fireworks, or even a hot car buckle. From my understanding of my research, radiation of the thermal type is the nuclear radiation. Basically, if a burn comes from something radioactive, it's classified as a thermal burn. Thermal burns are basically your common burns and will be treated accordingly. Just remember, the old wives tales like spreading mayonnaise or butter on it is not medical treatment. When your character gets to the hospital, they will be scraping the mayonnaise off of the burn. That will hurt. Chemical burns are when the skin comes in contact with a chemical for a period of time, resulting in skin damage. Some of the things that cause this can be, but are not limited to, gasoline, bleach, battery acid, household cleaners, teeth whitening products, hair dye, ammonia, pool cleaners, and more. I have personally used an after surgery mouthwash that chemically burned my mouth. It was painful and a bit confusing about what was going on at first since I assumed the pain was the mouthwash touching the surgical site, and later I just assumed that all of it was related to the surgery. I was a bit of an oddity because chemical burns are normally known right away. Signs typically appear quickly but in some cases take time. I believe that depends on the type of chemical your character comes in contact with, so make sure to research the chemical itself. Signs of a chemical burn are redness, feeling as if the skin is burning, changes in vision if the chemical somehow comes in contact with the eye, coughiness or shortness of breath if the chemical was inhaled, numbness, redness, and sometimes even black skin at the site of the contact, looking like the skin is melting in an oozing kind of way when it is not actually melting but is forming blisters and more. Chemical burns are treated by removing the clothing from the affected area or the contacts if it comes in contact with the eyes. Remove any dry chemicals that remain. Rinse with cool water for 20 minutes. However, if it comes in contact with the eyes, they should be rinsed until they reach medical help. Although there are a few chemicals, I don't know which ones they are, they're not removed with water. That's why your character needs to know what chemicals they are working with and the first aid if an accident happens. Knowing this could make your character a hero. Not knowing what to do could turn bad and potentially deadly. Also, jobs should train your characters. So there could be a story of a lawsuit for failure to properly train and someone being injured. Historically, characters might not have had all of the information on what to do when chemicals burned, and they might just have to wing it. Preventing these types of burns is always best. Training proper safety gear, correct storage, content labels with the first aid label, well ventilated areas, keeping chemicals away from children, never mixing chemicals, and common sense will save your characters from themselves. At least we hope, unless they are a jerk. And then storybook payback might ensue. Electric burns are burns that happen because of electricity. The way this can happen includes through appliances, wiring, lighting, lightning, electronics, and more. Electrical burns should be taken seriously because while there might be only a small sign of the burn outside, there could be internal damage. Signs of an electric burn are burns, (of course) confusion, headaches, dizziness, weakness, numbness, heart pounding or fluttering, tingling, heart arrhythmias, red or black urine, muscle contractions, balance problems, light headedness, shortness of breath, seizures, unconsciousness, entrance wounds, exit wounds, arc wounds, and more. How many of volts that come in contact with and how the electricity went through the body will make a huge difference in how severe the burn is. Because of the possible unknown internal damage, doctors advise seeking medical attention to find the full extent of the injury. The "let's be safe, not sorry" approach. Once again, prevention is always best. Different eras believe different things help with this. I have a family member who used to work in electrical lines and they used to carry around a stick in their back pocket to help with electrical shocks. Some people believed it would shock the stick, not them, while others swear it was only for knocking people off the lines when they got shocked. In case you're wondering what that means, when high voltage hits the human body, the muscles lock up. The person literally cannot let go. Using a stick to push them off keeps the second person from being shocked when they touch them. Radiation burns are burns caused by long and short wavelengths. These happen with prolonged exposure. The most common of these is sunburns. The signs and symptoms are basically the same as thermal burns. The real difference between thermal burns and radiation burns is the time it takes for the burn to show up on the skin. Thermal burns show up right now. Radiation can take minutes to weeks to show up. Next thing to know is that there are four degrees of burns. I did not know there were more than three, but hey, I learned something new. First degree burns are when the outer layer of the skin called the epidermis is burned. This is common with touching things like a stove, curling iron, or even sunburn. This is common with touching things like a stove, curling iron, or even a sunburn. They are treated at home and usually only painful for 24 to 48 hours. Sometimes in the case of sunburns, the dead skin will peel away after a few days. Second degree burns are when the burns go through the top layer of skin called the epidermis and down to the second layer of skin called the dermis. This is actually the most common type of burn. It is painful, can blister and swell, and will be red or brown in color. These can scar and usually take one to three weeks to heal. Medical help is not normally needed, but your character will need it if the burn is over a large area, a joint that could affect their movement, or it shows signs of infection. Remember, historically, infections kill. Third degree burns are when a burn goes through the outer layer of skin, the epidermis, through the middle layer of skin, the dermis, and the layer of fat under your skin, hypodermis. This type of burn also burns sweat glands, hair follicles, and most importantly nerves. When the nerves are burned, the burn will not hurt right away. However, this is deceptive and masks the seriousnessness of these types of burns. Third degree burns can look charred, dried, leathery, swollen, and can have black, white, or bright red coloring. There can also be second degree burns around the third degree burn. Fourth degree burns get a little more complicated as there are lots of things to break this down into further degrees of burns, but I'm not going to because I am not an expert. Instead, I will go with what the burn definition from burn survivor. Com. They define it as the full thickness burns affecting all layers of skin and also structures below the skin, such as tendons, bones, ligaments, and muscles. Fourth degree burns are traumatizing to the burn victim and anyone around them when it happens. They have their nerves burned off. Skin grafts are common. Infection is a high danger, especially in a historical or post apocalyptic story. This is also the stage of life threatening burns. Your character is likely to go into shock. Shock is when there is a sudden drop in blood flow through the body. When this happens, the organs are not getting the oxygen they need. The skin can be cool, clammy, pale, or ashen. Other signs might be rapid breathing, rapid pulse, enlarged pupils, nausea, vomiting, weakness, fatigue, dizziness, fainting, and more. There can be mental changes as well, such as mental function, un normal behavior, agitation, or intense anxiety. Shock has several stages but can potentially lead to death. First aid for shock is to lay the character flat on their back, assuming that was not the burned part of the body, and elevate their feet, keep the person still, the more they move, the less oxygen to the organs, loosen any tight clothing, cover them with a blanket to keep them from becoming chilled, do not let them eat or drink anything. I am not sure if no eating and drinking one is what they want you to do for the modern medical care in case they need emergency surgery or if it is important either way. Untreated infections can potentially turn septic and lead to death. This will happen faster if the bone is accessible to the infection through the burn. Sign of a burn infection are unusual redness around the burn, feeling hot to the touch, change in color to the burn, purplish coloring, sudden change in the thickness of the burn, green discharge, foul smell and fever. The next thing to know is the Rule of Nine Burn Chart. This was made in 1947 and published in 1951. This is the chart that was created to help calculate the total amount of the body that was burned. The numbers are a little different for adults and for children. These are broken down into increments of nine. For example, the adult leg, including the feet, is broken down so that the front of the leg equals 9 % and the back of the leg equals 9 %. If the front and the back were to be burned, you would add 9 % plus 9 % to equal 18 %. The breakdown of the body parts for the adult is as followed. Torso, front, 9 %. Back, 9 %. Together, 18 %. Pelvis, Front, 9 %. Back, 9 %. Together, 18 %. Head and neck, Front, 4.5 %. Back, 9 percent. 4.5 %, back 4.5 %, together 9 %, arm and hand, front 4.5 %. Back, 4.5 % and together 9 %. Genitalia is only 1 %, leg and foot, front 9 %, back 9 % and together 18 %. For children, it's a bit different. A child's head is larger at birth, as such it makes 18 % of the body's total. Starting at one, things change as the baby grows. For each year over one year old, 1 % should be subtracted from the head up to nine years old. The head of the children aged 10 and up should be calculated at 9 %. Of those same numbers, 0.5 % should be added to each leg for each year up to nine years old. That means the chart for newborns and children, one and under, torso, front 18 %, back 18 %, together 36 %, head and neck, front 9 %, Back 9 %, together 18 %, leg and foot, front 7 %, back 7 %, together 14 %, arm and hand, front 4.5 %, back 4.5 %, total 9 %. I will leave a link in the show notes where you can find the burn chart.
Fun fact:it is estimated that approximately 8,500 people in the United States were injured with fireworks in the year 2021. These can be thermal or chemical burns, but thermal is the most common. Now, for everyone's favorite part, what could possibly go wrong? Well, let me tell you! Likely to go wrong, your character has no training, and when someone burns themselves with a chemical, they do not know how to help the burn victim. Also likely to go wrong, your character spent too long in the sun and got a sunburn. If writing historically, there will be no sunscreen as we know it today. And the same could be true in a post apocalyptic story. Possible to go wrong, your character was carrying a hot pot or pan and accidentally burn themselves. When they do, they instinctively pull their hand back, dropping the pot or pan. This will make a mess, and if it's hot, there will be a second burn when it splashes back at them. Also possible to go wrong, your character was working on electrical wires, and when they were shocked, they didn't realize how badly they were burned. It might take a second character to realize their behavior is not what it should be and seek medical help for them. Unlikely to go wrong, your character lit gas fumes on fire and breathed in some of the fumes just as there was a flash fire, which burns their lungs. Unlikely to go wrong, your character's burn becomes infected and they do not realize it until it starts to smell. The stench could be very potent. Improbable but tactically still in the realm of possibilities. Your character survives a nuclear blast only to find that they have burns many days after the initial blast. Also improbable, but still tactically in the realm of possibilities. Your character pops a blister of a second degree burn that lets bacteria into the wound and soon they have a full blown infection that turns septic and they die. You can find this episode show notes and helpful links to find more on my website, alleyheart.com That's ALLEYHART. Com. Thanks for watching. Subscribe and follow for more episodes. Connect with me on my YouTube videos by dropping me a comment. A new episode comes out every Monday. Until then, happy wordsmithing.