Talking burn safety with U of M

MINNEAPOLIS/ST. PAUL (06/26/2023) — Summer is officially here, and it brings two popular activities that embody the joy and celebration of the season: grilling and fireworks. While these activities add excitement to outdoor gatherings and events, it is essential to prioritize burn safety to prevent accidents and ensure the well-being of everyone involved. 

Andrew Zinkel, MD, MBA, with the University of Minnesota Medical School, talks about proper grilling techniques, firework safety guidelines, burn types and how to treat them.
 
Q: How can I prevent potential burn hazards this summer? 

Dr. Zinkel: The most common safety risks with fireworks and grills are minor to severe burns, but there are ways to mitigate these risks. For both scenarios, always use them outdoors, away from homes, decks or hanging branches, and designate a safety perimeter for pets and kids. This should be at least three feet for grills and up to 35 feet for fireworks. 

For fireworks: 

• Have easy access to water in case of accidents.
• Supervise children with sparklers; these can ignite clothing and burn at 2,000 degrees Fahrenheit.
• Soak spent and unused fireworks in water before discarding them.
• Never hold a firework in your hand when lighting.
• Only light one firework at a time.

For grills:

• Never leave your grill unattended.
• For propane grills, use a mixture of soap and water to look for bubbles (a sign of a leak) the first time you use your grill for the season. It should be applied to the entire hose connection between the propane source and the grill. The line should be tested each season.
• If you use a starter fluid, use only charcoal starter fluid; never add charcoal fluid or any other flammable liquids to the fire.

Q: What are the differences between first-, second- and third-degree burns? 

Dr. Zinkel: Burns are described in degrees that correlate with skin layer depths based on a clinical diagnosis. First-degree burns are described as red, painful and tender without blister formation. Second-degree burns are divided into superficial and deep partial-thickness burns. In superficial partial-thickness burns, there is blistering of the skin. The exposed dermis is red and moist at the blister’s base and is painful to the touch. In deep partial-thickness burns, the skin may be blistered, the exposed dermis is pale white to yellow and the burned area is absent of pain sensation. Third-degree burns are full-thickness burns in which the skin is charred, pale, painless and leathery. Pain is absent and skin grafting is necessary for treatment, resulting in significant scarring.

Q: What should I do if I burn myself—can I treat it on my own?

Dr. Zinkel: Many first and second-degree partial-thickness burns can be treated at home. Partial thickness refers to a layer preceding a full-thickness burn, and it can be categorized into superficial and deep. The goals are first to control the pain. Cleanse the burn with mild soap and water or dilute with an antiseptic solution. Blisters may be left intact or drained, depending on size and location. Keep the wound covered with a clean, dry bandage and change it twice daily to prevent infection. Burns to your limbs—such as your hands or feet—should be elevated for 24-to-48 hours to prevent swelling.

Q: When do burns warrant a hospital visit?

Dr. Zinkel: Burns that warrant a hospital visit include those that are second-degree deep partial-thickness, third-degree full-thickness burns or pain that is not being controlled by over-the-counter medicines. Hospitalization is necessary for burns affecting the hands, face, feet, perineum and major joints, as well as circumferential wounds encompassing areas such as fingers, toes, hands, feet, arms, legs, neck, chest or abdomen. These wounds can result in scarring that can reduce blood flow to areas further away from the central body. Additionally, it can result in devastating consequences, including amputation and difficulty breathing, if not treated appropriately and followed closely in the clinical setting.

Q: How can I reduce scarring from a burn?

Dr. Zinkel: Burns can cause skin discoloration and scarring. The first thing you can do to prevent the progression of skin damage for minor burns is to wash the area with lukewarm water for 10-20 minutes. Apply aloe vera gel and a clean, dry bandage. Change the bandage twice daily and reapply the aloe vera. Once a scar has formed, there are treatment options, such as laser therapy, which can help improve the change in pigmentation of the skin to make the scar less noticeable.

Dr. Zinkel is the senior medical director of emergency medicine at the U of M Medical School. He oversees the clinical practice and administration of the M Health Fairview University of Minnesota Medical Center’s emergency departments, UMMC’s East and West campuses and  Health Fairview Masonic Children's Hospital. As the past president of the Minnesota Chapter of the American College of Emergency Physicians, he has been a fervent advocate on behalf of the specialty and our community patient population.

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