One of the most painful injuries is a burn. That's because when skin burns nerve endings are damaged. Burns can be caused by fire, the sun, chemicals, heated objects or fluids, and electricity. Every year millions of people in the United States are burned - thousands die as a result of their burns. Many require long-term hospitalization.

Serious burns are complex injuries. In addition to the burn itself, a number of other functions may be affected including muscles, bones, nerves, and blood vessels. The respiratory system can be damaged, with possible airway obstruction, respiratory failure and respiratory arrest. Since burns injure the skin, they impair the body's normal fluid/electrolyte balance, body temperature, body thermal regulation, joint function, manual dexterity, and physical appearance. Patients also may suffer emotional and psychological problems that begin at the emergency scene and could last a long time. 

Distinguishing a minor burn from a more serious burn involves determining the degree of damage to the tissues of the body. If you are not sure how serious the burn is, seek emergency medical help.

First-degree burns are those in which only the outer layer of skin is burned. The skin is usually red and some swelling and pain may occur. Unless the burn involves large portions of the body, it can be treated at home.

Second-degree burns are those in which the first layer of skin has been burned through and the second layer of skin is also burned. In these burns, the skin reddens intensely and blisters develop. Severe pain and swelling also occur. If a second-degree burn is no larger than 2 or 3 inches in diameter, it can be treated at home. If the burn covers a larger area, seek medical attention. You may need a tetanus booster.

Third-degree burns are the most serious and involve all layers of skin. Fat, nerves, muscles, and even bones may be affected. Areas may be charred black or appear a dry white. If nerve damage is substantial, there may be no pain at all. These burns should receive emergency medical attention.

Follow these steps when treating minor burns at home:

1. If the skin is not broken, run cool water over the burn for several minutes.

2. Cover the burn with a sterile bandage or clean cloth.

3. Take aspirin or acetaminophen to relieve any swelling or pain.

Seek emergency treatment immediately for major burns. Until an emergency unit arrives, follow these steps:

1. Remove the person from the source of the burn (fire, electrical current, etc.).

2. If the person is not breathing, begin mouth-to-mouth resuscitation immediately.

3. Remove all smoldering clothing to stop further burning.

4. If the person is breathing sufficiently, cover the burned area with a cool, moist, sterile bandage or clean cloth. Do not place any creams, ointments or ice on the burned area or break blisters.