Talk:Burn/Archive 1

Headings
Many of the sections below have been relocated to reflect similarity in subject matter to the respective sections that were started earlier and now immediately precede them. Some material has been separated the material immediately following it, but not in response to it, by later addition of a heading; in many cases, the resulting new section has been moved to follow material older than its own, that relates more closely to its subject matter. --Jerzy•t 04:44, 30 December 2007 (UTC)

Non-combustive burns
what about hot things that are not in combustion? one commonsly would call the injury from, say, a hot pan a burn. Is this medically incorrect? What is the difference between a burn and a scald? -- Tarquin 22:05 6 Jun 2003 (UTC)
 * Your points have been incorporated. -Menchi 22:13 6 Jun 2003 (UTC)


 * All burns from a source of heat whether it be cold water or ice are considered thermal burns. 65.96.38.93 (talk) 02:36, 22 August 2008 (UTC)


 * There still hasn't been anything added in the Causes section about thermal burns. If someone has a good source for that they should add it. — Preceding unsigned comment added by 76.179.52.165 (talk) 13:58, 11 December 2011 (UTC)

Friction burns
Shouldn't there be some information on burns due to friction, since those are slightly different from normal heat burns? Retodon8 20:32, 23 October 2005 (UTC)

Friction can cause burn?
Shouldn't friction be included in the list of causes? --Xinjinbei 07:34, 2 July 2007 (UTC)
 * Yes. I've added friction burn in two places. Carcharoth 08:05, 2 July 2007 (UTC)

Smoke burn

 * And talking of other types of burns,you can heal a sevier burn by putting magets on it smoke burn is a bit of an oddity. It seems to be a rare sort of burn associated with backdraft fires, or something similar. It shouldn't be confused with smoke inhalation, but I'm not quite sure enough about all this to add it to the article. Carcharoth 08:08, 2 July 2007 (UTC)

Cold burns
Anyone have a reliable source that cold can cause burns? I specifically came to this article to find out if that is true, and yet the citations I followed (WebLine, WebMD, Mayo Clinic, NIH, etc) don't list it as this article does. I'd suggest removing cold burns unless it can be determined that this is legitimate. ManiacalMonkey (talk) 02:02, 27 July 2009 (UTC)


 * Nobody replied in over a month about the cold burns, so I went ahead and removed it. If someone finds a credible source for the idea of a cold burn we can add it back. The sources used now seem very credible and they do not include it. ManiacalMonkey (talk) 16:49, 11 September 2009 (UTC)


 * Furthermore, per a discussion further down this page, I changed the redirect on Cold burn to frostbite instead. Ivanvector (talk) 22:52, 6 January 2011 (UTC)

First aid
I think there should be a section on the proper treatment of second degree burns (8 Dec 2005) —Preceding unsigned comment added by 04:48, 9 December 2005 (talk) 128.187.0.165

Treatment
This page could use more information about treating burns. Like how long should a person leave there hand on ice... how quickly should one get to ice etc... —Preceding unsigned comment added by 07:08, 5 July 2006 71.145.192.233 (talk)

The first bullet says that you shouldn't douse cold burns, and yet the cold burn section says that you should. I have no idea which is correct, but seemingly this should be corrected by someone who does. Also, it should probably be noted that medical assistance is generally not needed for any first degree burn unless further injury could occur. If burned myself on the oven and went to the ER with a red finger, they'd just be annoyed. --Ieatlint 00:21, 18 April 2007 (UTC)


 * At first glance, it does seem contradictory. However, there's a slight difference between dousing in water and using flowing water, which could need some clarification. --Sigma 7 06:40, 20 April 2007 (UTC)

I'd like to see more information about natural treatment of burns. --IronMaidenRocks (talk) 13:02, 7 March 2008 (UTC)

I can't believe this page even mentions honey but nowhere mentions running cold water! —Preceding unsigned comment added by 141.108.15.99 (talk) 06:23, 29 March 2011 (UTC)

Perspective
This article seems to be written from a first aid/medical perspective. I was thinking it might be a good idea to talk about it also from a biological perspective, eg. what actually distinguishes a burn (is it cell death?), and there's also little mention of radiation burns. cyclosarin (previously raptor) 10:15, 14 November 2006 (UTC)

Unsourced First Aid section
The First Aid section does not cite any sources for the information that it provides. If someone could provide valid sources, it would be a beneficial edit to make to the article.¤~Persian Poet Gal (talk) 07:28, 6 December 2006 (UTC)

First Aid Treatment
I have rewritten the first aid section, I am a qualified first aider(St John Singapore) and i written it with refrence to a first aid manual. I have added more info, corrected the tone, and revised some of the treatment. So can we now remove the tag saying its unencyclopedic for that section? And I only have a basic first aid certificate, and only referenced to a single manual, so if there are others who have better knowledge than me, please feel free to edit it. Fierywindz 13:01, 10 April 2007 (UTC)


 * The problem is more that Wikipedia shouldn't contain things of that nature. It should, however, fit well in Wikibooks (Sister project) on the subject of 1st aid. You can then link to it via something like wikibookspar. 68.39.174.238 22:10, 6 June 2007 (UTC)

Burn Remedies.
Common culinary mustard when applied to minor burns avoids pain and scarring at the burn site.
 * Is there a suggestion here? This isn't a reliable source, certainly not a medically reliable source. WLU (talk) 22:11, 28 April 2008 (UTC)


 * I've heard of many remedies, including aloe vera, butter, toothpaste, baking soda, egg whites, vinegar, tomatoes, potatoes, etc. Some people swear by the results, which of course are anecdotal. Does anyone know if any of these really effective, and if so, why? — Loadmaster (talk) 21:16, 30 March 2009 (UTC)

Unsafe first aid practice
The article states, douse a chemical burn with cool water for first aid, this isnt accurate in all chemical burns. For instance of the chemical is acidic the water will just dilute and spread the acid around, increasing burn size. - J. —Preceding unsigned comment added by 67.87.237.7 (talk • contribs) 05:30, 7 July 2007


 * I'll look into that, as I don't remember that being the correct solution I got from my reference. --Sigma 7 02:22, 8 July 2007 (UTC)
 * Fixed. I've also added a comment concerning chemicals which are special cases.  --Sigma 7 07:24, 13 July 2007 (UTC)

The article suggests Lidocaine as a topical anesthetic. According to Patient Self Care by Canadian Pharmacists Association's section on First Aid management of burns, benzocain and tetracane shouldn't be used and lidocain and dibucaine should be used sparingly due to risk of sensitizing the skin and/or developing allergic contact dermatitis with prolonged use. Pramoxine (Xylocaine) is a suitable alternative. Also topical aloe vera gel have not shown consistent results in aiding burn healing in humans. Because of the possibility of impairing wound healing, it shouldn't be used on open wounds. (from the same source). Dumbadum (talk) 23:02, 7 January 2009 (UTC)

Treatment and history of treatment (burn:injury)
The following mislocated contrib is moved from Talk:Burn (disambiguation) --Jerzy•t 04:44, 30 December 2007 (UTC) :
 * Why no real treatment section, or even a link to a "you just hurt yourself in the kitchen, what should you do" type site? It should also include the history of burn treatment, including previously used but now proven incorrect treatments (eg, butter). --Gront (talk) 01:56, 30 December 2007 (UTC)
 * Added a link to the Mayo clinic. Will (eventually) look for a history of burn treatment page. Gront (talk) 09:25, 30 December 2007 (UTC)
 * Also found http://www.ameriburn.org/index.php which has a very extensive education section on burn prevention. Gront (talk) 09:28, 30 December 2007 (UTC)

Burn temperatures?
How hot does water or metal have to be in order for it to cause tissue damage? Is there some kind of approximate mathematical relationship than can describe it? For instance, if you touch a 400(F) oven rack for a split second, you'll probably get away with a minor burn, but if you somehow got your hand caught in it you'd probably get very severely burned. Likewise, how hot can bath/hot-tub water be before a person's skin begins to be scalded? Jeeves 12:56, 10 Jun 2005 (UTC)


 * It's not a matter of temperature, but of heat. Rama 12:35, 14 July 2005 (UTC)

Tetanus
I have recently learned that deep burns require that the patient receive a tetanus shot. —Preceding unsigned comment added by 69.108.49.235 (talk • contribs) 00:12, 13 July 2007
 * Citation? --Sigma 7 07:17, 13 July 2007 (UTC)

Actual pictures
This article has a good diagram of all types of burns, but an actual picture of each type of degree burn would be useful. Klosterdev 21:01, 8 September 2007 (UTC)

Wiki-link loop
The 'Parkland Formula' link in the 'Management' section is now self-referential to 'Burns', so could be unlinkified. —Preceding unsigned comment added by 87.81.254.17 (talk) 03:48, 22 November 2007 (UTC)

Minor point of linkage
In the first section is a reference to "being defibrillated or cardioverted". There is an article titled Cardioversion, but it's relatively short. Should "cardioverted" become a link to that? 124.168.116.114 (talk) 00:48, 27 November 2007 (UTC)

Leading?
I removed this:
 * Statistically, it is the second highest unintentional cost of human life behind automobile accidents.

Not only does the cited source specifically put burns in third place, but I don't buy that for a second. First, is that only in America? First-world countires? The world? Heart disease and infections are the leading causes of death in the world by far, and they're unintentional.. in fact, burns don't even make the list at all, and the only "intentional" causes of death on the entire list are suicide, violence, and war. Come on, who put this ridiculous statistic in the article, it's obviously complete BS, use some common sense people D\=&lt; (talk) 01:35, 30 March 2008 (UTC)

Science of a burn? / What is a burn?
What about what physically happens at the cellular level to the dermis and such as excessive heat is applied to it? Klosterdev (talk) 07:49, 11 April 2008 (UTC)
 * Need reliable sources describing it, unless a doctor contributor wants to wing it. I'd guess that it'd first heat the skin, char the epidermis, then begin boiling water in the dermis, once the water has evapourated the remaining tissue would start to char.  But what about electrical burns?  And steam burns?  If we could get even a basic source discussing, I think that would be, if I may be histrionic for a second, awesome.  This doesn't look very reliable, but has a fairly low-level discussion that's pretty easy to understand (and a really gruesome picture...)  This could probably be used as a source for a draft, but eventually should be replaced.  Was this what you were thinking of, or less sequelae, more chemistry at the actual burn site?  WLU (talk) 13:02, 11 April 2008 (UTC)

Along the lines of what you're saying, I think it's particularly odd that this article never attempts to define a burn beyond saying that it is an injury. We get 100 things that cause burns, but we don't even know what a burn is. What differentiates a burn from any other kind of injury? Is it really nothing more than "an injury caused by X, Y or Z"? I always thought a burn was defined as a kind of cytolysis -- destruction of a cell usually caused by the water turning to steam, but sometimes due to the water turning to ice (or something else?). Maybe I just made that up. Brettland (talk) 04:47, 6 February 2009 (UTC) Thermal burns result in coagulative necrosis of skin or other tissues. Chemical burns result in liquefactive necrosis.Doctorwithwound (talk)

Perineum Burn
I can't remember where I read/heard this, but I remember reading that if the perineum is burnt (I think that would equate to the 1% body burn) then no matter how severely the rest of the body is burnt, a person is most likely to die. I was just wondering if that's been verified before or if it's even true? londonsista | Prod  16:40, 17 April 2008 (UTC) Perineal injuries increase the risk of morbidity and mortality. This is due to the increased risk of sepsis due to faecal soiling of wounds. Patients with massive burns usually have a bowel management system inserted (a rectal catheter). De-functioning colostomy or ileosostomy is fraught with complications in major burn patients, especially if done early. —Preceding unsigned comment added by 80.42.91.126 (talk) 17:03, 31 December 2008 (UTC)

Friction Burn?
Doesn't that qualify for another type of burn? —Preceding unsigned comment added by 201.150.76.120 (talk) 02:02, 19 July 2008 (UTC) Yes - this type of injury is classed an abrasion injury. The same principles of management apply as to any other type of burn.

sixth degree burn
would it be possible to survive a sixth degree burn on an extremity such as a hand or foot? 131.247.152.4 (talk) 06:01, 5 August 2008 (UTC)


 * Added "needs citation" tag because I am sure it is possible for an extremity to be completely burned off and someone still survive. 76.179.147.161 (talk) 21:36, 16 August 2008 (UTC)

treatment
Added some info on treatment.

Looks like this page needs more references though.

--Doc James (talk) 16:01, 7 December 2008 (UTC)

화상은 여과 차가움에 의해 야기될수있는 인저리의 타입이다..를 영어로 —Preceding unsigned comment added by Thdclgh (talk • contribs) 07:01, 5 February 2009 (UTC)

Pictures?
There are three pictures of second-degree burns in this article, and none of any other degree. This seems counterintuitive, perhaps one or more of them could be removed and replaced with pictures demonstrating other severities of injury. —Preceding unsigned comment added by 76.112.28.58 (talk) 05:28, 19 June 2009 (UTC)

Verbal Burns?
Why does the end of the summary talk about the slang form of "burn" when the rest talks about the actual condition? It doesn't seem like something that's important enough to deserve such a jarringly out of place mention —Preceding unsigned comment added by 99.187.236.126 (talk) 08:14, 5 July 2009 (UTC)

Please Move Pictures to End of Article
An individual seeking information on the "Burn Degree Scale" should not be required to see burned flesh in the process--we can use our imaginations. Those who don't want to use their imaginations can be directed to the bottom of the page, or to another page. Does someone have a particular attachment to this article? If so, please consider moving the images to the bottom of the page with appropriate links if you wish listed under the appropriate burn degree header. While indeed you could be showing much more graphic images, these images are graphic enough that you should give the reader a choice on whether or not they want to view images of other people's injuries.Francisco Herrero (talk) 21:03, 21 July 2009 (UTC)

Agreed. As a burn victim, it was really hard to look at those pictures. I understand that pictures should be included, but the bottom suggests itself. I can't focus on the words when a picture similar to my injuries is staring me in the face.216.175.65.78 (talk) 06:29, 11 September 2009 (UTC)


 * I have combined the images into the table which makes them work better in the article. The images should however be related spatially to the degree of burn. Doc James  (talk · contribs · email) 21:31, 15 January 2010 (UTC)

Prognosis
This is as mish-mash of burn patho-physiology and other stuff and could really be improved. Prognostication and decision making in burns is very important for patients, health-care resources and service planning. Doctorwithwound (talk) 23:22, 4 January 2010 (UTC)


 * If you can do this using good references feel free to try to clean it up. Doc James (talk · contribs · email) 21:22, 15 January 2010 (UTC)

Burn pain
That comment about "reduced sensation" next to the third degree burn picture has no place in there. That had to have been from someone that has never even had a mild sunburn. The picture for the third degree burn, if I didn't remember for a fact that there wasn't a camera in the room, I'd have been calling my doctor right now giving her some grief about using pictures of my burn on here. (Strangely enough, mine was a burn from the exhaust from a motorcycle, the picture credits says a cart.) Using that knowledge, I know for a fact that there is no "reduced sensation" with a burn like that....nor was there with the other exhaust burn I had that was third degree, nor with the plastic fire burn I had.

Any doctor that is telling their patients that are doing a disservice to their patients and needs to stop or give their licenses up please.

thank you for your time; bdraft —Preceding unsigned comment added by Bdraft (talk • contribs) 15:17, 27 January 2010 (UTC)

Cold burns (2)
I have noticed that cold burn is a redirect to burn, but the concept is not covered at all in the article. Could someone consider adding it? Waltham, The Duke of 03:54, 16 February 2010 (UTC)


 * Never mind; upon saving I saw the message higher on this page about why they were removed from the article. (I scanned the page before but apparently I missed it.) One might want to examine what links to "cold burn", though; I came here from Dry ice, which explicitly mentions cold burns. Waltham, The Duke of 04:04, 16 February 2010 (UTC)


 * Change it to frostbite Doc James  (talk · contribs · email) 04:30, 16 February 2010 (UTC)


 * All linked instances in articles have been taken care of. There weren't many of them, but it gives me second thoughts that in some cases the terms were used together but not as synonyms ("frostbites or cold burns") . Waltham, The Duke of 22:51, 22 February 2010 (UTC)


 * The redirect on cold burn has also been updated to point to frostbite. Ivanvector (talk) 22:53, 6 January 2011 (UTC)

4th to I think 5th degree burn survivor
Well, I'll get right to the point. I was brushing my teeth one day, early morning (don't call this irrelevent, I know it is) and I heard a TV show, about a girl who got so severely burned that she lost all her skin. It was apparently that she got set on fire, yet she survived. Very rare case there. Don't ask for citations, I don't remember the name of the show. I think it was something like "medical mysteries" or something like that. 70.95.111.148 (talk) 21:33, 6 January 2011 (UTC)

Any advice on an academic or other source,that I could write and get an image of HF burn victim? I am fine writing for a donation, just not having good look via Google with a high target source. Ideas? TCO (reviews needed) 22:25, 15 July 2011 (UTC)

Complications
Under complications, only "fourth degree" burns (whcih aren't even accepted in medical cirrcles yet) are listed as possibly having gangrene; Yet ANY burn can develop gangreen if not treated properly.

It should be moved to a general complications catagory, and liist specific complication only necessarily inherant to the type of burn (pain for first degree, death of local nerve ending for third, etc). — Preceding unsigned comment added by 75.175.16.194 (talk) 01:08, 11 June 2012 (UTC)

First aid: water
''Appropriate interventions should be initiated to stabilize these. This may involve targeted (using specific resuscitation formula to guide fluid administration) fluid resuscitation and, if inhalation injury is suspected, intubation and ventilation or serial assessment using a laryngoscope or similar. Once the injured person is stabilized, attention is turned to the care of the burn wound itself. Until then, it is advisable to cover the burn wound with a clean and dry sheet or dressing (such as cling film).''
 * Some of these are measures only a medical practitioner or at least a trained first aid respondent is allowed to perform. In contrast, no mention is made of the basic rule that (small) burns should be held under cold water for a period of time. Every other source mentions this:
 * On the NHS page: Cool the burn with cool or lukewarm water for 10 to 30 minutes.


 * On the mayoclinic site: For minor burns, including first-degree burns and second-degree burns limited to an area no larger than 3 inches (7.6 centimeters) in diameter, take the following action: Cool the burn. Hold the burned area under cool (not cold) running water for 10 or 15 minutes or until the pain subsides. Don't immerse large severe burns in cold water. Doing so could cause a drop in body temperature.


 * In the Merck: Small burns should be immediately immersed in cold water if possible.
 * The Encyclopaedia Britannica gives the same information.
 * I would think this is basic information that an article on burns cannot do without. If it's removed because wikipedia can not offer medical advice, then the advice that is given seems much more inappropriate in that regard.
 * Side note: the description of third degree burns as painless seems a bit misleading (judging by the reaction "What a joke" on this talk page): usually the surrounding skin will be burned to a lesser extend, so unless a large area is involved, people won't notice that part of it is anesthetic or hypoesthetic. Ssscienccce (talk) 12:49, 30 September 2012 (UTC)

A new review
Time to get this to GA
 * {{cite journal|last=Peck|first=MD|title=Epidemiology of burns throughout the world. Part I: Distribution and risk factors.|journal=Burns : journal of the International Society for Burn Injuries|date=2011
 * {{cite journal|last=Cancio|first=LC|coauthors=Lundy, JB; Sheridan, RL|title=Evolving changes in the management of burns and environmental injuries.|journal=The Surgical clinics of North America|date=2012 Aug|volume=92|issue=4|pages=959-86, ix|pmid=22850157}} Doc James (talk ·contribs · email) (if I write on your page reply on mine) 09:56, 9 October 2012 (UTC)
 * {{cite journal|last=Peck|first=MD|title=Epidemiology of burns throughout the world. Part I: Distribution and risk factors.|journal=Burns : journal of the International Society for Burn Injuries|date=2011
 * {{cite journal|last=Cancio|first=LC|coauthors=Lundy, JB; Sheridan, RL|title=Evolving changes in the management of burns and environmental injuries.|journal=The Surgical clinics of North America|date=2012 Aug|volume=92|issue=4|pages=959-86, ix|pmid=22850157}} Doc James (talk ·contribs · email) (if I write on your page reply on mine) 09:56, 9 October 2012 (UTC)

Severity measures

 * ''Moved from following the earlier 6 Jun 2003 discussion in secn

wow! that was quick! There's some sort of calculation involving body weight & percentage of skin affected by burns that is done by doctors. We should probably put this in too. -- Tarquin 22:20 6 Jun 2003 (UTC)
 * I think what you're thinking of is estimation of the area of burn injury (usually done from a diagram, or (roughly) estimated by the rule of 9's: 9% for face, 9% each arm, front of each leg 9%, back of each leg 9%, back 9%, front of torso 18%, back of torso 18%). If we could find a copyright-free diagram it'd be a good addition. The calculations with weight have to do with fluid replacement and probably are too specialized for here. -- Someone else 22:35 6 Jun 2003 (UTC)

Thickness
I haven't seen the terms "partial thickness," "full thickness" etc. defined anywhere in the article or discussion. I have only been able to glean a partial understanding from context. — Preceding unsigned comment added by 81.60.184.253 (talk) 22:35, 25 May 2011 (UTC)

Degrees
Perhaps adding some images to properly show the difference of a first, second and third degree burns.

Furthermore those images currently in the article, they dont appear to me to be of a second degree burn, rather first degree; im not a doctor, but i distinctly remember from my school books that a second degree burn is worse than that. —Preceding unsigned comment added by 12:31, 14 July 2005 (talk) 158.38.88.137

Please keep the classification section and table. The classification of burns as 1st - 3rd degree is not used in Europe and is ambiguous - is 1st worse than 3rd or is 3rd worse than 1st ?. Classifications which give more informnation (such as partial or full thickness are more specific and less ambiguous. Proper burn classification is very useful as it immediately tells you the likely treatment and prognosisBmphilp (talk) 10:52, 16 January 2009 (UTC)

It is incorrect that 3rd degree burns are painless. They COULD BE painless at FIRST because they destroy the nerve endings, thus pain can not be transmitted to the brain. But it will be painful later. And, it certainly would hurt if you were on fire, as you may be taking third degree burns on your skin, but cooking is occuring on the inside, like a steak on a fire grill. The snare (talk) 03:41, 24 December 2010 (UTC)

1st or 2nd degree?
The pictured burn doesn't look to me as if it were of second degree (compare with a 2nd degree burn example here), but closer o first degree. Benzh 14:50, 8 February 2006 (UTC)
 * The following contrib, in apparent response to the 8 February 2006 contrib, was placed above the "1st or 2nd degree?" heading that precedes them both, and not properly relocated here until now, so the succeeding discussion may have ignored it. --Jerzy•t 04:44, 30 December 2007 (UTC)
 * I agree...the pictures are not a second degree burn. Those are first. I just found that out from first hand experiance a couple of days ago. —Preceding unsigned comment added by 22:18, 27 February 2006 (talk) 68.50.47.1
 * Second-degree is when you get blistering, which did occure in this case. These two photos are more here to show the evolution leading to the blister (especially that in the beginning, it does not look that bad :p) than to illustrate the blisters themselves; of course here is much more impressive, though I suspect that there are elements of 3rd degree burns there too. Rama 08:46, 10 March 2006 (UTC)

Third degree burns considered painless? What a joke. I've had third degree burns from boiling oil and I can tell you that it's not painless, however that is a common myth. —Preceding unsigned comment added by 97.118.163.14 (talk) 18:12, 11 July 2008 (UTC)

4,5,6th degree
4th degree burn citation added: Judith Tintinalli's Emergency Medicine: A Comprehensive Study Guide, Section 16, Chapter 210 (look under Environmental Injuries). I am a Canadian emergency physician; I could also look it up in Rosen's if you prefer a second reference. (Minceymeatypie (talk) 08:42, 10 December 2010 (UTC))

Here, in Canada (at least ontario) there is no class 4 5 or 6 degree burns. There is nothing officaly past 3rd degree. could someone please cite where these classes are from/used? rz350 00:17, 10 March 2006 (UTC)


 * I have never heard of "class 4 5 or 6" either (and it's not like I am totally uninterested in the topic)... Rama 08:43, 10 March 2006 (UTC)


 * Based on my current anatomy class learings, and my class pressentation of the integumentary system, (the skin among other things,) I can tell you that burns are decided based on to what layer of skin it reaches: in order of superficial in internal, epidermis, dermis and subcutanious. Because there are only three layers, you can only get up to a second degree. —Preceding unsigned comment added by 04:54, 18 March 2006 (talk • contribs) Hakusa


 * I've never seen those terms either. However, Google Scholar does find a few uses of the term fourth-degree burn. A reference would be good, though. -- Anon, 22 March 2006 —Preceding unsigned comment added by 20:45, 23 March 2006 (talk) 85.164.14.146

Someone I know has suffered 4th degree burns, though I have never heard of 5th or 6th degree. Degrees 1, 2, and 3 apply to the skin burns. Once muscle, bone, and other tissues get involved it is beyond 3rd degree. Electrical burns can easily affect deeper tissues in this manner. --Vertigo —Preceding unsigned comment added by 20:43 & :48, 8 December 2006 (talk) 67.52.19.150


 * As a 3rd degree burn survivor, I can honestly say that the 4th degree designation is used when the burns reach the layers adjacent to the bone. When there is no healthy skin left after the escharotomy and the bone is exposed, it is termed a 4th degree burn. 5th and 6th degree diagnoses are rarely used as a subtype of 4th degree burns to distinguish the damage done. I will try to find documented and verifiable sources. Jimzim66 02:19, 12 February 2007 (UTC)


 * According to Google's summary of a medical journal (which is not accessible online), "In the fifth degree there is destruction of the muscles, and in the sixth degree burn there is charring to the bone or total gangrene." Not sure about 4th, though --Firehawk1717 21:19, 20 June 2007 (UTC)

This seems to be 'original research' or at least not generally-accepted as fact:
 * Burns that injure the tissues underlying the skin, such as the muscles or bones, are sometimes categorized as fourth-degree burns. These burns are broken down into three additional degrees: fourth-degree burns result in the skin being irretrievably lost, fifth-degree burns result in muscle being irretrievably lost, and sixth-degree burns result in bone being charred.

Also, these classifications seem ridiculous because no one could survive a 'fifth-degree' so why need a sixth?131.96.70.164 03:48, 3 August 2007 (UTC)
 * Re:6th Degree -- It may be relevant in post-mortem autopsy examinations, as a matter of defining depth of injury. (NM) —Preceding unsigned comment added by 24.19.199.238 (talk) 01:00, 2 September 2007 (UTC)
 * Doctor, i apologize for questioning your prognosis, but in the short time since the fall of Babylon, we have developed marvelous life saving techniques, such as ligation of severed arteries and medical amputation of irremediably damaged extremities. I respectfully suggest you permit me to assist you with this patient, rather than proceeding with your chuckeminthemiddenization. --Jerzy•t 04:44, 30 December 2007 (UTC)

I mentioned in the article that the 1st/2nd/3rd system is most common (eg, here) but that sometimes a 4th is added (as here). Classifications that include fifth and sixth degrees are in pretty limited use, but since some people make that extra distinction it seems reasonable to continue to mention it in the article. &mdash;One-dimensional Tangent (Talk) 04:34, 15 February 2008 (UTC)

I think we need some cites as to references to burns beyond 3rd in established medical literature. I also have never heard of those beyond 3rd, 3rd is the worst you can get as it chars and or/destroys the bone. I have an anatomy book that doesn't list any beyond 3rd. I heard of 4th degree burns in an episode of X-files once, but of course that's not a reliable source, leading me to believe it's not a real burn classification. As for those of you who have said you have heard of 3rd and 4th degree burns or suffered them yourself, who told you they were beyond 3rd? Was it your doctor or some reliable source? Also, what about burns that burn to the bone, leaving nothing there? I suppose the only course of action would be to amputate the limb, as it will never grow back and you can't do a skin graft, etc The snare (talk) 06:00, 17 May 2008 (UTC)


 * Has Be Bold been removed from Wikipedia culture? Unsupported by any citation at all, 5th and 6th degree burn inclusion sure looked like stealth vandalism to me. I removed, and I recommend that they not be restored without verification and confirmed citations. wcf Facts are stubborn. Comments? 21:50, 23 May 2008 (UTC)


 * While I can't provide proof, I once heard an emergency department doctor talk about 4th degree burns, but for lay person, and even EMS use, burns max out at 3rd degree. —Preceding unsigned comment added by 65.96.38.93 (talk) 02:34, 22 August 2008 (UTC)
 * It appears that fifth and sixth degree burns were used in the TV series The X Files and someone may believe that they are real. This does not appear to be the case, folks. I can still find no references to 5/6th degree that does not either refer back to this article or to X Files. wcf Facts are stubborn. Comments? 22:01, 9 December 2008 (UTC)

As the child of two doctors, I have never heard of a fourth degree burn. A friend who is an EMT has explicitly told me they do not exist. I'm a Boy Scout who teaches first aid and I would never mention fourth degree burns, and have never been told by anyone who knew what they were talking about that they existed. I don't think they should be included in the article unless they are specifically discussed in an extremely reliable source, not MayoClinic (Which included no publicly available sources that supported its claim of their existence), or WebMD (With no sources whatsoever. Good thing they have a disclaimer), or any other such website intended for the general public. It's clear there's a lot of misinformation, and even if valid sources are found, I think it would be best to note the controversiality of the information within the article. Coppaar ( talk ) 20:23, 3 November 2012 (UTC)

Rule of 9s
This hasnt been in use in britain (apparently) for a while because it was deemed inaccurate - see St. Johns handbook or similar —Preceding unsigned comment added by Stui (talk • contribs) 17:06, 26 July 2006


 * In the United States the rule of 9s is standard in EMS. The textbooks I have from wilderness first responder, wilderness EMT, and Paramedic school all teach the rule of 9s. 65.96.38.93 (talk) 02:29, 22 August 2008 (UTC)


 * Still extensively used. Does Britain have something better? Doc James  (talk · contribs · email) 01:39, 12 January 2010 (UTC)

Assessing burns
I'm pretty sure that the perineum is not a factor in the Rule Of Nines. --Hungoverdrawn 16:04, 13 December 2006 (UTC)

Perineum = 1% in rule-of-nines. The rule-of-nines is a good guestimation technique. The rule-or-tens (head + neck =10%, one arm = 10%, one leg = 20% etc) is even quicker, but of course less accurate. Lund & Browder charts combined with the useful fact that the patient's hand print = 1% is the most accurate method of assessing burn size. Accuracy is most important when burn surface area is 10% in children or 15% in adults, as these size burns represent potentially life-threatening injuries and require formal fluid resuscitation and monitoring to avoid hypovolaemic shock etc. Patients with resuscitation burns should be managed in burn units by the appropriate multi-disciplinary team. Doctorwithwound (talk) —Preceding undated comment added 18:02, 10 January 2010 (UTC).

Burn Chart
The burn chart says that there is no sensation with a full thickness burn, but this is both true and false. While the full thickness burn its self has no sensation, a full thickness burn is, with very few exceptions, surrounded by both superficial and partial thickness burns, which are very painful. Even though a full thickness burn technically has no sensation, I think it is important to note that full thickness burns are very painful. I also want to ad d that when I was in EMT class, and later paramedic school, we were discoureged from using 1st-3rd, but rather to use superficial, partial, and full thickness. I'm not going to change anything because people should give their opinions. 65.96.38.93 (talk) 02:29, 22 August 2008 (UTC)

Forever HVAC.
Allegedly, in the USA two little girls suffered over 90% burns in the 1990s but were saved. Yet, without any sweat-functional skin left, their body is no longer able to control core temperature and they must live 7x24h indoors in a dual-redundant HVAC equipped home. If they ever go outside or the aircon quits, they would be toast. Is that terrible story true? 91.82.35.63 (talk) 19:49, 29 December 2012 (UTC)

First degree burns and cancer
I find evindence that UV radiation from the sun increases risk of skin cancer, but I found nothing about a relation between all first degree burns and skin cancer. I think it is therefore incorrect to state that first degree burns increase risk of skin cancer. I added a 'citation needed' in the table. — Preceding unsigned comment added by 95.97.33.218 (talk) 13:48, 26 March 2013 (UTC)
 * Sunburns are classified as first degree burns. Have corrected. Doc James (talk · contribs · email) (if I write on your page reply on mine) 13:05, 20 April 2013 (UTC)

Strangely ambivalent statement and possibly inconsistent
The article contains the following sentence which seems quite strangely ambivalent and potentially non-scientific.

"It is not clear how to manage blisters, but it is probably reasonable to leave them intact."

From my experience and from a quick search of medical literature it seems to be pretty universally accepted that one NOT pop blisters as broken skin is a greater vector for infection and in many cases occlusive dressings are preferred as they keep the blister from popping and keep infection out.

I am not sure if it should be changed or not and this is not an article of my normal interest or to which I am a regular contributor so I figured it was better to take it to this location rather than following the Be Bold directive in this instance. &mdash; Falerin&lt;talk&gt;,&lt;contrib&gt; 02:36, 25 October 2013 (UTC)


 * Hi Falerin, if I remember right, I picked up on this in the GA review I did for the article, and the issue was that the sources weren't consistent in their recommendations. If you have good-quality sources that are authoritative and give clear evidence-based recommendations please bring them.   02:56, 25 October 2013 (UTC)
 * Have you looked at the refs in question? They do support the statement in question. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 03:48, 25 October 2013 (UTC)

Removal of 5th and 6th degree burn?
Why was that removed? It is real. — Preceding unsigned comment added by JEMZ1995 (talk • contribs) 22:23, 30 August 2013 (UTC)


 * Please refer to WP:MEDRS for Wikipedia's standards for sourcing biomedical information. The information added was sourced to the website "omg-facts.com" which doesn't meet the guideline.    14:50, 3 September 2013 (UTC)

My recollection is and my father (who is among many other hats a paramedic) verifies that 5th and 6th degree burns (burns through all flesh and to the bone, and burns where even the bone is charred or burned respectively) are defined in several medical texts and legal texts. Generally such burns are pretty much always fatal and are discovered only in autopsy of burn victims Technically one might survive a 5th degree burn with amputation but the prognosis is slim. I an fairly certain my human anatomy book in college mentioned them as well but it is not readily available. A search finds several sources online other than OMG Facts that lists them as well but I do not know that they conform to WP:MEDRS either as many are lawyer sites, but given that the concept seems to be prevalent and documented it should be straight forward enough to find sources that do meet notability for inclusion. &mdash; Falerin&lt;talk&gt;,&lt;contrib&gt; 02:45, 25 October 2013 (UTC)
 * And with just a bit more searching I can find a pretty authoritative medical source that defines such quite clearly, "The Manual of Surgery" reference http://www.manual-of-surgery.com/content/0057-Burns-and-Scalds.html, Not sure where and how to add them to this article at present but they should probably be restored. &mdash; Falerin&lt;talk&gt;,&lt;contrib&gt; 02:50, 25 October 2013 (UTC)
 * Not mentioned in the foremost textbook of burns and not mentioned in any of the review articles I have looked at. This ref you have provided, what is the ISBN and when was it published? Doc James  (talk · contribs · email) (if I write on your page reply on mine) 03:51, 25 October 2013 (UTC)
 * That edition of that book was published in 1921 and so fails WP:MEDDATE. Modern medical sources do not use these terms fifth and sixth degree.    19:38, 25 October 2013 (UTC)

Review
Review on critical care management of burns. JFW &#124; T@lk  14:28, 11 November 2013 (UTC)

Coagulopathy
Severe burns cause a DIC-like coagulopathy 10.1111/jth.13283 JFW &#124;  T@lk  20:47, 14 February 2016 (UTC)

Anus are not genitalia
Anus are not genitalia as pictured in the diagram of the lady ("Genitalia 1%" pointing at both her vagina and anus/sphincter). (unsigned comment by 92.2.43.2 on 23 August 2014‎)


 * I think that you're technically right, it is considered an erogenous zone, however. It may be that in the case of a burn their proximity is enough that both are considered. 76.10.128.192 (talk) 04:31, 27 December 2016 (UTC)

Gender related
The WHO states in this ref

"The higher risk for females is associated with open fire cooking, or inherently unsafe cookstoves, which can ignite loose clothing. Open flames used for heating and lighting also pose risks, and self-directed or interpersonal violence are also factors (although understudied)."

and

"Men are most likely to be burned in the workplace due to fire, scalds, chemical and electrical burns."

I thus do not see this as an improvement

Doc James (talk · contribs · email) 00:39, 31 July 2017 (UTC)
 * yes, agree--Ozzie10aaaa (talk) 11:10, 1 August 2017 (UTC)
 * "electrical equipment in home" as a common cause I am not seeing in the ref Doc James  (talk · contribs · email) 02:46, 1 August 2017 (UTC)


 * To the IP: Please don't add unsourced information while simultaneously removing sourced content. Carl Fredrik  talk 18:14, 1 August 2017 (UTC)
 * Requested semi page protection. Doc James  (talk · contribs · email) 21:53, 1 August 2017 (UTC)

Semi-protected edit request on 7 August 2017
Remove or replace: "While rates are similar for males and females the underlying causes often differ.[3] Among women in some areas, risk is related to use of open cooking fires or unsafe cook stoves.[3] Among men, risk is related to the work environments.[3]"

This level of specificity is not necessary in the main description, and if it is, it selectively specifies risk factors for women only. Risk factors get comprehensive coverage later in the article. 2601:240:C980:71D:6075:728B:28C:EBF2 (talk) 02:31, 7 August 2017 (UTC)
 * Yes check.svg Done jd22292 (Jalen D. Folf) (talk) 03:32, 7 August 2017 (UTC)
 * Undone. This person has been edited warring to remove sourced content without any basis in policies or guidelines. Jytdog (talk) 04:37, 7 August 2017 (UTC)

Immersion scald burns
This should be a separate article, and cover the various high risk populations, including both accidental and deliberate burns. Also Stocking burn, Sock burn and glove burn should redirect there.

All the best: Rich Farmbrough, 20:05, 11 February 2018 (UTC).


 * Treatment is the same as what is described here. This is just one mechanism of a burn. Not sure it needs its own article. Doc James  (talk · contribs · email) 11:44, 12 February 2018 (UTC)
 * It may not from a purely medical point of view, but there are important sociological aspects as well as social care issues that are related. All the best: Rich Farmbrough, 13:31, 12 February 2018 (UTC).

Fifth and sixth degree burns
Is there such thing as a 5th and 6th degree burn? If there is, should they be added to this page? ScamsAreHorrible172 (talk) 00:15, 19 March 2018 (UTC)
 * Not really. Doc James  (talk · contribs · email) 15:04, 21 March 2018 (UTC)
 * They are according to the NIGMS: https://www.nigms.nih.gov/education/fact-sheets/Pages/burns.aspx Lvsz (talk) 12:07, 18 June 2020 (UTC)

I didn't think there was such thing as a 4th degree either, at least I never heard about except in an X-files episode, is it a new term? The snare (talk) 05:43, 22 April 2018 (UTC)

About, 4th, 5th and 6th there's this, but they're lawyers, not doctors https://www.walkermorgan.com/fourth-fifth-sixth-degrees/

From what I've seen online, fourth, fifth, and sixth degree burns do exist, they just aren't well known since they are rare. Here are some of sources that talk about it: https://www.healthline.com/health/4th-degree-burn https://www.nigms.nih.gov/education/fact-sheets/Pages/burns.aspx https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=90&ContentID=P09575 Camshaft64 (talk) 01:38, 23 January 2021 (UTC)

Burn rates in the US
Under the Thermal section of this article, there is a claim made "In the United States, For non-fatal burn injuries, white males, aged <6 comprise most cases." When the linked source is checked, it is actually from a study of pediatric burn victims and is not a truly representative stat. In fact, the study itself claims 84,000 children are treated for burns yearly, while the CDC website claims the US has 1.1 million burns treated yearly. I do not want to make direct changes to this good article, but I thought I should raise this to everyone elses attention, in case a more wikipedia savvy editor would like to correct this. — Preceding unsigned comment added by PearadiseTC (talk • contribs) 21:46, 5 October 2021 (UTC)