Что делать при ожоге кипятком, током, кислотой, солнцем: доврачебная помощь в домашних условиях

Ожоги — частая бытовая травма. Может стать следствием стечения обстоятельств, неправильной работы бытовых приборов, несчастного случая. При этом важно правильно оказать первую помощь пострадавшему, не допустить распространения раневой поверхности и возникновения угрозы жизни.

Что делать при ожоге кипятком, током, кислотой, солнцем: доврачебная помощь в домашних условиях

Ожоги горячей водой относятся к термическим повреждениям. Согласно медицинской статистике, именно взаимодействие с горячими предметами и жидкостями выступает причиной возникновения 92-95% случаев ожоговых травм. Примерно половина из них — обваривание — повреждение кожи кипятком и водным паром.

Ожог на эпителиальной ткани возникает при тепловом воздействии в 70ºС. Учитывая, что температура кипения воды равна 100ºС, травмы от нее могут быть не просто серьезными, но и летальными. Тяжесть повреждения зависит от времени взаимодействия с повышенными температурами, а также площади поражения.

Особенности ожоговых травм

При взаимодействии человеческого организма со слишком высокими температурами, а также химическими веществами происходят органические и функциональные изменения в структуре кожи и слизистых оболочек:

  • сосуды — наблюдается патологическое расширение, способствующее переполненности кровью верхних и глубинных слоев эпидермальной ткани;
  • проницаемость капилляров — нарушение строения сосудистой стенки ведет к появлению инфильтрата, состоящего из лимфатической жидкости;
  • воспаление — происходит скопление медиаторов, отвечающих за воспалительный процесс;
  • нервные окончания — при легких ожогах пребывают в состоянии повышенной возбудимости, при тяжелых — перестают выполнять свои функции;
  • белки кожи — после воздействия высоких температур коагулируются, прекращая выполнять свои функции, наблюдается отмирание клеток;
  • общее строение кожи — повреждения могут быть лишь на поверхности, а также в глубинных слоях, вплоть до костной ткани.

Кожа и слизистые сохраняют способность к восстановлению только после легких и средних ожогов, при обугливании требуется пересадка тканей.

Из-за отмирания клеток кожи наблюдается повреждение сосудов и капилляров. Возможно кровотечение или образование тромбов в их просвете, что резко снижает шансы на самостоятельное заживление ожога. Возникновение раневой поверхности ведет к инфицированию организма через поврежденный эпителий, что чревато развитием нагноения и сепсиса.

Симптоматика

Кожа в месте ожога меняется. Характерны следующие симптомы:

  • покраснение;
  • гипертермия;
  • острая болезненность;
  • отечность;
  • волдыри с инфильтратом;
  • рана;
  • струп (от белого до бурого и черного окраса).

Симптоматика и последствия ожоговых повреждений прямо зависят от времени воздействия температуры, ее интенсивности, своевременности оказания первой помощи.

Виды ожогов

В зависимости от механизма появления травмы различают несколько типов ожогов.

  • Термические. Кроме кипятка, такие травмы оставляют открытый огонь, пар, раскаленные предметы. Как правило, соприкосновение с ними сопровождается острыми болезненными ощущениями, а очертания травмы четкие. Например, в месте контакта с раскаленным утюгом остается след в форме его рабочей поверхности.
  • Химические. Вызваны щелочами, газами, кислотами, солями металлов. Повреждения зачастую не переступают порогов поражения третьей степени, однако имеют свойство увеличиваться в размерах при неправильно оказанной помощи, а потому могут привести к довольно серьезным последствиям.
  • Лучевые. Возникают вследствие солнечного, инфракрасного, радиационного излучения. Самыми легко устраняемыми считаются солнечные ожоги, однако они также могут приобретать ужасающие масштабы и приводить к серьезнейшим осложнениям.
  • Электрические. Возникают из-за поражения организма током. Могут иметь небольшие площади непосредственного ожога, но отличаются внушительной их глубиной. Способны вызывать серьезные функциональные изменения в работе организма. При поражении высокими разрядами наблюдается обгорание всего тела с поражением мягких тканей, вплоть до костей.
Понимать природу ожога важно, чтобы оказать адекватную доврачебную помощь пострадавшему. Разные виды травм требуют принятия различных мер.

Степени тяжести

В отечественной медицине принято выделять четыре стадии ожогового повреждения кожи.

  • 1 степень. Характеризуется краснотой, болезненностью и отечностью ткани, подвергавшейся температурному воздействию. При этом на ней нет раневой поверхности или волдырей. Данный тип повреждения считается наиболее легким, требует врачебного вмешательства только в случае обширной площади ожога: 20% поверхности тела — для взрослых, и 10% — для пожилого человека или ребенка. Приблизительно определить масштабы ожога можно, ориентируясь на «правило ладони». Согласно ему, площадь ладони равна 1% от общей площади поверхности тела.
  • 2 степень. Ожог сопровождается сильными болевыми ощущениями, ярко выраженным отеком тканей. На поверхности кожи появляются волдыри с прозрачным инфильтратом. С течением времени он мутнеет, превращается в студенистую массу. Возможен разрыв волдырей с появлением раневой поверхности.
  • 3 степень. Характеризуется поражением глубоких слоев эпителия, вплоть до дермы. На поверхности кожи появляются множественные волдыри, содержимое их может иметь примеси крови. С развитием ожога пузыри сливаются между собой, после чего лопаются. Рана имеет вид буровато-черного струпа. При более тяжелой степени повреждения, называемой в медицине 3Б, наблюдается отмирание и подкожно-жировой клетчатки. В этом случае самостоятельная регенерация покровов становится невозможной.
  • 4 степень. Полное отмирание кожи, подкожно-жировой клетчатки, мышечных тканей, вплоть до костной. При этом вся площадь повреждения приобретает угольно-черный окрас, свидетельствующий о некротизации клеток.
Первая помощь необходима при любой степени повреждения. Однако чем сложнее травма, тем меньше манипуляций можно проводить в домашних условиях. Ожоги указанных степеней возможны при любых видах травмирующего воздействия, кроме солнечного.

Перебинтованная кисть

Первая помощь

Доврачебная помощь при возникновении ожогов основывается на устранении термического, электрического, светового или химического воздействия. Это первоочередная задача помогающего. В зависимости от источника травмы, он может:

  • прекратить поступление горячей воды к телу пострадавшего;
  • устранить источник пара;
  • затушить открытый огонь;
  • устранить возгорание на теле пострадавшего;
  • убрать с тела пациента горячий предмет;
  • отключить питание электрических приборов;
  • устранить источник тока путем отодвигания от него больного;
  • убрать оголенный провод с тела больного;
  • стряхнуть остатки сыпучего химического вещества;
  • смыть остатки жидкого химического вещества;
  • устранить источник лучевого ожога;
  • забрать пострадавшего из-под открытого солнечного света в тень.

Оценка общего состояния пострадавшего

Второй этап — оценка состояния пострадавшего. Важно понять:

  • в сознании человек или нет;
  • дышит он или нет;
  • есть ли препятствия для поступления воздуха;
  • насколько тяжелы последствия воздействия раздражителя.

Если больной не в сознании, необходимо проверить наличие пульса и дыхания. В случае их отсутствия следует без промедления вызвать экстренную медицинскую помощь. Затем убедиться, что дыхательные пути не заблокированы сторонними предметами или его собственным языком. Для это следует открыть рот больного и вытащить запавший язык. Если больной дышит, но без сознания, необходимо попытаться привести его в чувства с помощью нашатырного спирта, прохладной воды, легких похлопываний по щекам.

Необходимость обработки поврежденных участков

Оценивая место локализации ожога, следует быть особенно внимательным. Немедленную госпитализацию больного следует обеспечить:

  • при ожогах глаз;
  • при ожогах дыхательных путей;
  • после лучевого воздействия;
  • при электрическом ожоге, даже если площадь травмы невелика.

Далее оценивают тяжесть ожога. Если это повреждение первой или второй степени, на поверхности нет раны, а с момента появления травмы не прошло двух часов, следует охладить место температурного воздействия. После воздействия кипятком нужно поместить поврежденный участок кожи под струю холодной воды. Также допустимо прикладывание льда в пакете или холодного предмета, обернутого не использованным ранее полиэтиленовым пакетом. В случае появления раны следует просто дождаться естественного охлаждения тканей под действием воздуха, например, разместив пострадавшего у источника холода или у приоткрытого окна.

Если ожог находится под одеждой, ее необходимо устранить. При этом важно учитывать, что:

  • хлопок — не плавится, его можно просто снять;
  • синтетика — может прилипнуть к травме, поэтому ткань разрезают, минуя контуры раны (с поверхности ожога прилипшую синтетику не снимают).

Если наблюдается появление водянистых волдырей, их ни в коем случае не вскрывают. При наличии открытой травмы ее ничем не обрабатывают вплоть до приезда бригады скорой помощи или самостоятельной доставки пациента в медицинское учреждение. Такой подход актуален при возможности оказания больному врачебной помощи на протяжении часа после появления травмы. Если больница далеко, травмированную поверхность прикрывают отрезом проглаженной утюгом ткани, чтобы не допустить попадания в рану загрязнений.

Мазь от ожогов

Медикаментозная поддержка

При попадании загрязнений на поверхность ожога, может потребоваться самостоятельная антибактериальная обработка. Можно использовать любой доступный антисептик:

  • перекись водорода;
  • «Хлоргексидин»;
  • слабый водный раствор йода;
  • раствор «Фурацилина».

После обработки рану нельзя промокать ватой, марлей, тканью. Жидкости дают свободно стечь, после чего прикрывают поврежденное место стерильной повязкой, вплоть до момента госпитализации.

При серьезных ожогах важно дать больному любое обезболивающее средство. Это может быть:

  • «Анальгин»;
  • «Баралгин»;
  • «Дексалгин»;
  • «Кетонал».

Даже если удастся минимально обезболить повреждение — это уже успех, поскольку снижается вероятность развития шокового состояния.

Нельзя обрабатывать ожог народными методами, вроде сала или масла. Даже если это повреждение первой степени. Такой подход обеспечит возникновение воздухонепроницаемой пленки на месте повреждения, что чревато усугублением патологического процесса и дополнительными сложностями при оказании врачебной помощи.

Электротравма

Оценить серьезность травмы после воздействия током очень сложно. Даже если больной находится в сознании и визуально не вызывает беспокойства, через несколько минут ситуация может в корне измениться. Причина тому — функциональные нарушения в организме человека после воздействия заряда тока. Пациент может не просто потерять сознание спустя время после травмы, но и перестать дышать, нередки спонтанные остановки сердца.

Это говорит о необходимости вызова бригады скорой помощи даже при возникновении, на первый взгляд, слабых ожогов. Если не удается определить на теле больного места входа и выхода тока, это не значит, что их нет. Они могут скрываться под одеждой, сопровождаться глубокими изменениями. При этом пациент не чувствует боли из-за нарушения иннервации тканей или из-за шокового состояния. Если ожоги видны, их необходимо прикрыть стерильными повязками.

Кислота, щелочь

Основная доврачебная поддержка заключается в смывании остатков химических веществ с кожи обильным количеством прохладной проточной воды. Время промывания составляет не менее 20 минут, при этом струя должна быть достаточно сильной. После смывания раздражителей необходимо обратиться в медицинское учреждение для объективной оценки повреждений доктором и назначения терапии.

Единственное разрешенное домашнее средство — хозяйственное мыло, а точнее, его раствор. Им промывают пораженную поверхность до отсутствия ощущения мыльного скольжения. Использовать соду нельзя, поскольку «на глаз» приготовить раствор необходимой концентрации тяжело, а дополнительное раздражение нерастворенными крупинками может только усугубить ситуацию.

Нейтрализовать химические раздражители в домашних условиях запрещается. Неправильное соотношение веществ может спровоцировать реакции с выделением тепла, а значит, увеличение тяжести ожога.

Терапевтическая тактика

Лечение ожогов в домашних условиях возможно только при самой легкой степени повреждения. Вторая степень требует предварительной консультации доктора и назначения им специальных лекарственных препаратов. Третья и четвертая степени ожогов лечатся в условиях стационара с оперативным вмешательством (при необходимости), противошоковой и дезинтоксикационной терапией.

Для домашней терапии легких повреждений можно использовать:

  • антисептики — «Бетадин», «Йоддицерин»;
  • антибактериальные мази — «Левомеколь», «Аргосульфан»;
  • заживляющие мази — «Актовегин», «Солкосерил», «Бепантен».

Помогает пена в аэрозоле «Пантенол». Это аналог «Бепантена», обеспечивающий ускоренную регенерацию поврежденных тканей. При наличии образований с серозным содержимым лучше использовать мази с антибактериальным компонентом («Левомеколь», «Мирамистин», «Инфларакс») — на случай внезапного вскрытия раневой поверхности, чтобы предотвратить инфицирование.

Первая помощь при ожогах требует минимального количества знаний и действий. Тем не менее выполнить все манипуляции необходимо быстро и точно, чтобы своевременно облегчить состояние больного и не допустить шока. Самое главное при сильных ожогах и электротравмах — вызов бригады скорой помощи.

227 комментариев на «“Что делать при ожоге кипятком, током, кислотой, солнцем: доврачебная помощь в домашних условиях”»

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