**6. First aid in burns**

The appropriate first aid after burn injury is very important in reduction of burn depth, which means that it influences the requirement for surgical treatment, can shorten the hospitalization time, and results in better esthetic scar.

According to WHO, the person who gives the first aid to the burned child should stop the burning process by removing clothing and irrigating the burns; extinguishing flames by allowing the patient to roll on the ground, or by applying a blanket, or by using water or other fire-extinguishing liquids; use cool running water to reduce the temperature of the burn; in chemical burns, remove or dilute the chemical agent by irrigating with large volumes of water; and wrap the patient in a clean cloth or sheet and transport to the nearest appropriate facility for medical care [2].

WHO also pays attention on the actions that the person who gives the first aid to the burned child should not do; for example, do not start first aid before ensuring your own safety (switch off electrical current, wear gloves for chemicals, etc.); do not apply paste, oil, haldi (turmeric), or raw cotton to the burn; do not apply ice because it deepens the injury; avoid prolonged cooling with water because it will lead to hypothermia; do not open blisters until topical antimicrobials can be applied, such as by a health-care provider; do not apply any material directly to the wound as it might become infected; and avoid application of topical medication until the patient has been placed under appropriate medical care [2].

The person who gives first aid to the child after the burn injury is usually the person that was present during the accident—in most of cases—the parent. Unfortunately, the own results indicate that parents do not provide first aid to burned children correctly. The most common mistakes were no cooling the burn wound and no analgesics used [13].

The aim of prehospital care is stabilizing ABCDEs (airway, breathing, circulation, disabilities, and environment control), preventing ongoing burn injury and provision of analgesia, covering area involved, and rapid transfer to emergency department [9].

It is worth to underline that also first aid provided by medical stuff in the place of the injury is not correct. The situation seems surprising, because in Poland young doctors are trained in first aid (including first aid in burns) during studies.

Nessler et al. conducted the pilot study (the anonymous questionnaire) among young doctors in Malopolska region (Poland) to evaluate the knowledge of burn first aid, because many patients admitted to burn centers in Poland receive inadequate treatment just after burn injury. The questionnaire verified the respondents' knowledge about appropriate first aid provided several minutes after burn trauma and included questions about possibilities of actions after burn trauma in cases of burned patients. The obtained results were alarming, which revealed that the knowledge of burn first aid among young doctors is not satisfactory—none of the respondents answered correctly to all the questions. Only in 75% respondents knew that burn wound require cooling with running water, whereas only 25% respondents knew how to react after chemical injury [14].

It seems that more attention should be paid on education of caregivers of small children and medical stuff about first aid in burns.
