Treatment for Flash Burns in Welders
Immediately cool the burn with clean running water for 5-20 minutes to reduce pain and limit tissue damage. 1, 2
Immediate First Aid
- Cool the affected area with cold (15° to 25°C) tap water as soon as possible and continue until pain is relieved 3
- If clean running water is unavailable, superficial burns with intact skin may be cooled with ice wrapped in cloth 1, 2
- Remove jewelry from the affected area before swelling occurs 1
- Monitor for signs of hypothermia during cooling, especially in children 1, 2
Ocular Flash Burns (Actinic Keratitis)
- Flash burns to the eyes from welding (actinic keratitis) are painful but treatable 4
- Symptoms typically include pain, redness, light sensitivity, and tearing 5
- Immediate ophthalmologic referral is recommended for all but the most trivial eye burns 6
- First and second-degree flash burns to the eyes can be treated by primary care physicians, but third-degree burns require specialist care 4
Topical Treatment
- After cooling, apply a thin layer of one of the following:
- For eye flash burns, ophthalmologists may prescribe specific eye medications 4
Wound Care
- Loosely cover the burn with a clean, non-adherent dressing 1, 2
- Leave burn blisters intact as this improves healing and reduces pain 3
- For superficial wounds and abrasions, thoroughly irrigate with warm or room temperature potable water 3
Pain Management
- Administer over-the-counter oral analgesics such as acetaminophen or NSAIDs for pain relief 1, 2
- Consider multimodal analgesia with both acetaminophen and NSAIDs if pain is significant 1
- Cooling the burn site helps reduce pain by affecting the inflammatory cascade 7
Prevention of Future Injuries
- Welders should use appropriate personal protective equipment including proper eye protection 5, 8
- UV radiation exposure in welders can lead to cataracts, keratoconjunctivitis, dermatitis, and erythema 5
- Long-term UV exposure in welders has been linked to skin cancer and skin aging 8
When to Seek Medical Attention
- Burns involving the face, hands, feet, or genitals 1, 2
- Burns covering >10% body surface area in adults or >5% in children 1, 2
- Signs of infection or worsening condition 1
- Presence of inhalation injury (difficulty breathing, soot around nose/mouth) 1, 2
- Severe pain unresponsive to first-line treatments 1
- All eye flash burns should be evaluated by a healthcare professional 4
Common Pitfalls and Caveats
- Do not apply ice directly to a burn as it can produce tissue ischemia 3
- Prolonged cold exposure to small burns, or brief exposure to large burns, can cause further tissue injury and hypothermia 3
- Do not use pressure points or elevation to control bleeding as they are ineffective and may compromise direct pressure 3
- Non-welders working near welders are also at risk of flash burns and should use appropriate protection 9
- The time period of UV exposure in welders often exceeds permissible threshold levels 5