12 burns 2 Flashcards
Primary Survey
A = Airway and cervical spine control B = Breathing and ventilation C = Circulation and haemorrhage control D = Disability E = Exposure and environmental control F = Fluid resuscitation
Beware of co-existing injuries
from burns
§ MVA/MBA § Blast/explosion § Electrocution § Jump or fall from burning building
Airway Maintenance with C-spine Control burn
§ Clear airway of foreign material § Assess airway for swelling /signs of inhalation injury § Open airway with chin lift /jaw thrust § Minimise flexion/extension of neck § Apply c-spine immobilisation where cervical injury possible
With airway consider if there is any…….?
Stridor Accessory muscle use Extensive and deep facial burns Upper airway trauma Altered mentation Hypoxia/hypercarbia Haemodynamic instability Inability to clear secretions or respiratory fatigue Suspected inhalation injury, with history of being burned in an enclosed space Swelling Respiratory Distress Singed nasal hairs
Breathing & Ventilation
§ Expose chest & assess expansion for adequacy & symmetry
§ Ventilate with bag & mask or intubate if necessary
§ Carbon Monoxide- cherry pink but apnoeic
§ Respiratory rate > 20 bpm = abnormal
§ Circumferential chest burns may need escharotomy
Classification of burns
▪ Epidermal ▪ Superficial dermal ▪ Mid dermal ▪ Deep dermal ▪ Full-thickness
Depth of Burn
Superficial -
▪ Partial thickness –
▪ Deep partial thickness -
▪ Full thickness burn - m
Superficial -
involves the epithelium - pink, red, painful.
▪ Partial thickness
involves the epithelium and portions of the dermis –
blistered, mottled pink, painful, cool, hairs intact.
Deep partial thickness
involves the epithelium and the deeper portions of
the dermis- blistered, pale pink, painful, cool ,hairs may not be intact
Full thickness burn
ay extend through the skin to underlying structures -
may be cold to touch, typically white, brown or black, leathery, insensate,
may have thrombosed blood vessels, no hairs present or hairs fall out when
rubbed.
Factors to consider in determining burn depth
▪ How the injury occurred ▪ Causative agent ▪ Temperature of agent ▪ Duration of contact with the agent ▪ Thickness of the skin
Methods to estimate total body surface area (TBSA)
burned
▪ Rule of nines
▪ Palmar method
Tertiary burn
person propelled into solid object
crush injuries common
Secondary burn
From objects propelled by blast
a significant source of casualties
High risk of infection
