Burns Flashcards
5 types of burns
1.Thermal burns: exposure to heat- flame, flash, scald, or contact with hot objects
2.Chemical burns: acids, alkaline agents, or organic compounds
3.Electrical burns: severity based on voltage and length of exposure. Risk for potential cervical spine injury
4.Radiation exposure: thermal effect; damage to the cellular DNA
5.Inhalation injuries: inhalation of thermal and/or chemical irritants (upper vs lower airway injury)
What are some details about the different types of burns?
- Thermal is the most common ( scalding with children)
- Chemical- remove clothing and the things touching the skin. Continuous irrigation.
- electrical- difficult to assess ( may entrance and exit) exudate might clog breathing tubes.
3.
Burn Depth Classification
superficial thickness (1st degree)
Partial thickness (2nd degree)
Full thickness (3rd & 4th degree)
First Degree - Superficial
Involves only epidermis.
Causes: radiation burn or brief exposure to heat source.
Redness, pain, moderate to severe tenderness; minimal edema, peeling, itching
Mild analgesics, cool compresses, skin lubricants; heals within a few days
2nd degree Partial Thickness
Involves epidermis & dermis; may extend into hair follicles.
Causes: scalds, flash flame, contact
Moist blebs, blisters, edema, mottled white, pink to cherry-red, moderate to severe pain
Usually heal 2-3 weeks, depending on depth and area; may require grafting
Third degree- Full Thickness
Includes epidermis, dermis, and sometimes subcutaneous tissue; may involve connective tissue and muscle
Causes: flame, prolonged exposure, electrical, chemical, contact
Dry, leathery, eschar, waxy white, dark brown, or charred appearance, strong burn odor
No pain at burn sites due to loss of nerve endings; severe pain in surrounding areas.
Surgical intervention required.
Fourth Degree- Full Thickness
Includes deep tissue, muscle, and bone
Charred appearance
Causes: prolonged exposure or high voltage, electrical injury
Amputations likely; grafting of no benefit
Inhalation Injury
Caused by inhalation of thermal and/or chemical irritants
Upper vs lower airway injury
History of injury important.
Burns of the face, mouth, anterior neck
Clinical signs: singed facial hair, carbonaceous sputum, hoarse voice, stridor
Bronchoscopy for definitive diagnosis
Stridor intubate
rule of nine
Rule of Nines: anterior and posterior of head 9%. Anterior chest 9 + and 9 =18% If approximately half of arm were burned, the TBSA burned = 4.5%; anterior thigh + anterior lower leg = 4.5 % (total 9%)
Lund-Browder chart is another method and is more accurate for children
With all methods, estimate at initial evaluation and again 72 hours later.
Children and Burns
Prevention!
Splash and spill burns from hot food off stove is common
Hallmark signs of child abuse:
Definite line of demarcation
Frequent or repetitive hospital visits
Symmetrical burn wounds
Cigarette burns
Other burn vulnerable populations
The elderly patient
Clients with reduced mental capacity
People with reduced mobility and/or sensory impairments
On the scene care
Prevent injury to rescuer
Stop injury: extinguish flames or remove from the source
Cool the burn
Remove restrictive objects
Cover the wound
Irrigate chemical burns
Primary survey: ABCDE
on the scene care 2:
Note: Treat patient with falls and electrical injuries as for potential cervical spine injury. Don’t touch person if still in contact with the electrical current
Do assessment surveying all body systems and obtain a history of the incident and pertinent patient history
airway management
Administer 100% humidified O2 if carbon monoxide poisoning suspected
Consider early intubation and ventilator support (esp. burns to the face & neck)
Place in high Fowlers position (unless spinal cord injury)
Escharotomy if needed to relieve resp. distress
Turn, cough, deep, breath
Provide suctioning & chest physiotherapy
Bronchoscopy
Bronchodilators to treat severe bronchospasm
Phases of burns
I. Emergent: onset of injury to completion of fluid resuscitation-hypovelemic
II. Acute: from beginning of diuresis to near completion of wound closure- peeing a lot
III. Rehabilitative: from wound closure to return to optimal physical and psychosocial adjustment
