Burns

Question 1

Skin Functions

Answer 1

PRIS

1. protection - acts as a physical barrier against impacts, chemicals, infection, pressure
2. regulation - fluid balance through sweat, body temperature
3. sensation - detects cold, pain, heat, touch
4. immunity - first line of defense, innate and adaptive immune system

Question 2

Skin Layers

Answer 2

1. epidermis - uppermost layer; mainly dead cells
2. dermis - hair follicles, glands, blood vessels, nerves
3. hypodermis/subcutaneous layer - lowest layer of skin, has fat and connective tissue

Question 3

Classifying Burns

Answer 3

Body region, depth, body surface area, severity, age, pre-existing conditions, other injuries
BBDSAPO

Question 4

Body Region

Answer 4

Certain areas are more sensitive to burns: face, airway, chest, hands, feet, groin

Question 5

Depth of Burns

Answer 5

1. superficial/first degree - affects epidermis, red, painful, dry to touch
2. partial thickness/second degree - burned up to dermis, red, painful, moist, blisters
3. full thickness/third degrees - burned through all layers, leathery touch, eschar, painless, dry, black/white

Question 6

Body Surface Area (BSA)

Answer 6

• Rule of Nines; palm = about 1%;
• Child: arm-9%, head+neck-18%, leg-14%, anterior trunk-18%, posterior trunk-18%
• Adult: arm-9%, head-9%, neck-1%, leg-18%, anterior trunk-18%, posterior trunk-18%
• look at image

Question 7

Severity

Answer 7

1. Superficial - mild = <50%, moderate = >50%,
2. Partial Thickness - mild = <15%, moderate = 15-30%, severe = >30%
3. Full Thickness - mild = <2%, moderate = 2-10%, severe = >10%
   - moderate to patients below 5 and above 55 are severe
   - burns to face, airway, chest, hands, feet, groin are severe

Question 8

Types of Burns

Answer 8

1. Thermal
2. Chemical
3. Electrical
4. Radiation

Question 9

Thermal Burns

Answer 9

Causes: hot liquids, steam, objects
Treatments: remove jewelry, clothing; humidified O2 for airway burns; wrap between fingers and toes; do not peel clothing; partial thickness <10% = wet, then dry sterile dressing, otherwise just dry sterile dressing; Treat for shock

Question 10

Chemical Burns

Answer 10

Causes: liquid and powder chemicals
Treatments: brush away from patient and yourself; flush for 20 minutes; if in eyes, cover both eyes with most sterile dressing; treat for shock
Considerations: branch chemical container back to hospital, document chemical name, wait in safe zone, make sure patient is decontaminated

Question 11

Electrical Burns

Answer 11

Causes: electricity, lighting
Treatment: look for entry and exit wounds; treat like a thermal burn; SMR; monitor patient for arrhythmia. treat for shock
Considerations: lighting can be a threat 30mins after first strike; prioritize care based on respiratory/cardiac arrest if there are multiple patients

Question 12

Radiation Burns

Answer 12

Causes: sunburn. radiation therapy
Treatment: treat like thermal burns; treat for shock

Question 13

Circumferential Burns

Answer 13

skin loses elasticity during partial and full thickness burns, causes skin to contract, acts as a tourniquet, restricts circulation, prevents normal ventilations; escharotomy = in hospital treatment that allows skin to expand

Question 14

Dont’s

Answer 14

1. pop blisters
2. apply ointment
3. apply ice
4. remove stuck clothing

Question 15

Suspected Child Abuse

Answer 15

• mandated to report abuse ASAP; must file paperwork within 48 hours
• hot plate, light bulb, curling iron, steam iron, knife, grid, cigarettes, forks, immersion
• look at image

Question 16

Patient Assessment

Answer 16

1. ensure BSI/SS
2. ABC’s
3. Treat for shock
4. Questions: depth and extent of burns, critical areas, pre-exiting med conditions/other injuries, airway burns, duration of exposure

Question 17

Signs of Airway Burns

Answer 17

1. singed nose hair
2. cough up soot
3. ash in mouth