Burns injury Flashcards
Define burns injury
Injuries predominantly to the skin and superficial tissues, caused by heat (from hot liquids or flame) or contact with heated objects, electrical current, or chemicals.
Signs of burns injury on physical examination (generally)
- Erythema
- Clouded cornea
- Burns
- Cellulitis
Which layer(s) of skin does first degree burns affect and what does it feel like?
Epidermis
Dry, painful
Signs of first degree burn
- Redness
- Tenderness
- Pain
- No blistering
- 2-point discrimination
Causes of first degree burn (2)
Flash burns
Sunburn
Which layer(s) of skin does second degree burns affect and what does it feel like?
Epidermis, upper dermis
Wet, painful
Signs of a superficial second degree burn
o Some portion of the skin appendages remain viable
o Thin-walled fluid filled blisters
o Pink, moist and soft
o Very tender
Signs of a deep second degree burn
o Red-blanched white skin colour
o Slow capillary refill
o Thick-walled blisters
o Pinprick sensation intact
Causes of a second degree burn
Splash scalds
Which layer(s) of skin does third degree burns affect and what does it feel like?
Epidermis, dermis
Dry, insensate
Signs of 3rd degree burn
- White, leathery appearance
* Anaesthetic
Causes of 3rd degree burn
o Immersion scalds, flame burns, chemical injury, high-voltage electrical injury
Which layer(s) of skin does 4th degree burns affect?
subcutaneous tissue/tendon/bone
Causes of 4th degree burn?
o Prolonged exposure to third degree burn
Investigations for burns injury
• FBC o Low haematocrit, hypovolaemia, neutropenia, thrombocytopenia • Metabolic panel o High levels of urea, creatinine, glucose o Hyponatraemia o Hypokalaemia • Carboxyhaemoglobin o High levels in (inhalation injury) • ABC o Metabolic acidosis (in inhalation injury) • Fluorescein staining o Damaged corneal epithelial cells (in corneal burns) • CT head/spine • Wound biopsy culture o Wound infection • Wound histology
Epidemiology of burns injury
• 250,000 injuries in the UK each year
o Half visit A+E
o 5% are admitted
• 98% survival rate
• More common in males and white individuals
• 45% caused by fire/flame, 35% caused by scald, 10% caused by hot object and 5% caused by electrical
• 75% happen in the home
Aetiology of burns injury
- 70% of burns in young children come from hot liquids
- 20% of burns in young children involve abuse or neglect
- Flame injuries more likely in older children/young adults
- Scalds and cooking accidents more likely in older adults
- 26% of flame injuries involve alcohol
Risk factors burns injury
- Young children
- Age > 60
- Male
- Alcohol use
How do you measure burn size?
RULE OF 9S • Head = 9% • Neck = 9% • LHS arm = 9% o Palm = 1% • RHS arm = 9% • Anterior trunk = 18% • Posterior trunk = 18% • LHS leg =18% • RHS leg = 18% • Perineum = 1% • Genitalia = 1%
