Burns Injury

Question 1

Definition

Answer 1

When tissue damage occurs by thermal, electrical or chemical injury

Question 2

Aetiology

Answer 2

· Contact with hot objects
· Electricity
· UV light
· Irradiation
· Chemicals

· High Risk Patients
o Young children
o Elderly

Question 3

Epidemiology

Answer 3

UK has > 12,000 admission per year

Question 4

Presenting symptoms

Answer 4

· Note the circumstances of the burn
· Important to find out the time, temperature and length of contact with the agent
· Consider risk of smoke inhalation and carbon monoxide poisoning

Question 5

Signs on physical examination

Answer 5

· Check for inhalational injury or airway compromise:
o Stridor
o Dyspnoea
o Hoarse voice
o Soot in nose
o Singed nose hairs
o Carbonaceous sputum

· Check site, depth and distribution of burn

· Check size of Burn
o Described as a percentage of body surface area

Question 6

Partial thickness burn

Answer 6

Subdivided into:

· Superficial: red and oedematous skin + PAINFUL
(Heals within around 7 days with peeling of dead skin)

· Deep: blistering and mottling + PAINFUL
(Heals over 3 weeks, usually without scarring)

Question 7

Full thickness burn

Answer 7

o Destruction of the epidermis and dermis
o Charred leathery eschars
o Firm and PAINLESS with loss of sensation
o Healing will occur by scarring or contractures and requires skin grafting

Question 8

Investigations

Answer 8

· Bloods
o Oxygen saturation, ABG and carboxyhaemoglobin (if inhalational injury)
o FBC
o U&Es
o Group and Save

· Investigations for electrical burns
o Serum CK
o Urine myoglobin (check for muscle damage)
o ECG