Burns & Scalds Flashcards
Describe the causes, effects and initial management of burns and scalds.
Definition of a burn
A thermal insult which damages the skin and/or underlying structures
Types of burn and scald
Flame or radiation (thermal) Dry heat Wet heat Electricity Friction Corrosive chemicals
Scalds - caused by wet heat
Water
Steam
Fat
Hot liquid chemicals
Three main dangers of a burn
The burn itself
Flesh wounds
Infection
Dangers of an electrical burn
Safety of yourself and the patient - isolate electrical current before proceeding
Surface are of the burn may be misleading with possibility of deeper layers of tissue being affected
Shock, infection, damage to; respiratory, cardio-vascular and nervous system
Possibility of two burn sites - entry and exit wound
Dangers of a chemical burn
Safety of yourself and the patient
Toxic fumes
Chemical still burning
Dangers as for a thermal burn
Classification of burns
Superficial burns (1st degree)
Partial thickness burns (2nd degree)
Full thickness burns (3rd degree)
Assessment of burns
Scene assessment Mechanism of burn Surface area Patient type Complex burns Pre existing conditions Extremes of age
Superficial burns
Injury to the epidermis only.
Red, inflamed skin, painful to touch.
Generally no treatment required.
Partial Thickness burns
Injury to both the epidermis and the dermis.
Skin presents with reddened areas, blisters or open weeping wounds.
Patient complains of a great deal of pain.
Significant fluid loss occurs with subsequent shock.
Full thickness burns
Injury to the epidermis, dermis and subcutaneous tissue, possibly deeper.
May look charred or leathery.
Not painful (although associated 2nd degree burns will cause pain).
No capillary refill.
Body surface area (adult)
rule of nines
The adult body configuration is divided into anatomic regions that represent 9% or multiples of 9%.
Head 9% Left Arm 9%/Right arm 9% Front of torso 18% Back 18% Groin 1% Left Leg 18%/Right Leg 18%
Body surface area (infant or child)
rule of nines
The infant or child head represents a larger portion of the surface area. The lower extremities a lesser portion.
Head 18% Left Arm 9%/Right arm 9% Front of torso 18% Back 18% Left Leg 14%/Right Leg 14%
Time critical Burn
Any Major ABCD problems Any signs of airway burns History of hot gas inhalation Circumferential burns Facial burns Surface area >25%(12.5% children) Presence of other major injuries
Evaluation of critical burn areas
Burns to the hands, feet, genitalia, or face and burns that completely encircle body areas are considered to have high priority.
