EAC Burns and Scalds Flashcards
causes of:
Burns
Flame or radiation (thermal)
electricity
Friction
Corrosive chemicals
causes of:
Scalds
Water
Steam
Fat
Hot liquid chemicals
define:
Burn
Caused by dry heat
define:
Scald
Caused by wet heat
dangers related to:
Thermal burns
Shock caused by the loss of body fluids ie plasma
Infection of the exposed subcutaneous tissue or burst blisters
Damage to the respiratory tract caused by breathing in flames or hot air
dangers related to:
Electrical Burns/Electrocution
be sure to safeguard your own safety before dealing with the patient:
Isolate any electrical current before touching patients or attempting to remove them from the source of the electricity
may cause Cardiac Diarrhythmias so bring a defib’
Treat as a normal burn
Surface area may be misleading. Deep layers may be affected more seriously than would be apparent from a small surface burn
Immobilise C-Spine if history of incident suggests risk of injury
dangers related to:
Chemical Burns
destruction of tissues by chemical reaction.
The chemical may also be hot
Some chemicals can melt into the skin and tissues and then solidify
If possible identify the chemical
Remove all contaminated clothing
Irrigate freely with cold water
Applying an appropriate neutralising agent if available
Treating as for a normal burn
A phosphorus burn should be kept continually et; apple a wet dressing
define:
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
depths of burns
Erythema (slight, superficial)
Partial thickness
Full thickness
define:
Erythema (slight, superficial) burn
Reddening of the skin, sensation present
define:
Partial Thickness burn
Reddening with blistering, sensation present
define:
Full Thickness burn
Sever blistering accompanied by charring in the case of burns with an appearance of inflammation around the edge of the injury.
Underlying tissues will be damaged with coagulation of blood vessels in the skin and damage to nerve ending’s causing a loss of sensation
how to asses area of burns
serial halving:
Half burnt/half not burnt approach to give burn area of 75%, 50%, 25%, 12.5%,
points to remember hen assessing burns
Burns in the region of 10% of body area are serious and may produce severe shock.
The area burnt is more significant than the depth of the burn
Age of Pt. children shocked easier as they have less body fluid
Children and young adults may survive burns of 20%
Whereas infants and elderly may die from 10% burns
Superficial usually more painful then deep ones.
if age + % of burn >100 the prognosis is poor
Consider all burn area - do not differentiate
Time critical features of burns
Any major ABCD problems
Any signs of airway burns, soot or oedema around the mouth and nose
History of hot air or gas inhalation - these patients may initially appear well but can deteriorate very rapidly
Evidence of circumferential burns of the chest or neck
Any significant facial burns
Adults with surface burns >25%
paediatric patients with surface burns >12.5%
presence of other major injuries
any of these features present? correct A and B problems and pre-alert, rapid transport to nearest suitable receiving hospital. continue management en-route
complications of:
Burns and Scalds
Shock - clinical and psychological
Infection - don’t touch the injuries unnecessarily and wear sterile gloves
Respiratory tract damage
management of:
Burns and Scalds
Put out fire here safe to do so
Ensuring an open airway, observing for burn marks or singeing around mouth or nose, this may indicate inhalation of hot gases.
Administering Entonox or high % O2
Removing and constrictions such as rings, necklaces, shoes
Removing clothing which is hot and wet and not adhering to the skin
Cover burn area with sheets of cling film - overlapping rather than bound. DO NOT use cling film on chemical burns
Applying sterile dressings
Treating for emotional and hypovolaemic shock
Not applying creams or lotions
Not bursting blisters
management of:
Burns and Scalds with Respiratory Tract Damage
Ensuring open airway
Administering high % O2
Consider nebulisation with salbutamol where wheezing is apparent
Resuscitating if necessary
Removing to hospital as quickly as possible as rapid swelling can occur
causes of:
Respiratory Tract Damage
(burns and Scalds)
Inhaling flame
Inhaling hot smoke, fumes or atmosphere
Swallowing hot liquids
