Minor Burns and Sunburns

Question 1

• OTC Medications Associated with Photosensitivity (know)

Answer 1

• Antihistamines (cetirizine, diphenhydramine)
• Coal Tar + Derivatives (Tar Gel Shampoo)
• NSAIDs (ibuprofen, naproxen)
• Sunscreens
• Miscellaneous (i.e. benzoyl peroxide)

Question 2

• Exclusions for Self-Treatment (know!)

Answer 2

1. Burn to body surface area of 2% or more
2. Involving eyes, ears, face, hands, feet, or perineum
3. Chemical, electrical or inhalation burns
4. Persons of advance age
5. Diabetes mellitus or multiple medical disorders
6. Immunocompromised patients

Question 3

NEW BURN GRADING SYSTEM + Rule of Nine

Answer 3

• Superficial Burns
• Superficial Partial-Thickness Burn
• Deep Partial -Thickness Burns
• Full Thickness Burns

Rule of Nine

• Front/back of arm: 4.5, whole arm: 9
• Face: 9
• Front/back of torso: 18, whole: 36
• Front/back of leg: 9, whole 18

Question 4

NONPHARMACOLOGIC THERAPY

Answer 4

• Active cooling delays progression of the burn and increases healing if performed within 20 minutes of injury (tap 10-15 min).
• Oral analgesics and NSAIDs such as APAP, aspirin, ibuprofen or naproxen can be given to relieve pain.

Question 5

SKIN PROTECTANTS

Answer 5

• Make wound area less painful
• Protect wound from mechanical irritation caused by friction
• Rehydration helps relieve irritation and permits normal healing to continue

Apply as often as needed, if the burn has not improved in 7 days or if it worsens consult a PCP.

Question 6

TOPICAL ANESTHETICS

Answer 6

• Relieve pain by inhibiting the transmission of pain signals from pain receptors on the skin.
• Relief is short lived, 15 to 45 min.
• Higher concentrations are appropriate for burns in which the skin is intact.
• Lower concentrations are preferred when the skin is not intact because absorption is enhanced.
• They should be applied to small areas to avoid systemic toxicity.

Question 7

TOPICAL HYDROCORTISONE

Answer 7

• Hydrocortisone 1% not FDA for approved for burns but sometimes used for minor burns covering a small area (quarter).
• Hydrocortisone should be used with caution is the skin is broken (infection).

Question 8

ANTIMICROBIALS

Answer 8

• For minor burns, nonrx antibiotic or antiseptic products are of limited value
• These preparations may be used on minor burns when the skin has been broken to help prevent infection.
• Petrolatum based antimicrobials may act as a skin protectant and provide symptomatic relief

(DONT NORMALLY REC)

Question 9

PATIENT RISK FACTORS FOR THE DEVELOPMENT OF UVR-INDUCED PROBLEMS

Answer 9

1. Fair skin
2. Hx of 1+ serious/blistering sunburns
3. Blonde/red hair, blue/green/gray eyes
4. Hx of freckling
5. Previous growth on skin/lips by UV
6. Existence of a UV-induced disorder
7. Family hx of melanoma
8. Immunosupressive drug
9. Excessive lifetime exposure to UVR
10. Hx of an autoimmune disease
11. Xeroderma pigmentosum

Question 10

Types of Sunscreens

Answer 10

• Chemical sunscreens: work by absorbing and blocking the transmission of UVR to the epidermis
• Physical sunscreens are opaque and act by reflecting and scattering UVR

Question 11

Sunscreen Administration

Answer 11

• Applied 15 to 30 minutes before UV exposure and every 15 to 30 minutes thereafter

Recommended dosage:

• Face / neck: one-half tsp
• Arms / shoulders: one-half tsp to each side
• Torso: one-half tsp each to front and back
• Legs / top of feet: 1 teaspoon to each side

Safety considerations:
“Stop use if skin rash occurs.”

Question 12

PABA and Benzo sunscreens

Answer 12

Major skin sensitizer