FIRST AID AND EMERGENCY CARE LECTURE 8 BURNS

Definition Burn is a type of injury that affect only the Epidermal tissue and the Dermis, and rarely the deeper tissues such as as muscles, bones, and blood vessels due to exposure to physical form of energy, certain chemicals or radiation.

CAUSES Of Burn Injuries Heat Steam Flame Electricity Chemicals Light Radiation Friction

CLASSIFICATION OF BURNS CLASSIFICATION BY DEPTH Burns are described according to the depth of injury to the dermis and are classified into first, second, third and fourth degrees

This (degree of burn) is determined by: The nature of the agent such as temperature and concentration The length of contact The tissues resistance to injury such as the skin vascularity and thickness

First Degree Burns Involves only a partial thickness of the skin (The Epidermis) Characterized by dryness and erythema (redness) of the skin and slight edema Pain which subsides in 48 hours Epidermis peels off in small scales in five to ten days Has no complications or scarring

First degree of burns

Second Degree Burns Superficial Partial Thickness Extends into superficial (papillary) Dermis Characterized by redness with clear blisters, and subcutaneous edema, paleness with pressure Painful Lasts from 2-3 weeks Complications include local infection (Cellulitis)

Deep Partial Thickness Extends deep into (reticular) Dermis Characterised by red-and-white skin colour, less paleness Moist and painful Lasts many weeks and may progress to third- degree burn Complications include scarring, contractures and may required excision and skin grafting

Second degree of burns

Third Degree Burn Extends through the entire Dermis Characterized by stiff and white/brown skin, dry, leathery No pain Complications include scarring, contractures, amputation Requires excision

Third degree of burns

Fourth Degree Burn Extends through skin, subcutaneous tissue and into underlying muscles and bones Characterised by black, charred skin with eschar (slough and dead skin) Dry painless (no pain) Complications include amputation and significant functional impairment Requires excision

Fourth degree of burns

Assessment of area of burn This is done using the "rule of nines". The body is divided up into eleven areas, each representing 9% of the total body surface.

Body Area Percentage Of Burn Head and Neck 9% Anterior Trunk 18% Posterior Trunk Rt. Lower Extremity Lt. Lower Extremity Rt. Upper Extremity Lt. Lower Extremity Ext. Genitalia and Perineum 1%

Guide To Management Minor burns (less than 10%) can be treated in the hospital on out-patient basis Moderate and severe burns should be hospitalized for treatment Adult patients sustaining more than 20% burn require intravenous therapy.

First Aid Treatment Place the burning person in a horizontal position and roll him over in a blanket In case of respiratory arrest, do positive breathing, using the mouth-to-mouth or mouth- to-mask technique. CPR Apply cold bath using Normal Saline that is kept at 10 to 15C Cover the wound to minimize contamination and inhibit pain by preventing air to come in contact with the injured surface ( Clean cloth)

Medications or home remedies should not be applied Facilitate transport to a hospital of severely burned patients

Burn Therapy For Severe Burns Assure an adequate airway Look for and treat immediate life-threatening conditions Perform venipuncture with large bore needle Remove patients clothing Obtain history (Cause, time, place of burn, allergies, tetanus, diabetes, cardiac, renal and liver disease) Insert indwelling catheter

Clean wound by removing any dirt, irrigate with cooling water to prevent further damage Estimate % and depth of burn in a chart Provide adequate analgesic as needed Calculate fluids intake and output Dressings on superficial partial-thickness burns can be changed after 3-5 days in the absence of infection.

Do not open blisters. Do not add ice to burn.