Chapter 11 Burns

Burns Burns occur in every age group and in a variety of settings. Skin death and injury occur as applied heat exceeds body’s ability to disperse the heat. Damage depends on: Heat’s intensity Duration of contact Skin’s thickness

Types of Burns (1 of 3) Thermal burns Caused by: Kelsey Story Flames Hot objects Flammable vapor Steam Hot liquids Kelsey Story

Types of Burns (2 of 3) Chemical burns Pool Chemicals too… Caused by wide range of chemicals Acids Alkalis Organic compounds Pool Chemicals too… https://www.youtube.com/watch?v=uPntGk McJxg

Types of Burns (3 of 3) Electrical burns Caused by contact with electric current Injury depends on: Type of current Voltage Area exposed Duration of contact Typically an entrance and exit point https://www.youtube.com/watch?v=RpVY6jgB pcA

Evaluating a Thermal Burn Determine Depth (1 of 3) First-degree (superficial) burns affect skin’s outer layer. Redness Mild swelling Tenderness Pain Suzanne Tucker/ShutterStock, Inc.

Evaluating a Thermal Burn Determine Depth (2 of 3) Second-degree (partial-thickness) burns extend through entire outer layer and into inner layer of skin. Blisters Swelling Weeping of fluids Severe pain

Evaluating a Thermal Burn Determine Depth (3 of 3) Third-degree (full-thickness) burns penetrate skin layers into the underlying fat and muscle. Leathery, waxy, pearly gray skin Dry appearance

Evaluating a Thermal Burn Determine Extent (1 of 3) Estimate how much body surface area (BSA) the burn covers. The rule of nines for adults: The entire head = 9% One complete arm = 9% Front torso = 18% Complete back = 18% Each leg = 18%

Evaluating a Thermal Burn Determine Extent (2 of 3) The rule of nines for small children and infants: The entire head = 18% Each leg = 14%

Evaluating a Thermal Burn Determine Extent (3 of 3) A hand, including the fingers and the thumb held together, represents about 1% of a victim’s total body surface.

Evaluating a Thermal Burn Determine Burned Body Parts Burns on the face, hands, feet, and genitals are the most severe. Circumferential burns are more severe than noncircumferential burns.

Evaluating a Thermal Burn Determine Respiratory Involvement Superheated air can be absorbed by the upper respiratory tract. Swelling occurs in 2 to 24 hours.

Evaluating a Thermal Burn Determine Other Injuries Preexisting medical problems If the victim is older than 55 years If victim is younger than 5 years

Evaluating Thermal Burns Determine Burn’s Severity

Care for Thermal Burns (1 of 2) Burn care aims to: reduce pain. provide physical protection. provide a favorable environment for healing that minimizes the chances of scarring and infection.

Care for Thermal Burns (2 of 2) Stop the burning process. If clothing is burning, have the victim stop, drop, and roll. Smother the flames with a blanket or douse the victim with water. Remove all hot or smoldering clothing and jewelry. Monitor the victim’s breathing.

Care for First-Degree Burns Apply cold water or cloth. Give ibuprofen. Have the victim drink water. Apply aloe vera or other lotion. Keep burn raised.

Care for Small Second-Degree Burns Apply cold water or cloth. Give ibuprofen. Have the victim drink water. Apply antibiotic ointment. Cover burn with a nonsticking, sterile dressing. Seek medical care if the burn covers more than 10% BSA.

Care for Large Second-Degree Burns Apply cold and monitor for hypothermia. Give ibuprofen. Have the victim drink water. Cover the burn with a dry, nonsticking, sterile dressing. Treat for shock. Seek medical care.

Care for Third-Degree Burns Cover the burn with a dry, nonsticking, sterile dressing. Treat the victim for shock. Seek medical care.

Aftercare for Thermal Burns Follow physician’s recommendations. Wash hands before changing dressing. Leave unbroken blisters intact. Change dressings daily. Watch for signs of infection. Elevate burn for first 24 hours.

Scald Burns The result of contact with hot liquids Immersion burns: area of the body is fully immersed in a hot liquid. Spill burns: liquid spills, drops, or is thrown on a person.

Sunburn (1 of 2) The skin’s response to the trauma of ultraviolet radiation Can result in first- or second-degree burns © E. M. Singletary, M.D. Used with permission.

Sunburn (2 of 2) Various skin types respond differently. Type I skin—always burns; never tans Type II skin—burns easily; tans slightly Type III skin—sometimes burns; always tans gradually and moderately Type IV skin—minimally burns; always tans well Type V skin—rarely burns; tans deeply Type VI skin—does not burn

Care for Sunburns Apply cool compress for up to 45 minutes. Take cool showers and baths. Do not use benzocaine. Use ibuprofen to reduce pain and inflammation. Drink a lot of water. Use aloe vera or another body lotion to keep the skin moist.

Sunburn Aftercare Apply antibiotic ointment to a second-degree sunburn. If blisters break, gently wash twice daily. Seek medical care if infection occurs.

Chemical Burns Result of an acid or an alkali substance touching the skin

Care for Chemical Burns Flush body portion with water. Remove contaminated clothing and jewelry. Flush for 20 minutes or longer. Cover burn. Seek medical care.

Electrical Burns Thermal burn (flame) Arc burn (flash) True electrical injury (contact) © Chuck Stewart, MD.

Care for Electrical Burns Make sure the area is safe. Check breathing. Check for a spinal injury. Treat the victim for shock. Place dry, sterile dressings on all burn wounds. Place blankets under and over victim. Seek immediate medical care.

Contact With Outdoor Power Line Power must be turned off. A tingling sensation signals that you are on energized ground. Raise one foot off ground, turn around, and hop to safe area. Do not attempt to move any wires.

Contact Inside Buildings Turn off electricity. Unplug appliance. Do not touch appliance or victim until current is off. Damage occurs under skin.