Lesson 10: Burns Emergency Reference Guide p. 43-46

Objectives Define types of burn injuries Define & demonstrate proper management of superficial, partial thickness & full thickness burns Describe situations that require evacuation Identify ways to prevent burns

Different Types of Burns Heat Chemical Reactions Electricity Radiation

What Sources cause this burn? Heat: Fires Boiling water Steam Hot pot Melting substances, such as plastic Others?

Burns

Burns

Burns

What Sources cause this burn? Chemical: Pesticides Chemical fuels Battery acid Others?

Chemical Burn

What Sources cause this burn? Electrical: Electrical current Lightning Radiation: Sun Nuclear

Electrical Burns

Radiation Burns—Sun Burn 1st Degree Sun burn 2nd Degree Sun Burn

Frostbite (burn from cold)

Preventing Burns What steps can be taken to Prevent burns Heat? Cook in designated areas & limit access Position stove so there is easy escape route Never use open flame in tent Use caution around campfire

Preventing Burns (cont’d.) Chemical: Follow label directions for safe use Electrical: Take precautions to avoid lightning Radiation: Use sunscreen Wear UV blocking clothing Extra precautions needed for high altitude & near water/snow

Checking & Caring for Burns STOP the Burning! Remove source of the burning Cool affected area Be suspicious of airway complications when: Burns are to face/neck Soot is in the mouth/nose Singed facial hair Dry cough that accompanies a burn

Stop the Burn How do you stop the Burning? Heat: Electrical: Remove from heat source Smother flames Flush with large amounts of water Electrical: Turn off electricity

Stop the Burn (cont’d.) Chemical: Radiation: Get out of direct Sun Remove Chemical (brush off, if dry chemical) Flush with large amounts of water Radiation: Get out of direct Sun Flush with water

Checking Burns Specific care depends upon the source & depth of the burn Signs and Symptoms: Superficial Skin is red & painful Possible swelling Partial Thickness Skin is red, painful, swollen Blisters may take an hour to form

Checking Burns (cont’d.) Full thickness: Skin is painless (in area of full thickness burn) Skin is pale and stiff, if caused by scolding Skin is charred, if caused by fire

Depth of Burns

Degree of Burn (1st, 2nd, 3rd) Partial Thickness Superficial Deep Thickness

Burn Percentage “Rule of Palmar Surface” or “Rule of 9’s” for estimating coverage of burn or TBSA Larger the percentage the more serious the burn Palm of individuals hand = 1% of body surface Rule of Nines: Torso front = 18% Torso back = 18% Each arm = 9% Each leg = 18% Head = 9%

Rule of Nine’s

Caring for Burns In case of major electrical burn (i.e. lightning) care for cardiac or respiratory problems first After assessment & removal of burn source: Expose burn fully (do not remove melted clothing) Cool or flood with cold water for at least 20 min. Gently wash burn to remove any dirt Leave blisters intact Remove jewelry, if possible Dress minor burn with thin layer of antibiotic If not available, leave burn alone

Caring for Burns (cont’d.) Cover burn with gauze pad or thin roll of gauze Do not pack burns with ice Elevate burned extremities to minimize swelling. Swelling slows healing Encourage patient to gently move burned area Treat for shock & hypothermia

Caring for Burns (cont’d.) Manage airway Re-dress burn twice daily: Remove by soaking dressing with water, if needed Re-wash wound to remove old ointment Apply clean covering Redressing/examination will likely be painful. If evacuation is imminent, leave burn alone

Guidelines for Evacuation GO FAST: Trouble breathing Partial/full thickness covers 10% or more Partial/full thickness wraps around a body part Serious burns to head/face/neck/hands/feet/genitals Full thickness on > 5% of body Chemical burns Partial/full thickness for child/elderly patient Level of pain good indicator of necessity of evacuation

Scenario A 16 yr old is sitting at a table with boiling water. Pot spills into her lap. She is screaming in pain. You see a scalding burn that is white & skin is sloughing off. Burns are covering the top of both thighs & her right arm from elbow to wrist. What do you do?

Questions??? What else could you add to your First Aid Kit?