Chapter 11 Burns

An estimated 2 million burn injuries occur each year in the United States, resulting in 75,000 hospitalization and more than 3000 deaths. It is estimated that about 70% of all burn injuries occur inside the home. Skin death and injury occur as the applied heat exceeds the body’s ability to disperse the heat.

Types of Burns Thermal (heat) burns Chemical burns Electrical burns

Thermal Burns Contact with flames, hot objects, hot liquid, and steam are common causes of burns. Just 3 seconds of exposure to water at 140ºF can cause a full-thickness burn in an adult. At 156ºF, the same burn occurs in one second.

Evaluating a Thermal Burn (1 of 2) Determine the depth (degree). First-degree (superficial) Second-degree (partial thickness) Third-degree (full thickness) Determine the extent (Rule of palm). Determine which parts of body are burned.

Evaluating a Thermal Burn (2 of 2) Determine whether other injuries or medical conditions exist, or if the patient is elderly or very young. Determine the severity of the burn.

Care for Thermal Burns Stop the burning process. If clothing is burning, have the victim drop and roll. Smother the flames with a blanket or douse the victim with water. Once the fire is extinguished, remove all hot clothing. Remove jewelry if possible. Monitor the victim’s breathing.

Recognizing First-Degree Burns (Superficial) Redness Mild swelling Tenderness Pain

Care for First-Degree Burns Immerse the burned area in cold water or apply a wet, cold cloth. Administer ibuprofen to relieve pain. Have the victim drink as much water as possible. After the burn is cooled, apply aloe vera. Raise a burned arm or leg to reduce swelling.

Recognizing Second-Degree Burns (Partial Thickness) Blisters Swelling Weeping fluids Intense pain

Care for Small Second-Degree Burns Immerse the burned area in cold water. Administer ibuprofen to relieve pain. Have the victim drink as much water as possible. After a burn has been cooled, apply a thin layer of an antibiotic ointment. Cover the burn with a dry, nonsticking, sterile dressing. Seek medical care for burns covering more than 20% of the BSA in adults, or 10-20% in children or elderly.

Care for Large Second-Degree Burns Do not apply cold because it could cause hypothermia. Cover the burn with a dry, nonstick, sterile dressing. Treat victim for shock. Seek medical care.

Third-Degree Burns (Full Thickness) Dead nerve endings Leathery, waxy skin Pearly gray or charred skin

Care for Third-Degree Burns It usually is not necessary to apply cold to third-degree burns because pain is absent. Cover the burn with a dry, nonsticking, sterile dressing. Treat victim for shock. Seek medical care.

Chemical Burns A chemical burn is the result of a caustic or corrosive substance touching the skin. They continue to burn as long as they are in contact with the skin; remove quickly. First aid is the same for all chemical burns.

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

Electrical Burns Thermal burn (flame) Arc burn (flash) True electrical injury (contact)

Care for Electrical Burns Make the scene safe. Monitor breathing and treat accordingly. If victim fell, check for a spinal injury. Treat victim for shock. Place blankets under and over victim. Seek immediate medical care.

Contact With Electrical Current If there are downed power lines, turn off power before approaching patient. If you feel a tingling sensation in your legs as you approach the victim, stop. If you can safely reach the victim, do not attempt to move any wires. Do not attempt to move downed wires unless you are trained and equipped.