1. First Aid and Emergency Nursing (Theory)
University of Tabuk Faculty of Applied Medical Sciences Department of Nursing
First Aid and Emergency Nursing (Theory)
(NUR 410)

2. Curriculum & Course Development Committee
BURN
are a group of conditions with outcomes that include the removal of skin by thermal(heat or radiation), chemical, electrical means.
DEPARTMENT OF NURSING
Curriculum & Course Development Committee

3. Curriculum & Course Development Committee
Assessment of Burns
The type of burn (thermal, electrical, chemical, radiation)
The severity of the burn includes the depth of the burn (superficial, partial thickness or full thickness)
The extent of the burn based on percent of body area burned (rule of nine)
DEPARTMENT OF NURSING
Curriculum & Course Development Committee

4. Illustrations of Rule of 9 for Adult and Young
DEPARTMENT OF NURSING
Curriculum & Course Development Committee
Department of Nursing

5. Injuries are superficial / mild Swelling& redness of the injured area
BURN CLASSIFICATION
First - Degree Burns The least serious burns are those in which only the outer layer of skin is burned, but not all the way through.
Injuries are superficial / mild
Swelling& redness of the injured area 
Pain develops
No blisters seen
Burned area becomes white on touch
Takes 3-6 days to heal
Department of Nursing

6. Remove patient from heat source Remove the burnt clothing
BURN CLASSIFICATION
Treatment
Remove patient from heat source
Remove the burnt clothing
Run cool water over burnt area
Gently clean the injured area
Gently dry 
Apply anti biotic such as Silver Sulphadiazine
Use a sterile bandage to cover burns
Take tetanus vaccination, if required
Department of Nursing

7. Burns extends to middle skin layer, dermis
BURN CLASSIFICATION
Second-Degree Burns
Burns extends to middle skin layer, dermis 
Swelling, redness and pain observed
Burnt area may turn white on touch
Blisters develop, that ooze a clear fluid 
Scars may develop
Restricts movement, if injury occurs at joint
Dehydration may occur
Healing time varies, depends on extent of injury
Department of Nursing

8. Clean the affected area thoroughly Gently dry
BURN CLASSIFICATION
Treatment
Clean the affected area thoroughly
Gently dry
Apply antibiotic cream over affected area
 Make the patient lie down
Keep burnt body part at a raised level
Skin graft may be required
Physical therapy may be essential to aid mobility 
Splints may be used to rest affected joints 
Hospitalization is essential
Department of Nursing

9. BURN CLASSIFICATION Third-degree burns
Damage occurs to all 3 skin layers
Destroys adjacent hair follicles, sweat glands, nerve endings 
Lack of pain due to destroyed nerves
Injured area does not turn white on touch
No blisters observed
Swelling occurs
Skin develops leathery texture 
Discoloration of skin observed
Scars develop 
Crusty surfaces (Eschars) develop-impairs circulation 
Dehydration occurs resulting in shock 
Department of Nursing

10. BURN CLASSIFICATION Symptoms may worsen with time
Disfigurement may result 
Healing depends on extent of injury 
90% body surface injury results in death 
60% injury in elderly, fatal 
Treatment 
Requires immediate hospital care 
Dehydration treated through intravenous fluid supply 
Oxygen is administered 
Eschars are surgically opened 
Department of Nursing

11. BURN CLASSIFICATION Periodically run clean cool water over burns
Nutritious diet helps to heal quickly 
Regular monitoring essential 
Mental Depression treated by anti-depressants
 Prevention 
Install smoke alarm in your home 
Employ 'children friendly' safety measures at home 
Avoid synthetic clothing while cooking 
Carry out fire drills at home and work place
Department of Nursing

12. Major Types of Burn: I. Heat Burn
The seriousness of a heat burn depends upon the degree of the burn and the amount of the body surface involved.
DEPARTMENT OF NURSING
Curriculum & Course Development Committee

13. Major Types of Burn: II. Chemical Burn
is common in industry. It can cause by acids or alkalis, such as kitchen and bathroom cleaning products.
DEPARTMENT OF NURSING
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14. Curriculum & Course Development Committee
Care for Chemical Burn
Flush the area at once with water for at least 20 minutes. Continue to flood the area while clothing is being removed.
A solution of a mild acid may then be used to neutralize alkali (sodium hydroxide or potassium hydroxide) burns of the skin. One or two tsp of vinegar (acetic acid) in one pint of water may be flushed over the burned area after it has been thoroughly washed with water.
DEPARTMENT OF NURSING
Curriculum & Course Development Committee

15. Curriculum & Course Development Committee
Care for Chemical Burn
With acid such as sulfuric, nitric, hydrochloric, trichloroacetic (most corrosive) and carbolic (phenol), flushed the burned area with water and remove all the clothing. After flushing thoroughly with water it would be advisable to pour a solution made of one teaspoon of baking soda per pint of water over the affected area to neutralize any acid remaining in the body.
Cover with a clean dressing or sheet and immediately transport the victim to a medical facility
Carbolic acid (phenol) is not water soluble, ethyl alcohol (gin and whiskey are both satisfactory (should be use for first washing.
DEPARTMENT OF NURSING
Curriculum & Course Development Committee

16. Major Types of Burn: III. Electrical Burn
The entrance wound may be small, but the electricity continues to burn as it penetrates deeper and may burn a greater area below the surface that is suspected from surface appearance.
There may be two burns, because the current can enter the body in one place and leave by another, burning each area. Be sure to look for a second burned area.
DEPARTMENT OF NURSING
Curriculum & Course Development Committee

17. Care for Electrical Burn
Cover the site with a dry (preferably sterile) dressing and transport the victim to the ED
Do not attempt to remove the victim from the source of electricity unless trained to do so.
DEPARTMENT OF NURSING
Curriculum & Course Development Committee

18. Four Types of Injury with Electrical Burn
Entrance wound – caused by electric current into the body and might appear a flat, black or depressed.
Exit wound – caused by electric current exiting the body and might appear as black, charred and “blown out” as the current exits the body.
Arc wound – caused by the electric current crossing a specific body part (e.g. Knee, elbow, axilla) and an increase in temperature occurs that elicits a “petechiae type” appearance.
Thermal wound- caused by electrical current that ignites a person’s clothing in a thermal burn.
DEPARTMENT OF NURSING
Curriculum & Course Development Committee

19. Major Types of Burn: IV. Radiation Burn
Nuclear burns – injury due to nuclear radiation. When radiation injury and burn injury occurs simultaneously, each tend to make the other worse.
Solar burns- ordinary sunburn. The person who exposed himself to the sun for a prolonged period of time can sustain a near total body first degree burn. The effect of this should pass in a matter of twenty-four or forty eight hours, for this period of time the patient may require treatment as for a moderate burn and will experience severe discomfort.
DEPARTMENT OF NURSING
Curriculum & Course Development Committee

20. Curriculum & Course Development Committee
Question no. 1
The newly admitted client has a large burned area on the right arm. The burned area appears red, has blisters, and is very painful. How should this injury be categorized?
Superficial burn  
Superficial partial-thickness burn  
Deep partial-thickness burn  
Full-thickness burn
DEPARTMENT OF NURSING
Curriculum & Course Development Committee
Department of Nursing

21. Curriculum & Course Development Committee
Question no. 2
A client presents with deep partial-thickness burns to the anterior trunk and left anterior arm, and full-thickness burns to the anterior left leg and perineum, and superficial burns to the right anterior leg. The nurse calculates the percentage of TBSA burned as which of the following?
  41.5% of TBSA  
32.5% of TBSA  
31.5% of TBSA  
40.5% of TBSA
DEPARTMENT OF NURSING
Curriculum & Course Development Committee
Department of Nursing

22. Curriculum & Course Development Committee
References
Daniel Limmer ,Michael F. O’keefe. Emergency Care .12 th ed, Pearson Education, Inc., ISBN-10: X • ISBN-13:
Kathleen Sanders Jordan, Emergency Nursing Core Curriculum,5 th ed, Philadelphia, W.B. Saunders company :A division of Harcourt Brace & company,2000.
Burns - First Aid and Emergency Treatment Guide Medindia 
DEPARTMENT OF NURSING
Curriculum & Course Development Committee
Department of Nursing