1. Lesson 10: Burns

2. 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

3. Types of Burns Heat: Fires Boiling water Steam Hot pot
Melting substances, such as plastic
Others?

4. Types of Burns Chemical: Pesticides Chemical fuels Battery acid
Others?

5. Types of Burns Electrical: Radiation: Electrical current Lightning Sun
Nuclear

6. 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

7. Preventing Burns 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

8. 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

9. 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

10. Stop the Burn 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

11. 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

12. Checking Burns 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

13. Burn Percentage
“Rule of Palmar Surface” or “Rule of 9’s” for estimating coverage of 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%

14. 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

15. 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

16. 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

17. 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

18. 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?