1. September 29-30, 2014

2. Burns can be caused by: heat, electricity, UV radiation, or chemicals

3. First degree burn: only epidermis is damaged. Second degree burn: Damage extends partway into dermis. Third degree burn: Damage extends all the way through dermis.

4. First degree burn: only epidermis is damaged. Second degree burn: Damage extends partway into dermis. Third degree burn: Damage extends all the way through dermis. Signs: red, swollen skin Example: most sun burns Will heal on own

5. First degree burn: only epidermis is damaged. Second degree burn: Damage extends partway into dermis. Third degree burn: Damage extends all the way through dermis. Signs: red, swollen skin Example: most sun burns Will heal on own Signs: blistering Skin will heal care

6. First degree burn: only epidermis is damaged. Second degree burn: Damage extends partway into dermis. Third degree burn: Damage extends all the way through dermis. Signs: red, swollen skin Example: most sun burns Will heal on own Signs: blistering Skin will heal with care Signs: blackened or blanched (gray-white) skin, lack of pain due to damaged nerves Skin will not heal; grafts must be done

7. Burned skin can no longer carry out its functions Turn & Talk Quick review: What are the functions of the skin? Analyze: Which functions are most critical? 1)Protection from abrasion / chemical damage / UV damage / pathogens / against dessication 2)Excretion of wastes 3)Thermoregulation 4)Synthesis of Vitamin D

8. Burned skin can no longer carry out its functions Most critically, skin can no longer Prevent loss of fluids and electrolytes Fluid loss and electrolyte imbalance can cause kidneys to shut down and patients to go into shock due to low blood volume. Happens almost immediately, unless fluids are replaced. Protect the body from pathogens Infection becomes a major concern within 2-3 days following severe burns.

9. Burned skin cannot thermoregulate. Hypothermia becomes a problem. Burned skin cannot regenerate. Scar tissue forms. If the scar tissue is extensive, mobility may be affected.

10. The severity of burns is determined by both the degree (depth) of the burn and the % of the body covered. Burns are critical if More than 25% of the body has second degree burns More than 10% of the body has third degree burns How to estimate body %?

11. “Rule of nines” If the whole anterior right arm is burned …

12. “Rule of nines” If the whole anterior right arm is burned … 4.5%

13. “Rule of nines” If the whole anterior right arm is burned … 4.5% If 1/3 of the abdomen is burned …

14. “Rule of nines” If the whole anterior right arm is burned … 4.5% If 1/3 of the abdomen is burned … 3%

15. “Rule of nines” If the whole anterior right arm is burned … 4.5% If 1/3 of the abdomen is burned … 3% If a whole leg (all sides) is burned …

16. “Rule of nines” If the whole anterior right arm is burned … 4.5% If 1/3 of the abdomen is burned … 3% If a whole leg (all sides) is burned … 18%

17. “Rule of nines” You do: Half of upper back All of right arm All of head

18. “Rule of nines” You do: Half of upper back 4.5% All of right arm 9% All of head 9%

19. What are the two most important complications of severe burns and why does each occur?

20. Loss of fluids & electrolytes (causing kidney malfunction & shock) Infection

21. There a three main types of skin cancers, defined by the type of cell from which they arise. Basal cell carcinoma – arise from the basal edge of the epithelial tissue. Squamous cell carcinoma – arise from the keratin- producing cells in the middle of the epithelial tissue. Melanoma – arise from the melanin-producing cells at the basal edge of the epithelial tissue Excess sun exposure increases the risk of each of these cancers

22. Most common form of skin cancer Affects ~2.8 million people in the US each year Slow-growing and rarely fatal

23. Second most common form of skin cancer Affects ~700,000 people in the US each year Grow and invade surrounding tissue quickly <5% are fatal

24. Third most common skin cancer Affects ~76,000 people in the US each year Quickly metastasizes (spreads) to blood vessels and lymph nodes – which allows it to spread to other locations in the body Fatal in more than 10% of cases Melanoma may be the least common type of skin cancer, but it is by far the most deadly. Moreover, while rates of most other cancers are declining in the US (due to a reduction of smoking) melanoma rates are increasing.

25. What were our objectives today? How did we meet them? What was our learner profile trait and how did we use it? How does what we did today address our unit objective? Homework: Homework: Study for Quiz !