1. Kathy Sheriff, RN, BSN

2. Definition  Tissue damage caused by intense heat, electricity, radiation, or certain chemicals, all of which denature cell proteins and cause cell death in the affected areas

3. Severe Burns  Life threatening  Extreme loss of body fluids  Proteins and electrolyte imbalance 1000s of extra calories needed IV or gastric tube feeding  Kidneys shutdown  Circulatory shock  Infection Risk/ Sepsis

4. Immediate Treatment  Replace lost body fluids  IV STAT

5. Burn Charts for BSA  Rule of Nines for adults and Lund- Browder for children  Burns are critical >25% 2 nd degree burns >10% 3 rd degree burns 3 rd degree burns of the face, hands, or feet

6. (A) Rule of nines (for adults) and (B) Lund-Browder chart (for children) for estimating extent of burns. (Redrawn from Artz CP, JA Moncrief: The Treatment of Burns, ed. 2. Philadelphia, WB Saunders Company, 1969; used with permission.)

7. First Degree Burns  Epidermis  Localized redness, swelling, and pain  Heals in a few days  Sunburn

8. Second Degree  Partial thickness  Epidermis and upper region of dermis  Symptoms of first degree plus blisters/bullae  Repair in 3 to 4 weeks as long as infection is prevented

9. Third Degree  Full-thickness  Entire area of skin involved  Gray-white, cherry red, or blackened  No pain  Initially little or no edema  Skin grafting  Debridement of eschar  Extensive scarring

15. Resources  http://www.merckmanuals.com/professio nal/injuries_poisoning/burns/burns.html# v1112906 http://www.merckmanuals.com/professio nal/injuries_poisoning/burns/burns.html# v1112906  http://www.nlm.nih.gov/medlineplus/ency /imagepages/19575.htm http://www.nlm.nih.gov/medlineplus/ency /imagepages/19575.htm  http://www.mayoclinic.com/health/medic al/IM04388 http://www.mayoclinic.com/health/medic al/IM04388