Ch11 presentation burns

Chapter 11Burns

Burns

• Burns occur in every age group and in a variety of settings.

• Skin death and injury occur as heat exceeds the body’s ability to disperse it.– Damage depends on:

• Intensity of heat• Duration of contact• Thickness of skin

Burn Classifications

• Thermal burns− Caused by:

• Flames• Hot objects• Flammable vapor• Steam• Hot liquids

Burn Classifications

• Chemical burns− Caused by wide range of chemicals

• Acids• Alkalis• Organic compounds

Burn Classifications

• Electrical burns– Caused by contact with electric current– Injury depends on:

• Type of current• Voltage• Area exposed• Duration of contact

Evaluating a Thermal Burn

• Determine depth of burn.– First-degree (superficial)– Second-degree (partial-thickness)– Third-degree (full thickness)

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© American Academy of Orthopaedic Surgeons. © American Academy of Orthopaedic Surgeons.

Evaluating a Thermal Burn

• Determine the extent of the burn.– Estimate how much body surface area (BSA)

the burn covers.– The rule of nines

© Jones & Bartlett Learning.

Evaluating a Thermal Burn

• Determine the extent of the burn (cont’d).− The rule of the hand

• A hand represents about 1% of a person’s total body surface.

© Jones & Bartlett Learning.

Evaluating a Thermal Burn

• Determine which parts of the body are burned.– Burns on the face, hands, feet, and genitals

are the most severe.– Circumferential burns are more severe than

noncircumferential burns.

Evaluating a Thermal Burn

• Determine respiratory involvement.– Superheated air can be absorbed by the

upper respiratory tract.– Swelling occurs in 2 to 24 hours.

• Restricts or shuts off airway

Evaluating a Thermal Burn

• Determine:– Whether other injuries exist– Preexisting medical problems– If the person is older than 55 years– If person is younger than 5 years

Evaluating Thermal Burns

• Determine the burn’s severity.

First Degree (Superficial) Burns

• What to look for:– Redness– Mild swelling– Tenderness– Pain

First Degree (Superficial) Burns

• What to do– Apply cold water or

compress.– Give ibuprofen.– Elevate arm or leg.– Have the person

drink water.– Apply aloe vera or

other lotion.© Jones & Bartlett Learning.

Small Second-Degree(Partial Thickness) Burns

• What to look for:– Blisters– Swelling– Weeping of fluids– Severe pain

• What to do:– Follow the first

three steps for first degree burns.

– Apply antibacterial ointment.

– Cover with a loose, dry, nonstick, sterile dressing.

Large Second-Degree(Partial Thickness) Burns

• What to do– Follow the first three steps for first-degree

burns.– Apply cold.

• Monitor for hypothermia.– Call 9-1-1.

Third-Degree (Full Thickness) Burns

• What to look for– Dry, leathery, gray colored, or charred skin.

• What to do– Cover burn with a dry, nonstick sterile

dressing.– Call 9-1-1.

Later Care for Thermal Burns

• Follow physician’s recommendations.• Suggestions:

– Wash hands before changing dressing.– Leave unbroken blisters intact.– Change dressings daily.– Watch for signs of infection.– Elevate burn for first 24 hours.– Give pain medication, if necessary.

Scald Burns

• The result of contact with hot liquids– Immersion burns: area of the body is fully

immersed in a hot liquid.– Spill burns: liquid spills, drops, or is thrown on

a person.

Sunburn

• The skin’s response to the trauma of ultraviolet radiation

• Can result in first- or second-degree burns

© E. M. Singletary, MD.Used with permission.

Care for Sunburns

• Apply cool compress for up to 45 minutes.• Take cool showers and baths.• Do not use benzocaine.• Use ibuprofen to reduce pain and

inflammation.• Drink a lot of water.• Use aloe vera or another body lotion.

Sunburn Aftercare

• Apply antibiotic ointment to a second-degree sunburn.

• If blisters break, gently wash twice daily.• Seek medical care if eyes are affected or

if infection occurs.

Chemical Burns

• Result of an acid or an alkali substance touching the skin

• Chemicals burn as long as they are in contact with skin.

• Check the safety data sheet, if available.

Chemical Burns

• What to look for– Pain– Burning– Breathing difficulty– Eye pain or vision

change

© American Academy of Orthopaedic Surgeons.

Chemical Burns

• What to do– Brush dry chemical

off skin.– Flush burn with

large amounts of water for at least 20 minutes or until EMS arrives.

– Call 9-1-1.© Jones & Bartlett Learning.

Chemical Burns

• What to do (cont’d)– For a chemical in an eye

• Tip head so affected eye is below nose.• Wash eye with warm water from nose out to side

of face for at least 20 minutes.

Electrical Burns

• Thermal burn (flame)• Arc burn (flash)• True electrical injury (contact)

© Chuck Stewart, MD.

Contact With Outdoor Power Line

• Power must be turned off.• A tingling sensation signals that you are on

energized ground.– Raise one foot off ground, turn around, and

hop to safe area.• Do not attempt to move any wires.

Contact Inside Buildings

• Turn off electricity.• Unplug appliance.• Do not touch

appliance or person until current is off.

• Damage occurs under skin.

© Jones & Bartlett Learning.

Electrical Burns

• What to look for– Burn wound, which might appear small– Entrance and exit wounds– Multiple burns– Absent breathing/pulse

Electrical Burns

• What to do– Check breathing.– Call 9-1-1.– Check for broken bones.– Treat the person for shock.– Cover wounds with sterile dressings.