Burns Assessment Management 1Objectives2Understand types of BurnsUnderstand the pathophysiology of the BurnsUnderstand Rule of NineUnderstand Classification of Burns Identify best practices in home c ID: 860211
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1 Burns A Comprehensive Review Assessmen
Burns A Comprehensive Review Assessment & Management 1 Objectives 2 ▪ Understand types of Burns ▪ Understand the pathophysiology of the Burns ▪ Understand Rule of Nine ▪ Understand
2 Classification of Burns ▪ Identify b
Classification of Burns ▪ Identify best practices in home care setting for the management of patients with Burns Statistics 3 ▪ Burn Injuries Receiving Medical Treatment: 450,000 Pat
3 ients in 2013. ▪ Fire/Burn/Smoke Inha
ients in 2013. ▪ Fire/Burn/Smoke Inhalation Deaths Per Year in USA : 3,400 ▪ Hospitalizations Related to Burn Injury: 40,000 in 2013 ▪ Survival Rate: 96.6% | Gender : 69% male
4 - 31 % female ▪ Ethnicity: 59% Cauc
- 31 % female ▪ Ethnicity: 59% Caucasian, 20% African - American, 14% Hispanic, 7% Other ▪ Admission Cause: 43% fire/flame, 34% scald, 9% contact, 4% electrical, 3% chemical, 7% oth
5 er ▪ Place of Occurrence: 72% home,
er ▪ Place of Occurrence: 72% home, 9% occupational, 5% street/highway, 5% Recreational/Sport, Definition 4 Burns are injuries to tissues caused by heat, friction, electricity, radiat
6 ion, or chemicals Classification of Bur
ion, or chemicals Classification of Burns 5 1. Thermal Burns – caused by exposure to excessive heat. 2. Electrical Burns – caused by direct contact with electricity. 3. Chemical Burns
7 – caused by contact with chemicals.
– caused by contact with chemicals. Burn Victim 6 Types of Burns 7 Superficial ( 1 st degree) Partial thickness ( 2 nd degree) Full thickness ( 3 rd degree ) Full thickness (4 th degree)
8 Types of Burns • Includes only the out
Types of Burns • Includes only the outer layer of skin, the epidermis •Skin is usually red and very painful •Equivalent to superficial sunburn without blisters Dry in appearance •He
9 aling occurs in 3 - 5 days, injured epit
aling occurs in 3 - 5 days, injured epithelium peels away from the healthy skin •Hospitalization is for pain control and maybe fluid imbalance 8 Superficial ( 1st degree ) Types of Burns
10 9 Superficial ( 1st degree ) Types of B
9 Superficial ( 1st degree ) Types of Burns 10 Second degree : Partial Thickness • Blisters can be present • Involve the entire epidermis and upper layers of the dermis • Wound will
11 be pink, red in color, painful and wet a
be pink, red in color, painful and wet appearing • Wound will blanch when pressure is applied • Should heal in several weeks (10 - 21 days) without grafting, scarring is usually minimal
12 Types of Burns 11 Second degree : Full
Types of Burns 11 Second degree : Full Thickness • Can be red or white in appearance, but will appear dry. • Involves the destruction of the entire epidermis and most of the dermis
13 • Sensation can be present, but dimin
• Sensation can be present, but diminished • Blanching is sluggish or absent • Full thickness will most likely need excision & skin grafting to heal Types of Burns 12 Second degree
14 : Partial Thickness Types of Burns 13
: Partial Thickness Types of Burns 13 Second degree : Full Thickness Types of Burns 14 Third degree : • All layers of the skin is destroyed •Extend into the subcutaneous tissues •
15 Areas can appear, black or white and wil
Areas can appear, black or white and will be dry •Can appear leathery in texture •Will not blanch when pressure is applied •No pain Types of Burns 15 Third degree Types of Burns 16 Thi
16 rd degree Types of Burns 17 Fourth degre
rd degree Types of Burns 17 Fourth degree Full thickness burn extends into muscle and bone. Types of Burns 18 Fourth degree Rule of Nine 19 The most accurate way to estimate the amount of
17 tissue injury following a burn is to me
tissue injury following a burn is to measure the extent of the body surface burned. The "Rule of Nines" method is a simple and reasonably reliable guide in which the various parts of the
18 body are divided into surface areas of
body are divided into surface areas of 9% each (or multiples of 9%). Burns which cover 20% or more of the body surface can be fatal without treatment. Rule of Nine 20 Total Body Surface
19 Area (TBSA) Can you evaluate the TBSA? B
Area (TBSA) Can you evaluate the TBSA? Burn Care 21 Stop the Burning Process | Remove smoldering clothing | Brush off dry chemicals |Irrigate liquid chemicals Airway Intubate severe fac
20 ial burns and severe smoke inhalation En
ial burns and severe smoke inhalation Endotracheal tube 7.5mm or greater (in adults) Breathing Humidified 02 for possible carbon monoxide poisoning Circulation Remove constricting clothing |
21 Secure large - bore IV access, use sut
Secure large - bore IV access, use suture instead of tape Start IV fluids | Place foley to monitor urine output Disability Examine eyes for injury – irrigate as needed for possible che
22 mical injury or foreign body Perform a d
mical injury or foreign body Perform a detailed neurologic exam for electrical injuries Calculate burn size score | Keep patient warm Burn Care 22 Apply Clean , dry dressings Tetanus proph
23 ylaxis Keep patient warm Common Treatmen
ylaxis Keep patient warm Common Treatment 23 ▪ Vaseline Gauze ▪ Xeroform Gauze ▪ Topical Antibiotic Ointments ▪ Silver Sulfadiazine ▪ Sulfamylon Cream ▪ Biafine Cream ▪ Medical