This document provides information on burns, including:
- Burn epidemiology statistics showing they are the second leading cause of trauma deaths.
- An overview of skin anatomy and the different layers (epidermis, dermis, subcutaneous tissue) affected by burns of varying depths.
- Descriptions of superficial, partial thickness, and full thickness burns based on the skin layers involved and appearance.
- Methods for estimating burn extent, including the Rule of Nines and Rule of Palm.
- Considerations for management of burns including stopping the burning process, assessing airway/breathing/circulation, treatment of the burn wound, and indicators for advanced life support.
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Burns ppt
1. MAHARAJ VINAYAK GLOBAL UNIVERSITY
Jaipur Nursing College
Subject: Medical Surgical Nursing
Topic: Burns
Presented By
Mr. Kailash Chandra Saini
Assistant Professor
1
4. 4
Skin Form & Function
īŽ Largest body organ
īŽ More than just a passive covering
īŽ Functions:
ī¨Sensation
ī¨Protection
ī¨Temperature regulation
ī¨Fluid retention
10. 10
Superficial Burns
īŽ Superficial (First degree)
ī¨ Involves only epidermis
ī¨ Red
ī¨ Painful
ī¨ Tender
ī¨ Blanches under pressure
ī¨ Possible swelling, no blisters
ī¨ Heal in ~7 days
11. 11
Partial Thickness Burns
īŽ Partial Thickness
(Second degree)
ī¨ Extends through
epidermis into dermis
ī¨ Salmon pink
ī¨ Moist, shiny
ī¨ Painful
ī¨ Blisters may be present
ī¨ Heal in ~7 to 21 days
13. 13
Full Thickness Burns
īŽ Full Thickness (Third degree)
ī¨ Through epidermis, dermis
into underlying structures
ī¨ Thick, dry
ī¨ Pearly gray or charred
black
ī¨ May bleed from vessel
damage
ī¨ Painless
ī¨ Require grafting
14. 14
Burn Depth
īŽ Often cannot be accurately
determined in acute stage
īŽ Infection may convert to higher
degree
īŽ When in doubt, over-estimate
23. 23
Critical Burns
īŽ Full-thickness burns involving hands, feet,
face, upper airway, genitalia, or
circumferential burns of other areas
īŽ Full-thickness burns covering more than
10% of total body surface area
īŽ Partial-thickness burns covering more than
30% of total body surface area
īŽ Burns associated with respiratory injury
24. 24
Critical Burns, continued
īŽ Burns complicated by fractures
īŽ Burns on patients younger than 5 years old or
older than 55 years old that would be classified
as moderate on young adults
25. 25
Moderate Burns
īŽ Full-thickness burns involving 2% to 10% of total
body surface area excluding hands, feet, face,
upper airway, or genitalia
īŽ Partial-thickness burns covering 15% to 30% of
total body surface area
īŽ Superficial burns covering more than 50% of
total body surface area
26. 26
Minor Burns
īŽ Full-thickness burns involving less than 2% of
the total body surface area
īŽ Partial-thickness burns covering less than 15%
of the total body surface area
īŽ Superficial burns covering less than 50% of the
total body surface area
27. 27
Associated Factors
īŽ Patient Age
ī¨< 5 years old
ī¨> 55 years old
īŽ Burn Location
ī¨Circumferential burns of chest, extremities
30. 30
Stop Burning Process!
īŽ Remove patient from source of
injury
īŽ Remove clothing unless stuck
to burn
īŽ Cut around clothing stuck to
burn, leave in place
31. 31
Assess Airway/Breathing
īŽ Start oxygen if:
ī¨Moderate or critical burn
ī¨Decreased level of consciousness
ī¨Signs of respiratory involvement
ī¨Burn occurred in closed space
ī¨History of CO or smoke exposure
īŽ Assist ventilations as needed
32. 32
Assess Circulation
īŽ Check for shock signs /symptoms
Early shock seldom results from effects of
burn itself.
Early shock = Another injury until proven
otherwise
33. 33
Obtain History
īŽ How long ago?
īŽ What has been done?
īŽ What caused burn?
īŽ Burned in closed space?
īŽ Loss of consciousness?
īŽ Allergies/medications?
īŽ Past medical history?
34. 34
Rapid Physical Exam
īŽ Check for other injuries
īŽ Rapidly estimate burned,
unburned areas
īŽ Remove constricting bands
35. 35
Treat Burn Wound
īŽ DO NOT apply ointments or creams
īŽ Superficial Burn:
ī¨Cool, moist dressings
ī¨Protect from exposure to air
īŽ Partial/Full Thickness Degree Burns:
ī¨Cover with dry dressing (commercial burn
sheets are acceptable)
36. 36
Pediatric Considerations
īŽ Thin skin, increased severity
īŽ Large surface to volume ratio
īŽ Poor immune response
īŽ Small airways, limited respiratory reserve
capacity
īŽ Consider possibility of abuse
37. 37
Burns in Infants and Children
īŽ Critical Burns:
ī¨ Full-thickness burns covering > 20% of BSA
ī¨ Burns involving hands, feet, face, upper airway,
genitalia
īŽ Moderate Burns:
ī¨ Partial-thickness burns 10%-20% of BSA
īŽ Minor Burns:
ī¨ Partial-thickness burns < 10% of BSA
46. 46
Management
īŽ Remove chemical from skin
īŽ Liquids
ī¨Flush with water
īŽ Dry chemicals
ī¨Brush away
ī¨Flush what remains with water
47. 47
Chemical Burns
īŽ Occur whenever a
toxic substance
contacts the body
īŽ Eyes are most
vulnerable.
īŽ Fumes can cause
burns.
īŽ To prevent
exposure, wear
appropriate gloves
and eye protection.
48. 48
Care for Chemical Burns
īŽ Remove the
chemical from the
patient.
īŽ If it is a powder
chemical, brush
off first.
īŽ Remove all
contaminated
clothing.
49. 49
Care for Chemical Burns, cont'd
īŽ Flush burned area
with large amounts of
water for about 15 to
20 minutes.
īŽ Transport quickly.
50. 50
Specific Chemical Burns
īŽ Phenol
ī¨Not water soluble
ī¨Flush with alcohol
īŽ Sodium/Potassium/Magnesium
ī¨Explode on water contact
ī¨Cover with oil
51. 51
Specific Chemical Burns
īŽ Tar
ī¨Use cold packs to solidify tar
ī¨Do NOT try to remove
ī¨Tar can be dissolved with organic
solvents later
52. 52
Chemical Burns to the Eye
īŽ Hold open eyelid
while flooding eye
with cold water.
īŽ Continue flushing
en route to
hospital.
īŽ Do not use other
chemicals
54. 54
Considerations:
īŽ Intensity of current
īŽ Duration of contact
īŽ Kind of current (AC or DC)
īŽ Width of current path
īŽ Types of tissues exposed (resistance)
55. 55
Electrical Burns
īŽ Non-conductive injuries:
ī¨Arc burns
ī¨Ignition of clothing
īŽ Conductive injuries:
ī¨âTip of Icebergâ
ī¨Entrance/exit wounds may be small
ī¨Massive tissue damage between entrance/exit
57. 57
Other Complications
īŽ Cardiac arrest/arrhythmias
īŽ Respiratory arrest
īŽ Spinal fractures
īŽ Long bone fractures
īŽ Internal organ damage
58. 58
Electrical Burn Management
īŽ Make sure power is
off before touching
patient.
īŽ Check ABCS
īŽ Two wounds to
bandage.
īŽ Transport patient
and be prepared to
administer CPR.
59. 59
ALS Indicators
īŽ Possible airway involvement including singed
facial hair, soot in mouth/nose, or hoarseness
īŽ Burns with injuries: shock, fractures, or
respiratory problems
īŽ Partial or full thickness burns to the face
īŽ Partial or full thickness burns > 20% BSA
īŽ Severe pain (ALS pain control)