Burns are tissue damage that results from heat, overexposure to the sun or other radiation, or chemical or electrical contact. Burns can be minor medical problems or life-threatening emergencies. The treatment of burns depends on the location and severity of the damage.
2. INTRODUCTION
Burn injuries occurs when energy from heat source is
transferred to the tissues of the body.
Heat may be transferred through conduction or
radiation.
A scald is burn injury caused by contact with hot liquid
or steam but the term ‘burn’ is often used to include
scald.
Most burns only affects skin. Disruption of skin can
lead to increased fluid loss, infection, hypothermia,
scarring, changes in appearance and body image.
3. DEFINITION
Injuries that results from direct contact with or
exposure to any thermal, chemical, electrical, or
radiation sources are termed as BURNS.
Damage to skin or tissues caused by heat, flame, or
steam.
7. •FIRST DEGREE BURNS:
o It involves only
epidermis.
o Tissue will blanch with
pressure.
o It produces pink to
reddish colour on
burned skin.
o Involves minimal tissue
damage.
o S&S: redness, pain,
swelling
8. •SECOND DEGREE BURNS:
o It involves epidermis and
portion of dermis.
o Often involves other structures
such as sweat glands, hair
follicles.
o bright red and Blisters are
produced.
o Oedema, decreased blood
flow to tissue can lead to third
degree burn
o S&S: severe pain, swelling,
blisters
o Healing time: depend on
9. •THIRD DEGREE BURNS:
o It involves epidermis, dermis
and hypo-dermis.
o Both dermis and epidermis are
destroyed.
o They produce deep scars.
o Sometimes nerves ending also
may destroyed.
o S&S: charred skin or translucent
white skin with coagulated
vessels, pain may or may not
present.
o Healing time: depend on
severity. It needed to be treated
10. •FOURTH DEGREE BURNS:
o It involves deep injuries to
muscle, bone, tendons.
o These may occur with deep
flame, electrical or chemical
injuries.
o S&S: wound may become
blackened, depressed and
sensation is absent.
o If extremity is involved,
amputation is required.
21. SUBSEQUENT MANAGEMENT
FIRST AID
PREVENTION OF SHOCK AND RESPIRATORY
DISTRESS
WOUND ASSESSMENT AND WOUND CARE
PREVENTION OF COMPLICATIONS AND
INFECTION
NUTRITIONAL SUPPORT
REHABLITATION
FUNCTIONAL AND COSMETIC
RECONSTRUCTIONS
22. FIRST AID FOR BURN INJURY:
If the skin is not broken, run cool water over the burned
area or soak it in a cool water bath.
Reassure the victim and keep calm.
Cover the burn with sterile non-adhesive Bandage.
Protect burn from friction and pressure.
Over the counter pain medications may be used to help
relieve pain , that also help to reduce inflammation and
swelling.
Make sure that victim is breathing. If the breathing has
stopped or the victims airway is blocked then open airway
and if necessary begin CPR.
Do not use blanket and towel.
Avoid breaking blisters.
23. DO NOT:
Do not apply ointment, butter,
medications, fluffy cotton dressings, ice,
adhesive bandages, cream, oil, or any
household remedy to burns.
Do not allow the burn to become
contaminated. Avoid breathing and
coughing on burned area.
Do not disturb blisters or dead skin.
24. AIRWAY MANAGEMENT:
• Persons who are burned on face and neck or those
who inhaled flame, steam or smoke should be
observed closely for laryngeal oedema and airway
obstruction.
• For mild pulmonary injury, inspired air is humidified
patient is encouraged to cough so that secretions
removed by suctioning.
• For severe injury, it is necessary to remove
secretions by bronchial suctioning and to administer
bronchodilators , mucolytic agents.
• Early management may required intubation and
ventilation.
• Elevation of head and chest by 20-30 degree to
25. HYPERBARIC OXYGEN
THERAPY(HBOT):
It is non-invasive mode of medical treatment.
In which the patient is entirely enclosed in a pressure
chamber filled with oxygen at a Pressure greater than
atmosphere.
Topical hypererobic oxygen therapy techanique
includes delivering 100% oxygen directly to an open,
moist wound at a pressure slightly higher than
atmospheric pressure through special devices.
It is specially used in also used in the treatment of
smoke inhalation. CO has a high affinity to hemo-
globin and when it is inhaled it will bind to hemo-globin
forming compound called carboxy-hemoglobin, this will
lead to hypoxia and decreases oxygen delivery to
26. FLUID MANAGEMENT:
Fluid loss is best immediately replaced through
two large caliber peripheral intravenous
catheters. An indwelling foley catheter is inserted
to monitor urine output accurately.
Adult with >15% of burns and child with >10% of
burns BSA requires fluid resuscitation.
*All resuscitation formulae should be delivered
as a goal directed therapy to prevent the
complications of hypovolemic shock and over-
hydration.
27. WOUND MANAGEMENT:
The wound is one of cause of morbidity and
mortality of burn injuries. Until the wound is
healed, patient remains at risk of complications.
GOALS of wound care:
Cleanse wound & eliminate dead tissues and
debris.
Prevent further destruction of viable skin.
Provide for patient comfort.
• Wound dressings.
29. DERMABRASION:
It is the surgical procedure to
improve appearance of scars,
restore function and correct
disfigurement of injury.
It is used to smooth scars
tissue by shaving or scarring off
the top layers
Scars are permanent but their
appearance will improve.
The procedure may be
performed in a dermatological
surgeon’s office or in a out-
30. SKIN GRAFTS:
It is a surgical procedure in
which piece of skin from one
area to another area.
Skin from another person or
animal is used to cover only
large burned areas.
The skin is taken from donor’s
site, which was healthy skin
implanted at damaged recipient
site.
That is performed under general
sanesthesia.
This time may be 3 weeks or few
months.
31. ROLE OF NURSE IN BURN
MANAGEMENT:
RESTORING NORMAL FLUID BALANCE
PREVENTION OF INFECTION
MAINTAIN ADEQUATE NUTRITION
PROMOTING SKIN INTEGRITY
RELIEVING PAIN AND DISCOMFORT
PROMOTING PHYSICAL MOBILITY
STRENGTHENING COPING STRATEGIES
SUPPORTING PATIENT AND FAMILY
32. NURSING MANAGEMENT:
NURSING ASSESSMENT:
Assess airway, breathing, circulation, disability,
exposure and need for fluid resuscitation.
Assess severity and conscious level.
Assess for associated injuries.
Assess for any pre-existing illness, drug therapy,
allergies.
Establish patient’s tetanus immunization
Body surface area burned: rule of nine.
Depth of burn
Circumferential extremity burns
34. ROLE OF NURSE IN
REHABILITATION:
Promoting activity intolerance
Schedule care in a way that each person has a
periods of uninterrupted sleep.
A good time is planned for rest, after the stress of
dressing changes and exercise.
Improving body image and self concept
Assess the patient concern about body images
and can refer to support group.
Help patients practice their responses to people
who may stare or inquire about their injury once
they are discharged from the hospital.
35. CONTINUE...
Monitoring and managing potential
complications
Contracture may main complication which may
come after the recovery of burns.
It may be minimized by doing or applying range
of motion exercises.
Although there is a procedure escharotomy to
make patient relieve from scars.
36. PREVENTION OF BURN
INJURY:
IN GENERAL:
Keep matches, lighters, chemicals and lit candles out of
kid’s reach.
Put child’s safety covers on all electrical outlets.
Make sure especially when using irons and curl irons.
Prevent house fires by making sure you have smoke
alarm in every level of your home and in each bedroom.
Check these monthly and change it.
IN BATHROOM:
Set thermostat in your hot water heater to 120 degree
farenheit, or use low medium setting.
Always test bathwater with your elbow before use.
Turn kids away from fixtures so they are less likely to
37. CONTINUE...
IN KITCHEN:
Turn pot handles toward the back of the stove.
Never let child use walker in kitchen.
Avoid using tablecloth that can pull hot drink or plate on
them.
Keep hot drinks and foods out of reach of children.
Never drink hot beverages when child is sitting in your lap.
Never hold baby while cooking.
OUTSIDE/IN THE CAR:
Use playground with caution. If it’s very hot outside, use
equipment only in morning.
If you leave your car seat and stroller in sun then when you
are using cover it with blanket or towel.
Don’t forget to apply sunscreen when going outside. Use
product with SPF 15 or higher.