2. Burns
Classifications According to DEPTH
• 1st degree redness, epidermis
• 2nd degree blisters, dermis
• 3rd degree charred, subcutaneous
Determine the depth!!
What are the causes?
3.
4. Burn Severity
Determine extent of burned area!!
Remember the Rule of Nines
Adult Child
Anatomic structure Surface area Anatomic structure Surface area
Head 9% Head 18%
Anterior Torso 18% Anterior Torso 18%
Posterior Torso 18% Posterior Torso 18%
Each Leg 18% Each Leg 14%
Each Arm 9% Each Arm 9%
Perineum 1% Perineum 1%
6. Burn Severity
Look for complicating factors!!
• Below 5 years old (fluid loss)
• Above 55 years old (delayed healing)
• Diabetes (delayed healing)
• CVD (hypoperfusion)
7. BURN SEVERITY CLASSIFICATION
CRITICAL
• 3rd degree burn involving hands, feet, face, or genitals
• 3rd degree burns covering more than 10%
• 2nd degree burns covering more than 20%
• burns encompassing a body part
MODERATE
• 3rd degree burns covering 2%-10%
• 2nd degree burns covering 10%-20%
• 1st degree burns greater than 50%
8. FIRST AID
• Stop the burning process (HOW?)
• Remove clothing / jewelry
• Transport if critical / moderate
• Do not drain the blisters
• Take analgesic
• Cover with “burn sheet”
10. Epidemiology (Rabies)
• Incidence rate:
– 5–7/million
– Average cases: 326 annually (Phil.)
– Philippine is 4th worldwide
– San Lazaro Hospital:
• Pet dogs – 88% of cases
• Stray dogs – 10% of cases
• Cats – 2% of cases
11. Transmission
• Incubation periods (Human):
– 1 days to 5 yrs. (average 8wks)
– Variations:
1. Severity of the bite
2. Site of bite in relation to nerve supply and
distance from CNS
3. Size of innoculum, protection offered by
clothing and other factors
4. Age and immune status of the host
12. Transmission
• Virus stays in:
1. CNS
2. Liver
3. Salivary gland
• Travels thru the nerve
• Incubation periods:
– 1 days to 5 yrs. (average 8wks)
13. Snake Bites? . . . Look for . . .
• Check the puncture marks
• Pain, redness, swelling at bite mark
• Breathing difficulty
• Blurred vision
• Numbness
14. What next?
• Keep the victim still and calm
• Decrease blood flow to bitten area
• Wash the wound and cover
• Transport the victim
• Keep the victim awake
• Apply a tourniquet when necessary
• Do not suck out the venom
16. Antivenin Therapy
• Antivenin dose depends on the severity of
envenomation and administered over 2-
4hrs.
Grade I = No antivenin
Grade II = 3-4 amp. in 500ml
Grade III = 5-15amp. in 500ml
• Pt re-evaluated every 2hrs and if
necessary a repeat dose of antivenin
should be evaluated and given.
17. Antivenin Therapy
• Children: antivenin be increased by
50% bec. of higher rate of venom to
body mass.
• Pregnancy is not contraindicated
• Antivenin for coral snake bite should be
initiated even if envenomation is only
suspected for there are frequently no local
manifestation
18. Insect Stings
Bees and wasp stings
contain chemicals
such as histamine and
other enzymes that
destroy collagen fibres
and tissue death!
19. Marine Stings
The most common form
of envenomation is
through stinging cells
called nematocysts.
The deadliest of such
animals are the box
jellyfish and the man-o-
war.
20. What to do with stings?
• redness
• pain
For Mild Allergic Reaction,
• swelling take anti-histamine and put
• itching a cold pack on the skin.
• nausea
• allergic reaction
** worst case scenario is anaphylaxis
21. Allergy is an exaggerated immune
response to a foreign substance which has
been introduced through the skin, GI tract,
or the respiratory tract.
Sometimes (around
5%) people would
exhibit severe
allergic reactions
which is called
anaphylaxis.
22. Anaphylactic Reaction
• Itching and
burning
• Widespread
urticaria
• Swelling of the
lips and tongue
• Bronchospasm
• Hypotension
Anaphylaxis is a life threatening condition!!
23. First Aid for Anaphylaxis
Inject EPINEPHRINE immediately - it will
buy you 15-20 minutes then transport to
nearest hospital.
28. Ingested Poison
• Food Poisoning
– Shellfish
– E. Coli
– Salmonella
– Botulism
– Heavy Metal
• Household Chemicals
• OTC Drug Overdose
• Alcohol
29. First Aid for Ingested Poison
• Get critical info
1. age / weight
2. type of poison
3. dose and time
• Assess ABCs
• Lie on left side
• Give activated
charcoal if instructed
30. Inhaled Poisons
Carbon Monoxide
- tasteless, colorless, odorless
- binds to hemoglobin
Signs to look for . . .
- altered state of consciousness
- pink/rosy skin complexion
What is the appropriate first aid?
31. Injected Poisons
• Envenomation
- stings
Transport to closest
- snake bites medical facility!!
• Drug Overdose
- narcotics Check vital signs
- stimulants frequently!
- hallucinogens
32. Absorbed Poisons
Look for . . . In June 2004, 25 Russian soldiers
- powder on the skin became ill from thalliumof
when they found a can
exposure
- burns mysterious white powder in a
rubbish dump on their base.
- itching / irritation Oblivious to the danger of misusing
- redness and rashes an unidentified white powder from
a military dump site, they added it
to tobacco, and used it as a
substitute for talcum powder on
What to do? their feet.
