definition of burn

1. MD. Golam Kibria
BSN(DU), B.COM, MPH
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2. BURN
A. Definition:
Cell destruction of the layers of the skin and the resultant
depletion of fluid and electrolytes.
B. Types of burns: According to mechanism
1.Thermal burns
2.Chemical burns
3.Electrical burns
4.Radiation burns
C. Types of burn:
Burn is typically divided into three major categories-
1.First degree or superficial burn
2.Second degree or partial thickness burn
3. Third degree of full thickness burn in which structure
beneath the skin is definitely affected .
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3. D. Methods to estimate extent of burn
injury :
(rules of nine)
a. Head and neck-9%
b. Anterior trunk-18%
c. Posterior trunk-18%
d. Arms(9%)-18%
e. Legs(18%)-36%
f. Perineium-1%
E. Factors determination the severity of a
burn:
a) Depth of burn
b) Size of burn(percentage of body
surface area)
c) Part of body burned
d) Age
e) Past medical history
f) Cause of burn
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4. SIGNS AND SYMPTOMS:
Signs symptoms of burn develop of depth of the burn as well as extent of
the area-
1st degree burn:
1. Epidermises are affected
2. Skin becomes pink or red colour
3. It may form small thin blister
4. Usually heal itself within 3 to 7 days
2nd degree burn:
1. Part of the skin damaged or destroyed
2. Epidermis and dermis both are affected
3. Thicken walled blister appear all over the burned area
4. The underlying tissue is deep red in colour and is usually wet and shiny
appearance.
5. Healing is requiring form 21 to 28days
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5. 3rd degree burn:
1. Epidermis and dermis both are destroyed and
underlying structure, like tissue, muscle ,bones may be
involved.
2. The appearance of this burn may vary .The colour may
be deep red, white, black or brown.
3. Usually this type of burn appears dry. It requires
grafting procedure.
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6. EMERGENCY MANAGEMENT:
1. Remove constricting jewelery and clothing.
2. Cover burns with sterile on clean cloths.
3. In case of chemical burn, clothing which has been socked
by the chemical agent must be removed immediately.
4. Assess for associated trauma.
5. Evaluate the degree and extent of the burn and treat life –
threatening condition.
6. Ensure a patient airway and administer 100% oxygen as
prescribed, if the burn occurred in an enclosed area.
7. Monitor for respiratory distress.
8. Initiate peripheral IV access to non-burned skin proximal
to any extremity burn.
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7. 9. Assess for hypovolemia and prepare to administer IV
fluids to maintain fluid balance.
10. Monitor vital signs closely
11. Insert a foley’s catheter as prescribed, and maintain
urine output at 30 to 50 ml per hour.
12. Maintain NPO status.
13. Insert a nasogastric (NG) tube as prescribed, to
prevent paralytic ileus, to prevent vomiting, and to
reduce the risk of aspiration.
14. Administer tetanus prophylaxis as prescribed.
15. Administer pain medication, as prescribed, by the IV
route.
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8. 16. Administer prophylactic antibiotic, as prescribed.
17. Administer wound care, as prescribed, which may
include cleansing, debriding loose tissue, and
removing any damaging agents, followed by the
application of topical antimicrobial cream and a
sterile dressing.
18. The goal is to prevent shock by maintaining
adequate circulating blood volume and maintaining
vital organ perfusion.
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9. COMPLICATION:
1. Shock
2. Cardiac arrest
3. Infection
4. Post burn contracture
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