Burns are skin injuries caused by heat, flames, electricity, chemicals, friction, or sunlight. The severity depends on the depth of injury - first degree burns involve the outer layer of skin while third degree burns extend deeper. Proper burn care includes stopping the burning, removing clothing, ensuring an open airway, cooling the burn, treating for shock, preventing infection, managing pain, and addressing physical and emotional needs during recovery.

3. Burn
Burns are skin injuries resulting
from heat, Flame, electric current,
chemicals, friction, or excessive
sunlight exposure. Based on the
standard depth of injury.

4. skin

5. Anatomy of skin
1. Human skin is divided into two layers
a. epidermis (outermost)
b. dermis ( innermost)
2. separated by basement membrane (BM)
3. A layer of loose connective tissue
beneath the dermis called
hypodermis, or subcutis

6. The Skin Overview

7. The Human Skin
1. Average about 3000 square inches
or 2 square meters.
2. Weighs about 6 pounds (15% of BW)
3. The largest organ
4. Receives 1/3 of the body’s blood volume
5.Varies in thickness (0.5mm~6mm)
6. constantly being renewed (26~42 days).

10. The most important function of the
skin is to act as a barrier against
infection. The skin prevents loss of
body fluids, thus preventing
dehydration. The skin also regulates
the body temperature by controlling
the amount of evaporation of fluids
from the sweat glands. The skin serves
a cosmetic effect by giving the body
shape.

11. When the skin is burned, these functions
are impaired or lost completely. The severity
of the skin injury depends upon the size of
the injury, depth of the wound, part of the
body injured, age of the patient, and past
medical history. Because of the importance
of the skin, it becomes clear that injury can
be traumatic and life threatening. Recovery
from burn injury involves four major
aspects: burn wound management, physical
therapy, nutrition, and emotional support.

12. Pathophysiology
Pathophysiologic changes result from
major burns during the initial burn-
shock period. Changes include tissue
hypo perfusion and organ hypo
function secondary to decreased
cardiac output, followed by a
hyperdynamic and hyper metabolic
phase.

14. Assessment

15. Rule of nine

16. First, Second, and Third Degree Burns.
Classification

17. Assessment
with all trauma victims, a primary and
secondary trauma survey, including
assessment of airway, breathing, and
circulation as well as vital signs, is done.
Other assessment parameters specific to
the burn injury focus on extent and
severity of burn injury.

18. Extend of burn

19. First-degree (superficial)
burns
Superficial tissue destruction involving the
epidermis only.
Local pain and erythema; blisters are absent
for about 24 hours.
Mild to absent systemic response.
Rapid healing (normally 3 to 5 days) without
scarring.
First-degree burns generally do not require
treatment, except in the case of large burns
of infants or elderly persons.

21. Second-degree (partial-thickness)
burns
Tissue destruction involving the epidermis
and part of the dermis.
Skin appearing red to pale and moist
Formation of wet, thin-walled blisters
immediately after injury.
Intact tactile and pain sensors
Healing in 21 to 28 days with variable
amount of scarring.

23. Third-degree (full-thickness)
burns
Tissue destruction involving the epidermis,
dermis, and underlying subcutaneous
tissue.
Injury appearing white, cherry red, or black;
the injury may or may not contain deep
blisters or visible thrombosed veins.
Dry, hard, leathery appearance due to loss
of epidermal elasticity
Painless to touch because of destruction of
all superficial nerve ending in skin.

25. Nursing diagnosis
Impaired Gas Exchange related to
inhalation injury
Ineffective Breathing Pattern related to
circumferential chest burn, upper airway
obstruction.
Risk for Infection related to loss of skin
barrier and altered immune response
Body Image Disturbance related to
cosmetic and functional sequelae of burn
wound.

26. Nursing interventions
Stop the burning process if possible
Remove all clothing and jewelry
Ensure patent airway
Prepare for incubation
Cannulate two veins
Cool the burn for several minutes. Do not use
ice.
Remove restrictive objects.
Cover the wound with sterile dressing or a
clean, dry cloth.

27. Prevent shock by initiating I.V. fluid
therapy immediately.
Ensure that the client avoids oral
intake and is placed in an upright
position t prevent aspiration of
vomitus.
Transport the client to the nearest
emergency medical center. Note the
time of burn (needed for
resuscitation).

29. Administer 100% Oxygen until the arterial blood gas
determination demonstrates adequate oxygenation,
and perform frequent neuralgic assessment until
hypoxia resolves.
Support pulmonary function through early intubation
and volume ventilator-assisted respiration with optimal
positive end expiratory pressure, large tidal volume,
and lowest possible inspired oxygen concentration.
Provide pain relief.
Monitor acid-base balance and electrolyte levels.
Provide appropriate fluid resuscitation, based on the
parkland formula.

30. Thanks for your
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