burns pathophysiology parkland formula rule of nine

1. GROUP 5:
FIRE AND
BURNS

2. Table of contents
01
04
02
05
03
06
TYPES OF
BURNS
PARKLAND
FORMULA
RULE OF NINE
PHASES OF
BURNS
SIGNS AND
SYMPTOMS
MANAGEMENT

3. Thermal - Superficial heat
Chemical - Burn caused by a toxic substance, can be alkali or acidic
Radiation - sunburns & cancer treatment
Inhalation - Caused by inhaling smoke which can cause flame injury
or carbon monoxide poisoning
Friction - Burns caused when an object rubs of the skin
Cold- Skin has been over exposed to cold
Electric - electrical current that passes through the body causing
damage within.
TYPES OF BURNS

4. PATHOPHYSIOLOGY

5. PARKLAND FORMULA
Parkland Formula
- Use for fluid resuscitation or fluid replacement
Formula:
Body weight (kg) x Total Body Surface Area (TBSA) x 4
mL

6. EXAMPLE:
1. 150 lbs x 27% x 4 mL. How many mL in the 1st 8 hours?
1. 100 lbs 50%. How many mL for the 1st 24 hours?

7. EXAMPLE:
3. 200 lbs and 63%. How many mL will be given over the
next 24 hours?
4. 132 lbs and 20%. How many mL in the first 8 hours?

8. EXAMPLE:
1. 150 lbs x 27% x 4 mL. How many mL in the 1st 8 hours?
Answer:
150 lbs/2.2 = 68.2 kg
68.2 kg x 27% x 4 = 7,365.6
7,365.6 / 2 = 3,682.2
1. 100 lbs 50%. How many mL for the 1st 24 hours?
Answer:
100 lbs/2.2 = 45.5kg
45.5 kg x 50 x 4 = 9,100

9. EXAMPLE:
3. 200 lbs and 63%. How many mL will be given over the next 24 hours?
Answer:
200 lbs/2.2 = 90.9/91kg
91 kg x 63% x 4 = 22,932
4. 132 lbs and 20%. How many mL in the first 8 hours?
Answer:
132/2.2 = 60 kg
60 kg x 20% x 4 = 4,800 mL
4,800/2 = 2,400 mL

10. RULE OF NINE
Adult:
● Head/HEad and Neck = 9%
- Anterior = 4.5%
- Posterior = 4.5%
● Trunk and Lower = 36%
- Anterior = 18%
- Chest = 9%
- Abdomen = 9%
- Posterior = 18%
● Legs (Lower Extremities) = 18% (per leg)
- Anterior = 9%
- Posterior = 9%

11. ● Arm = 9%
- Anterior = 4.5%
- Posterior = 4.5%
- Upper = 4.5%
- Anterior = 2.25%
- Posterior = 2.25%
- Forearm = 4.5%
- Anterior = 2.25%
- Posterior = 2.25%
● Perineum = 1%

12. Infant to (< less than 8 years old)
● Head/Head and Neck = 18%
- Anterior = 9%
- Posterior = 9%
● Trunk = 36%
- Anterior = 18%
- Chest = 9%
- Abdomen = 9%
- Posterior = 18%
● Leg = 14%
- Anterior = 7%
- posterior = 7%
● Arm = 9%
- Anterior = 7%
- Posterior = 7%
- Upper and Lower = 4.5%
- Upper Anterior = 2.5%
- Lower Anterior = 2.5%
● Perineum = 0%

14. PHASES
OF BURNS

15. PHASES
FIRST PHASE
● also called Emergent Phase/Shock
Phase/Resuscitation Phase
● Superficial injuries that affect only
the outer layer of the skin, known
as the epidermis.
● Within 24 hours-48 hours (need to
give care)
● Priority: Fluid shifting/fluid deficit
SECOND PHASE
● also called Acute/Diuretic
Phase
● Extends beyond the epidermis
and affects the underlying
layer (dermis) of the skin.
● Post 48 hours to 5 days
● Priority: Risk for infection

16. PHASES
THIRD PHASE
● also called Recovery Phase
● Severe and extends through all layers of the skin,
potentially damaging underlying tissues such as
muscles, bones, and nerves.
● More than 5 days
● Priority: Restore optimal functioning of the patient

17. SIGNS AND
SYMPTOMS

18. FIRST PHASE
● ↓ BLOOD PRESSURE
● ↑ HEART RATE
● ↑ PULSE RATE
● ↓ URINARY OUTPUT

19. SECOND PHASE
● ↑ BLOOD PRESSURE
● ↑ HEART RATE
● ↑ PULSE RATE
● ↑ URINARY OUTPUT
● ↓ HCT
● HYPONATREMIA
● HYPOKALEMIA

20. FIRST DEGREE
● REDNESS
● MILD SWELLING
● PAIN
● DRY AND PEELING SKIN

21. SECOND DEGREE
● BLISTERS
● SEVERE PAIN
● SWELLING
● RED OR SPLOTCHY
APPEARANCE

22. THIRD DEGREE
● WHITE OR CHARRED
SKIN
● NUMBNESS
● DIFFICULTY IN
BREATHING (IF AIRWAY
IS AFFECTED)

23. Management to Infection Control
1. WOUND CARE
- Scab removal/Wound debridement
- Topical agents
- Dressings
1. INFECTION CONTROL
- Isolation
- Hand hygiene
- PPE
1. MONITORING
- Laboratory tests
1. NUTRITIONAL SUPPORT
- High protein foods

24. TYPES OF
GRAFT

25. 1. Autograft
● Involves the transfer of skin from one area of the patient's body
(donor site) to another (recipient site).
Advantages
● Lower risk of rejection
● Faster healing
● Preserves function & appearance
Disadvantages
● Limited donor sites
● Can result in scarring the donor site
TYPES

26. 2. Isograft/Synergist
● Involves the transfer of skin between genetically identical
individuals, such as identical twins.
Advantages
● Lower risk of rejection
● Faster healing
● Preserves function & appearance
Disadvantages
● Limited availability of genetically identical donors
TYPES

27. 3. Homograft/Allograft
● Involves the transfer of skin from one individual (donor) to
another individual (recipient) of the same species.
Advantages
● Provides temporary wound coverage
● Can buy time for other treatments
Disadvantages
● Risk of rejection
● Not a permanent solution
TYPES

28. 4. Heterograft/Xenograft
● Involves the transfer of skin from one species to another.
Advantages
● Provides temporary wound coverage
● Alternative when other options are unavailable
Disadvantages
● High-Risk of rejection
● Not a permanent solution
TYPES