This document provides a summary of a full thickness third degree burn. It begins with an overview of burn injuries and classifications. It then describes the pathophysiology of a full thickness third degree burn, which destroys the epidermal and dermal layers of skin. Treatment includes wound care, pain management, antibiotics, and skin grafts. Nursing care focuses on preventing infection and maintaining skin integrity. The document ends with a personal story from the perspective of a nursing student who suffered a full thickness burn injury in a car accident, describing her physical and emotional struggles.
The document discusses burn injuries and their management. It begins by defining burns as wounds caused by exposure to heat, chemicals, fire, radiation, or electricity. Burns can result in 10-20 thousand deaths annually. Survival is best for burns covering less than 20% of the total body surface area and for patients aged 15-45 years old. The document then covers types of burns including thermal, chemical, electrical, and radiation burns. It discusses burn wound assessment and classification according to depth and extent of body surface area involved. The phases of burn care and plastic surgery for burn management are also summarized.
Introduction
Burns
Clinically Relevant Anatomy Of Hand
Common Hand Problems In Burns
Surgical Management
Evidence based Physical Therapy Rehabilitation
Outcome Measures
Summary
References
This study examined 213 patients presenting with post-burn contractures in Pakistan over four years. The commonest site of contracture was the neck. Most patients (92) had received initial burn injury management in general surgery units rather than plastic surgery units, and few (26) received appropriate treatment like skin grafts, splinting, or physiotherapy. None of the patients received proper anti-deformity splinting or physiotherapy during acute burn treatment. This highlights the need for improved initial burn management to prevent severe, long-standing contractures in developing countries like Pakistan.
A complete review for all medical students and doctors working in burn unit in any hospital. #Emergency #BurnProtocol #protocol #Burns #Abhishek #MUSTKNOW #knowledge #Medical #Health
Burn is coagulative necrosis of the skin’s tissues, usually caused by excessive heat
Excess heat causes rapid protein denaturation and cell damage
Wet heat (scald) travels more rapidly into tissue than dry heat (flame)
A surface temperature of over 60˚C produces immediate cell death as well as vessel thrombosis
The dead skin tissue is known as Eschar
This topic is oriented mainly on the Bailey & Love - 26th edition.
This will be of immense help for the MBBS - Students for the Theory as well as Clinical application.
Classification, Principles, assessment and management of burnalazarbekele47
The document provides an outline for principles of management of burn injuries. It begins with defining burns and discussing the epidemiology, types, classification, and pathophysiology of burns. It then covers assessment of burn wounds including depth and percentage of total body surface area burned. The document outlines primary survey and management of burns which includes airway management, as inhalation injuries often accompany severe burns. It discusses indications for hospitalization and monitoring of burn patients.
The document discusses burn injuries and their management. It begins by defining burns as wounds caused by exposure to heat, chemicals, fire, radiation, or electricity. Burns can result in 10-20 thousand deaths annually. Survival is best for burns covering less than 20% of the total body surface area and for patients aged 15-45 years old. The document then covers types of burns including thermal, chemical, electrical, and radiation burns. It discusses burn wound assessment and classification according to depth and extent of body surface area involved. The phases of burn care and plastic surgery for burn management are also summarized.
Introduction
Burns
Clinically Relevant Anatomy Of Hand
Common Hand Problems In Burns
Surgical Management
Evidence based Physical Therapy Rehabilitation
Outcome Measures
Summary
References
This study examined 213 patients presenting with post-burn contractures in Pakistan over four years. The commonest site of contracture was the neck. Most patients (92) had received initial burn injury management in general surgery units rather than plastic surgery units, and few (26) received appropriate treatment like skin grafts, splinting, or physiotherapy. None of the patients received proper anti-deformity splinting or physiotherapy during acute burn treatment. This highlights the need for improved initial burn management to prevent severe, long-standing contractures in developing countries like Pakistan.
A complete review for all medical students and doctors working in burn unit in any hospital. #Emergency #BurnProtocol #protocol #Burns #Abhishek #MUSTKNOW #knowledge #Medical #Health
Burn is coagulative necrosis of the skin’s tissues, usually caused by excessive heat
Excess heat causes rapid protein denaturation and cell damage
Wet heat (scald) travels more rapidly into tissue than dry heat (flame)
A surface temperature of over 60˚C produces immediate cell death as well as vessel thrombosis
The dead skin tissue is known as Eschar
This topic is oriented mainly on the Bailey & Love - 26th edition.
This will be of immense help for the MBBS - Students for the Theory as well as Clinical application.
Classification, Principles, assessment and management of burnalazarbekele47
The document provides an outline for principles of management of burn injuries. It begins with defining burns and discussing the epidemiology, types, classification, and pathophysiology of burns. It then covers assessment of burn wounds including depth and percentage of total body surface area burned. The document outlines primary survey and management of burns which includes airway management, as inhalation injuries often accompany severe burns. It discusses indications for hospitalization and monitoring of burn patients.
Burns are caused by thermal injury and result in skin and tissue damage. They are classified by depth and extent of body surface area affected. Common types include scalds, flames, chemicals, electricity, and radiation. Management involves assessing airway/breathing, fluid resuscitation to prevent shock, wound care, pain relief, and infection control. Resuscitation aims to stabilize the patient and replace fluid losses using formulas like Parkland or Brooke, followed by acute wound management and later rehabilitation.
The statement that "the position of comfort is the position most likely to lead into contractures" is applicable to every burn patient who has sustained a serious injury. Burn injuries can range from superficial to full thickness burns and require careful treatment and positioning to prevent contractures and promote healing. Occupational therapists play an important role in managing burns through techniques like positioning, splinting, edema management, desensitization, exercise, and education on prevention of further injury.
This document provides an overview of burns and pressure sores. It begins with definitions of the skin and its layers. It then discusses burns in depth, including the pathophysiology and zones of burns, burn classifications based on causative agent, depth and total body surface area affected. Pressure sores are also briefly introduced. In-depth information is provided on assessing burn depth and the characteristics of first to fourth degree burns.
Burns are caused by direct contact with or exposure to thermal, chemical, electrical or radiation sources. The document discusses the classification, pathophysiology and clinical manifestations of burns. It covers the different types of burns according to etiology, depth and severity. Assessment methods like the Rule of Nine and Palm Method are also described. Common signs include pain, fluid loss, edema, respiratory issues and potential psychological impacts.
The document provides guidelines for the initial care of burn patients. It describes evaluating the patient's airway, breathing, and circulation as top priorities in the primary survey. It recommends establishing intravenous access and monitoring vital signs. The secondary survey involves a full head-to-toe examination to assess the extent and depth of burns and check for other injuries. Proper wound care includes cleaning and dressing burns, with topical antibiotics like silver sulfadiazine applied. Fluid resuscitation is also critical based on the percentage of total body surface area burned. Admission to a burn unit is recommended for deeper or more extensive burns.
This document defines and classifies different types of burns, including thermal, electrical, chemical, and radiation burns. It describes burns based on depth, with first degree involving the epidermis, second degree also involving the dermis and causing blisters, third degree being full thickness and causing charring, and fourth degree extending into underlying tissues. Burns are also classified based on percentage of total body surface area affected as minor, moderate, or major. The pathophysiology of burns is described, including increased vascular permeability, fluid shifts leading to hypovolemia, and increased risk of infection, renal failure, and multiorgan dysfunction. Infections from bacteria such as Streptococcus and Pseudomonas are common complications. Causes
This document discusses burns, including their classification, pathophysiology, management, and special considerations for inhalation injuries and airway management. Some key points include:
- Burns are classified by depth and total body surface area affected. Deep second and third-degree burns require grafting or flaps for healing.
- Burns cause local tissue damage and systemic inflammatory responses impacting circulation, immunity, metabolism, and other organ systems.
- Initial management focuses on airway protection, fluid resuscitation, pain control and wound care. Admission criteria include burns over 15% of total body surface area or those involving special areas.
- Inhalation injuries are suspected with certain histories and symptoms and require early intubation
This document discusses burns, including types, fluid considerations, nursing priorities, assessments, determining severity, depth of burns, treatment, and fluid resuscitation formulas for the first and second 24 hours. Burns can cause fluid shifts and hemoconcentration. Nursing priorities include maintaining airway, assessing respiratory and circulatory status, and determining burn severity using the rule of nines. Treatment focuses on respiratory status, wound care, pain management, infection prevention, and nutrition. Fluid resuscitation formulas are provided to guide fluid administration.
This document discusses the management of burn wounds. It begins by defining burns and assessing the severity based on airway, breathing, circulation, disability and exposure. The percentage of body surface area burned is determined using the Rule of 9s. Burns are then classified based on depth, from very superficial to full thickness. Different types of dressings are recommended based on burn depth, from moisturizing creams for very superficial burns to silver-based antimicrobial dressings for full thickness burns. Nutrition is also discussed as being extremely important for recovery, with high calorie and protein intake needed.
This document provides an overview of burns, including definitions, classifications, pathophysiology, management, and complications. It defines burns as thermal injuries to the skin and tissues. Burns are classified based on depth and extent of damage. First, second, and third degree burns are described. Hospitalization is generally recommended for burns over 10% of total body surface area. The pathophysiology involves fluid shifts, cardiac, metabolic, immunologic, and renal effects. Burn management includes airway control, fluid resuscitation, wound care, infection prevention, pain relief, and nutrition. Complications can include shock, infection, renal failure, and scarring.
1. In India, over 1 million people suffer moderate to severe burns every year, with 70% occurring in the productive 15-35 age group and 80% of cases being women and children involved in kitchen accidents.
2. Burns are classified based on depth and healing time - first degree affects the outer skin layer, second degree also involves the dermis, third degree extends deeper, and fourth degree involves muscle and bone.
3. Assessment methods include the Rule of Nines, Lund-Browder chart, and palm rule. Management involves first aid, fluid resuscitation per the Parkland formula, wound care including dressings, surgery, and preventing infection and organ failure.
In this ppt detailed explain about the burns - definition,causes,depth of burns,extent of burns,rule of nine,reaction of burns,investigation , complication,emergency care,treatment and management.I hope this is useful for your studies.Thank you for choosing this slide.
This document discusses burn injuries and their management. It covers types of burns including thermal, chemical, electrical, and radiation burns. It describes assessing burn wounds based on depth and extent of body surface area involved. Superficial, deep, and full thickness burns are defined. Methods for calculating burned body surface area using Lund and Browder charts or the rule of nines are provided. Vascular, fluid, and metabolic changes resulting from burns are outlined. The phases of burn injuries including emergent, acute, and rehabilitative are summarized. Key aspects of managing burns such as wound care, fluid resuscitation, and monitoring for infection are highlighted.
This Presentation is about burn in children it's defination ,causes , classification , methods of estimation of TBSA of burn , diagnose , medical , surgical and nursing management and complications.
The document provides instructions for nursing students to complete a Humanbecoming Process Reflection assignment. It includes instructions for several parts of the assignment:
1) A clinical data sheet with demographic information, activities, orders, and time management.
2) Assessment data including lab values and physical assessment to be completed on SimChart.
3) A concept map on the patient's disease process including story, risk factors, signs/symptoms, diagnosis, pathophysiology, treatment and nursing interventions.
4) A nursing care plan identifying problems, interventions and evaluations for the patient's highest priority physiological and psycho-social problems.
The document provides an example nursing diagnosis and instructions for completing the nursing care plan component
En este informe se expone una reseña histórica de los bancos en Honduras cual ha sido su evolución desde sus inicios, así mismo se detalla las fechas de fundación de los bancos en Honduras y sus siglas, cuales son las normativas de la comisión nacional de banca y seguros para el funcionamiento de los bancos.
Kayla faced an ethical dilemma when her dog Roxy was diagnosed with cancer that had spread throughout her abdomen. The vet said Roxy was suffering and asked if Kayla wanted to euthanize her or take her home. Kayla prayed and consulted family for advice. When she saw Roxy's tail wag in response to her, she decided to take Roxy home and see if her condition improved with a special diet and pain management. A few days later, Roxy's symptoms improved and she has been enjoying life since, though weak. Justice and fidelity guided Kayla to consider Roxy's quality of life and remain faithful to her by giving her a chance to feel better.
Kayla Bigbee outlines her nursing philosophy in this paper. She defines nursing as a holistic profession focused on meeting patients' physical, emotional, spiritual and mental needs. Biblical principles like demonstrating God's love through compassionate care influence her approach. The humanbecoming theory teaches her to see patients as experts and establish trust. Her experiences in nursing school and with patients in clinicals have shaped her identity as a caring nurse committed to critical care. She has become more confident, motivated and passionate about nursing through overcoming struggles in her program.
- The document lists the author's awards, activities, scholarships, and work experience in industrial design. It includes the Hugh Greenlee and Meisel Scholarships for Excellence in Industrial Design from the Cleveland Institute of Art.
- As a student designer at Stryker Medical, the author worked on a team of five students over a semester to develop a new medical emergency product. They communicated directly with Stryker employees to research users and design detailed concepts.
- The author had an internship at Nottingham Spirk Design, where they contributed to design tasks like brainstorming, research, and refining concepts for clients in various industries.
A pocket version of the Creed of Creativity, with daily affirmations, sound bites, lessons for survival, A Declaration of Independence from Jewish Tyranny, The Mission of The TCM Security Legions, The 16 Commandments of Creativity, The Creativity Creed and Program, and more! By Ben Klassen, 1991.
Burns are caused by thermal injury and result in skin and tissue damage. They are classified by depth and extent of body surface area affected. Common types include scalds, flames, chemicals, electricity, and radiation. Management involves assessing airway/breathing, fluid resuscitation to prevent shock, wound care, pain relief, and infection control. Resuscitation aims to stabilize the patient and replace fluid losses using formulas like Parkland or Brooke, followed by acute wound management and later rehabilitation.
The statement that "the position of comfort is the position most likely to lead into contractures" is applicable to every burn patient who has sustained a serious injury. Burn injuries can range from superficial to full thickness burns and require careful treatment and positioning to prevent contractures and promote healing. Occupational therapists play an important role in managing burns through techniques like positioning, splinting, edema management, desensitization, exercise, and education on prevention of further injury.
This document provides an overview of burns and pressure sores. It begins with definitions of the skin and its layers. It then discusses burns in depth, including the pathophysiology and zones of burns, burn classifications based on causative agent, depth and total body surface area affected. Pressure sores are also briefly introduced. In-depth information is provided on assessing burn depth and the characteristics of first to fourth degree burns.
Burns are caused by direct contact with or exposure to thermal, chemical, electrical or radiation sources. The document discusses the classification, pathophysiology and clinical manifestations of burns. It covers the different types of burns according to etiology, depth and severity. Assessment methods like the Rule of Nine and Palm Method are also described. Common signs include pain, fluid loss, edema, respiratory issues and potential psychological impacts.
The document provides guidelines for the initial care of burn patients. It describes evaluating the patient's airway, breathing, and circulation as top priorities in the primary survey. It recommends establishing intravenous access and monitoring vital signs. The secondary survey involves a full head-to-toe examination to assess the extent and depth of burns and check for other injuries. Proper wound care includes cleaning and dressing burns, with topical antibiotics like silver sulfadiazine applied. Fluid resuscitation is also critical based on the percentage of total body surface area burned. Admission to a burn unit is recommended for deeper or more extensive burns.
This document defines and classifies different types of burns, including thermal, electrical, chemical, and radiation burns. It describes burns based on depth, with first degree involving the epidermis, second degree also involving the dermis and causing blisters, third degree being full thickness and causing charring, and fourth degree extending into underlying tissues. Burns are also classified based on percentage of total body surface area affected as minor, moderate, or major. The pathophysiology of burns is described, including increased vascular permeability, fluid shifts leading to hypovolemia, and increased risk of infection, renal failure, and multiorgan dysfunction. Infections from bacteria such as Streptococcus and Pseudomonas are common complications. Causes
This document discusses burns, including their classification, pathophysiology, management, and special considerations for inhalation injuries and airway management. Some key points include:
- Burns are classified by depth and total body surface area affected. Deep second and third-degree burns require grafting or flaps for healing.
- Burns cause local tissue damage and systemic inflammatory responses impacting circulation, immunity, metabolism, and other organ systems.
- Initial management focuses on airway protection, fluid resuscitation, pain control and wound care. Admission criteria include burns over 15% of total body surface area or those involving special areas.
- Inhalation injuries are suspected with certain histories and symptoms and require early intubation
This document discusses burns, including types, fluid considerations, nursing priorities, assessments, determining severity, depth of burns, treatment, and fluid resuscitation formulas for the first and second 24 hours. Burns can cause fluid shifts and hemoconcentration. Nursing priorities include maintaining airway, assessing respiratory and circulatory status, and determining burn severity using the rule of nines. Treatment focuses on respiratory status, wound care, pain management, infection prevention, and nutrition. Fluid resuscitation formulas are provided to guide fluid administration.
This document discusses the management of burn wounds. It begins by defining burns and assessing the severity based on airway, breathing, circulation, disability and exposure. The percentage of body surface area burned is determined using the Rule of 9s. Burns are then classified based on depth, from very superficial to full thickness. Different types of dressings are recommended based on burn depth, from moisturizing creams for very superficial burns to silver-based antimicrobial dressings for full thickness burns. Nutrition is also discussed as being extremely important for recovery, with high calorie and protein intake needed.
This document provides an overview of burns, including definitions, classifications, pathophysiology, management, and complications. It defines burns as thermal injuries to the skin and tissues. Burns are classified based on depth and extent of damage. First, second, and third degree burns are described. Hospitalization is generally recommended for burns over 10% of total body surface area. The pathophysiology involves fluid shifts, cardiac, metabolic, immunologic, and renal effects. Burn management includes airway control, fluid resuscitation, wound care, infection prevention, pain relief, and nutrition. Complications can include shock, infection, renal failure, and scarring.
1. In India, over 1 million people suffer moderate to severe burns every year, with 70% occurring in the productive 15-35 age group and 80% of cases being women and children involved in kitchen accidents.
2. Burns are classified based on depth and healing time - first degree affects the outer skin layer, second degree also involves the dermis, third degree extends deeper, and fourth degree involves muscle and bone.
3. Assessment methods include the Rule of Nines, Lund-Browder chart, and palm rule. Management involves first aid, fluid resuscitation per the Parkland formula, wound care including dressings, surgery, and preventing infection and organ failure.
In this ppt detailed explain about the burns - definition,causes,depth of burns,extent of burns,rule of nine,reaction of burns,investigation , complication,emergency care,treatment and management.I hope this is useful for your studies.Thank you for choosing this slide.
This document discusses burn injuries and their management. It covers types of burns including thermal, chemical, electrical, and radiation burns. It describes assessing burn wounds based on depth and extent of body surface area involved. Superficial, deep, and full thickness burns are defined. Methods for calculating burned body surface area using Lund and Browder charts or the rule of nines are provided. Vascular, fluid, and metabolic changes resulting from burns are outlined. The phases of burn injuries including emergent, acute, and rehabilitative are summarized. Key aspects of managing burns such as wound care, fluid resuscitation, and monitoring for infection are highlighted.
This Presentation is about burn in children it's defination ,causes , classification , methods of estimation of TBSA of burn , diagnose , medical , surgical and nursing management and complications.
The document provides instructions for nursing students to complete a Humanbecoming Process Reflection assignment. It includes instructions for several parts of the assignment:
1) A clinical data sheet with demographic information, activities, orders, and time management.
2) Assessment data including lab values and physical assessment to be completed on SimChart.
3) A concept map on the patient's disease process including story, risk factors, signs/symptoms, diagnosis, pathophysiology, treatment and nursing interventions.
4) A nursing care plan identifying problems, interventions and evaluations for the patient's highest priority physiological and psycho-social problems.
The document provides an example nursing diagnosis and instructions for completing the nursing care plan component
En este informe se expone una reseña histórica de los bancos en Honduras cual ha sido su evolución desde sus inicios, así mismo se detalla las fechas de fundación de los bancos en Honduras y sus siglas, cuales son las normativas de la comisión nacional de banca y seguros para el funcionamiento de los bancos.
Kayla faced an ethical dilemma when her dog Roxy was diagnosed with cancer that had spread throughout her abdomen. The vet said Roxy was suffering and asked if Kayla wanted to euthanize her or take her home. Kayla prayed and consulted family for advice. When she saw Roxy's tail wag in response to her, she decided to take Roxy home and see if her condition improved with a special diet and pain management. A few days later, Roxy's symptoms improved and she has been enjoying life since, though weak. Justice and fidelity guided Kayla to consider Roxy's quality of life and remain faithful to her by giving her a chance to feel better.
Kayla Bigbee outlines her nursing philosophy in this paper. She defines nursing as a holistic profession focused on meeting patients' physical, emotional, spiritual and mental needs. Biblical principles like demonstrating God's love through compassionate care influence her approach. The humanbecoming theory teaches her to see patients as experts and establish trust. Her experiences in nursing school and with patients in clinicals have shaped her identity as a caring nurse committed to critical care. She has become more confident, motivated and passionate about nursing through overcoming struggles in her program.
- The document lists the author's awards, activities, scholarships, and work experience in industrial design. It includes the Hugh Greenlee and Meisel Scholarships for Excellence in Industrial Design from the Cleveland Institute of Art.
- As a student designer at Stryker Medical, the author worked on a team of five students over a semester to develop a new medical emergency product. They communicated directly with Stryker employees to research users and design detailed concepts.
- The author had an internship at Nottingham Spirk Design, where they contributed to design tasks like brainstorming, research, and refining concepts for clients in various industries.
A pocket version of the Creed of Creativity, with daily affirmations, sound bites, lessons for survival, A Declaration of Independence from Jewish Tyranny, The Mission of The TCM Security Legions, The 16 Commandments of Creativity, The Creativity Creed and Program, and more! By Ben Klassen, 1991.
This document contains a list of book titles and authors including: The Best American Mystery Stories edited by Scott Turow and Otto Penzler; Journal of Medical Speech-Language Pathology; Collected Essays by Leonard LaPointe; Collected Essays on Language, Laughter, and Life; Profanity, Snake Wine, and Feral Children; Fifty Shades of Grey by E L James; The Lost Art of Resurrection by Freddy Silva; The Practice of Initiation and Awakening in the Great Cultures of the World; A Mediterranean Guide to Joyful Living by Juan M. Martín Menéndez; and the word "Factor the aliveness".
Burn injuries can be caused by heat, chemicals, electricity, or cold and trigger an inflammatory response. Severe burns lead to a prolonged hypermetabolic state that increases risks of organ failure, infection, and death. It is important to classify burns by depth and size to determine appropriate treatment, such as immediate surgery for deep burns versus moist wound care for frostbite. Severe or major burns covering over 10% of total body surface area have long-term impacts and require specialized burn center care.
This document summarizes the epidemiology, causes, management, and pathophysiology of thermal burn injuries. Some key points:
- Thermal burns are a major cause of death and disability worldwide, especially in those under 40. The average burn patient is 24 years old with 19% total body surface area burned.
- Most burns are preventable and caused by carelessness, while others result from smoking, alcohol, hot substances (2/3 of cases), and fire/flame (1/4 of cases). Major determinants of mortality include organ failure, infection, burn extent, and age/sex.
- Initial burn management focuses on stabilizing respiration, fluid resuscitation, and infection prevention
This document provides an overview of physiotherapy for burn patients. It discusses the types, causes, and classifications of burns including superficial, partial thickness, and full thickness burns. It also covers burn wound zones, complications of burns like infection and metabolic issues, and the general management of burns including first aid, hospital referral, early hospital management, and fluid replacement. The goal of physiotherapy is to prevent contractures and aid in rehabilitation.
1. The document discusses tissue engineered allograft implants and regenerative medicine, focusing on the skin as the largest organ. It describes the layers and functions of skin, as well as how the body responds to burns through inflammation and regeneration.
2. When the body is damaged by burns, it initiates an inflammatory response by increasing blood flow and sending white blood cells to the injured area. If damage is superficial, the skin can regenerate itself through restitution, but deeper burns result in scarring as the body replaces damaged tissue with collagen fibers.
3. Burn injuries are a serious threat, with common causes being fires, scalds from hot liquids, and contact with hot surfaces. Household items like st
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.
Burn injuries are caused by thermal, chemical, electrical, or radiation sources and result in tissue damage. Thermal burns are caused by flame, hot liquids, steam, or explosions and can range from superficial to full thickness. Chemical burns destroy tissue through strong acids or alkalies. Electrical burns generate intense heat from passing electrical energy. Radiation burns result from exposure to radioactive sources. Burn severity is determined by depth, size, location, and patient factors. Treatment involves wound care, pain management, infection prevention, and rehabilitation.
This document discusses burn management and provides details on epidemiology, etiology, pathophysiology, and emergency care for burns. It is divided into multiple sections:
1) Epidemiology in Egypt - Domestic burns account for 75% of injuries. Females experience more scald burns at home while males experience more electric and flame burns outdoors.
2) Etiology and types - Common causes are scalds, flames, flashes, and electrical burns. Water temperature and contact time determine scald depth.
3) Emergency management - Airway protection, oxygen supplementation, fluid resuscitation based on burn size, and wound assessment and cooling (if small burn) are priorities in the emergency setting.
This document discusses burn management and treatment. It defines burns and their causes, classifying them as physical (thermal, electrical) or chemical. Burn depth is classified in 4 degrees based on skin layer involvement. Extent of burn surface area is estimated using the Rule of Nines. Large burns can cause shock due to fluid loss, pain, or infection. Initial fluid resuscitation is crucial using formulas like Parkland to replace lost fluid volume over the first 24 hours. Wound care and infection control are also important for management.
The document describes a case of a burn victim who was beaten, set on fire, and left on the side of a road. When EMS arrived, they found the man lying on the ground screaming in pain, with burned flesh and still smoking clothes. An initial assessment found burns on his hands, chest, and back, along with a head wound bleeding profusely and signs of shock. Nearby witnesses reported that a group of men had beaten and kicked the victim before setting him on fire.
This document discusses modern burn care, which is divided into 4 phases:
1) Initial evaluation and resuscitation on days 1-3 involving accurate fluid resuscitation and evaluation of other injuries.
2) Initial wound excision and closure using staged operations to change the natural history of the disease during the first few days.
3) Definitive wound closure replacing temporary covers with permanent ones, and reconstruction of complex areas like the face and hands.
4) Rehabilitation, reconstruction and reintegration beginning during resuscitation but becoming more involved later in the hospital stay.
The document provides information on the management of burns, including definitions, epidemiology, classification, assessment, and treatment approaches. It describes the pathophysiology of burns and potential complications. Management involves initial first aid including cooling, fluid resuscitation proportional to burn size, regular monitoring of urine output and electrolytes, and treatment of complications as needed. Inhalational injury requires special attention and evaluation including possible bronchoscopy.
Burns can be caused by heat, cold, electricity, chemicals, friction or radiation. They are classified by depth and extent of the burn. First degree burns affect the outer layer of skin while fourth degree burns damage deeper tissues. Burn management involves three phases - emergent, acute, and rehabilitative care. The emergent phase focuses on assessment, wound care, and fluid resuscitation. The acute phase emphasizes infection prevention, wound grafting, pain management, and exercise. Rehabilitation aims to minimize scarring and functional loss through exercise, pressure garments, and psychological support.
The document discusses burns, including definitions, causes, classifications, assessment, and management. Burns are injuries caused by heat, chemicals, electricity, or radiation. They can range from superficial to full thickness. Assessment involves determining burn severity and extent using methods like the Rule of Nine. Management consists of three phases - emergent, acute, and rehabilitation. The emergent phase focuses on fluid resuscitation to prevent shock based on established formulas.
The skin is the largest organ of the body. It protects the body from microbes, regulates temperature, and allows for sensation. The skin has three layers - the epidermis, dermis, and subcutaneous tissue. Burns are injuries caused by heat, chemicals, electricity or radiation and are classified based on depth and extent of damage. Burn management involves emergent care to address life threats, the acute phase during wound healing, and rehabilitation to address scarring and return the patient to normal activities.
This document provides information on burns, including burn classifications, pathophysiology, assessment, management, and the role of nurses in burn care. It states that an estimated 4,500 people die from fire/burn injuries annually in the US, while 45,000 suffer burn injuries severe enough to require hospitalization. The management of burns involves resuscitation to restore fluid volume, wound care to promote healing and prevent infection, pain management, nutrition support, and rehabilitation. Nurses play a key role in providing care, advocacy, education, and monitoring patients' condition and progress.
Burn injuries can result from heat, cold, chemicals, electricity or radiation. They cause skin and tissue damage through coagulation necrosis. Globally, about 1% of the population sustains burns annually. In the US, over 2 million burn injuries are reported each year. Burns significantly increase morbidity and mortality. Younger children commonly experience scalds while flames cause most adult burns. Burn depth, extent, mechanism and presence of inhalation injury are important factors in classification and prognosis. Both local and systemic inflammatory responses can result from severe burns.
The document provides an overview of burns, including epidemiology, classification, severity, treatment and complications. It notes that around 500,000 people in the US are treated annually for burns, which can be caused by heat, fires, scalding or chemicals. Burn extent is determined using the Rule of 9s or Lund & Browder chart and severity is classified from first to fourth degree burns based on depth of tissue damage. Treatment depends on severity but may include fluid resuscitation, wound care, surgery and infection prevention. Complications can include infection, respiratory distress and contractures.
Burns are classified by depth and extent of injury. Superficial burns only affect the epidermis while deep burns damage the dermis. Full thickness burns destroy the entire dermis. Management involves fluid resuscitation, wound care, prevention of infection and complications. Local wound care includes cleaning, silver sulfadiazine cream and dressing changes. For deep burns, debridement and skin grafting may be needed. Monitoring of vitals, urine output and blood work is important. Escarotomy may be required for circumferential full thickness limb burns to prevent limb loss.
Burns are injuries caused by heat, chemicals, electricity or radiation. They can occur at any age and socioeconomic group. Thermal burns result from flame, hot liquids or objects, while chemical burns are caused by strong acids or alkalis. Electrical burns occur from electricity passing through the body. Radiation burns come from exposure to radiation sources. Burns are classified by depth and extent of body surface area affected. Management involves cooling the wound, establishing airways, fluid resuscitation, and calculating fluid needs using formulas based on total body surface area burned. The goal is adequate circulation and urine output to prevent shock.
1. Running head: FULL THICKNESS BURN 1
Full Thickness Third Degree Burn
Kayla Bigbee
California Baptist University
Author Note
This paper is presented to Professor Toro in partial fulfillment for the
requirements of Adult Health II, NUR 440 on October 2, 2015
2. FULL THICKNESS BURN 2
Full Thickness Third Degree Burn
Burns are one of the most communal forms of traumatic injuries and one of the third
leading causes of accidental death in the United States. According to the Centers for Disease
Control and Prevention (CDC) (2012), 1.1 million burn injuries require medical attention.
Roughly 50,000 of these burn victims require hospitalization; 20,000 have major burns involving
at least 25 percent of their total body surface, and approximately 4,500 of these people die
(2012). Burns can result from a multitude of causes such as Ultraviolet Radiation, explosions,
burst of steam, heated liquids or metals, fires, electrocution, or direct contact with a flame or
flammable clothing. Burns are classified by four levels (degrees) that encompass the depth and
damage the burn has caused the tissue of the affected area(s). Third degree burns are the second
to most serious burn that can occur on the human body (Nursing Central, 2012). Serious burns
can be a devastating injury both physically and emotionally. This paper will discuss the
description and pathophysiology of third degree burns, signs and symptoms related to this
condition, medication and treatment, nursing care and a personal story from a victim of a third
degree burn.
What is a Full Thickness Third Degree Burn?
The human body is protected by layers of skin and fat which include the epidermis,
dermis and subcutis. These layers of skin play a vital role for the human body by providing
prevention of water loss, regulation of body temperature, protection from infection, and defense
against light (Porth and Grossman, 2014). Third degree burns destroy both the epidermal and
dermal layers of the skin. They may also damage the underlying fat, bones, muscles and tendons.
The burn site may appear charred (black), white, red, or brown. Normally there will be no
blanching in red areas due to interruption of the blood supply to the affected area. There will also
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be no feeling in the area since the nerve endings are destroyed. In addition to color, the burn may
also appear to be sunken in due to the underlying destruction of subcutaneous fat and muscle
(Morton and Fontaine, 2012). The loss of hair follicle destroys the ability of the skin to
regenerate. Burn injuries to the skin affects skin function which can potentially lead to
combinations of infection, dehydration and hypothermia (2012).
Severity and Classification
Burn severity is classified by the degree and depth of the burn and the instrumental agent,
along with time and circumstances surrounding the burn injury. Morton and Fontaine (2012) list
several factors that must be measured to assess the severity of the burn. These factors include the
percentage of body surface area burned, the depth of the burn, the anatomical location of the
burn, the person’s age, the person’s medical history, the presence of concomitant injury, and the
presence of inhalation injury (2012). Some methods listed by Moton and Fontaine (2012) use
percentages of total body surface area (TBSA) to estimate the extent of a burn. The quickest
method is call the “rule of nines” or “rule of palms” which is normally used as initial assessment
or can be used to estimate small scattered burns. The rule of nines divides the body into parts by
multiples of 9%. Burns may involve only part of the surface of a body part or it could extend
along the entire body part. An example would be if the arm was burned only on the anterior
portion, then the TBSA would be 4.5%, but if the entire arm was burned then the value would be
9% (2012).
Another method that is more extensive and highly recommended for larger burns is the
Lund and Browder method (Morton and Fontaine, 2012). The Lund and Browder method is
highly recommended and is known to be more accurate due to the fact that it takes into account
the age and development of the patient. The surface measurements are given to each body part in
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terms of the patient’s age. However, this method is known to be time-consuming and should be
done after initial resuscitation efforts have been made (2012).
The American Burn Association (ABA) (2015) developed a Severity Grading System
which determines the magnitude of the injury and provide information needed for proper care by
hospital staff. The severity is categorized as minor, moderate or major. Patients who are
classified with moderate or major burn injuries are normally referred to a burn center and or
transferred for specialized care (2015). Moderate and major burns must be taken seriously and
action must be taken fast because they may lead to a plethora of other systemic complications in
the body.
Pathophysiology
The injury of cells begin when the tissues are exposed to an energy source, such as
thermal, chemical, electrical or radiation energy. Morton and Fontaine (2012) measure varying
degrees of injury by zones. The zone of coagulation is where the most damage has occurred to
the tissue and it has reached 113 degrees Fahrenheit. This zone has lost the ability to rejuvenate
and requires surgical intervention. The zone of stasis surrounds the zone of coagulation and
contains cells that are most at risk during burn resuscitation. These cells can either recover or
become necrotic within 24-72 hours, depending on intervention and course of damage (. The
next zone is called the zone of hyperemia and contains areas of increased blood flow which can
bring needed nutrients to the tissue for recovery and remove waste products. This area will heal
rapidly and no cell death should occur (2012).
Systemic response. Most burn victims are confronted with hemodynamic instability,
impaired respiratory function, a hypermetabolic response, major organ dysfunction and sepsis.
The extent of injury along with the greatness of response rely heavily on each other.
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Hemodynamic instability begins almost immediately with injury to the blood supply (capillaries)
in the injury site. Fluid is lost from vascular and interstitial places which is why it is common to
see victims in a form of hypovolemic shock. Respiratory system dysfunction is another common
problem associated with burns and occurs when the victim has been trapped in a structure and
has inhaled significant amounts of smoke, carbon monoxide and other fumes. Manifestations of
respiratory system dysfunction include hoarseness, drooling, inability to handle secretions,
hacking cough, and labored/shallow breathing. Blood gases will show a drop in partial pressure
of arterial oxygen. It is common for signs of respiratory injury and obstruction to be delayed for
twenty-four to forty-eight hours after a burn. Monitoring patients for early signs of respiratory
distress and other pulmonary conditions is necessary. Metabolic and nutritional requirements are
known to increase due to the stress of a burn injury. The body will secrete stress hormones such
as catecholamine and cortisol in order to maintain homeostasis. Heat production will normally
increase to maintain body temperature. Increased oxygen consumption, increased glucose use,
and protein and fat wasting is a characteristic response to burn trauma and infection.
Hypermetabolism will normally appear within 7-17 days of burn injury. The last and most
significant complication of the acute phase of a burn injury is sepsis. Sepsis may arise from a
burn wound, pneumonia, urinary tract infection, or an infection somewhere else in the body.
Since the skin is the body’s first line of defense and works hand in hand with the immune
system, the body is open to bacterial infection once a severe burn occurs.
Treatment and Medication
Treatment for burn victims includes both immediate treatment and long term treatment.
Initially, the first step is to stop the burning process, cool the burn, provide pain relief and cover
the burn. Active cooling can help prevent the progression of the burn by removing heat. Immersion
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or irrigation with lukewarm water for at least 20 minutes can be extremely helpful (Porth and
Grossman, 2014). Immediate submersion is more important than removal of clothing, which may
delay the cooling involved areas. Applying ice water is not recommended because it can actually
block the blood flow to the affected area turning it from partial thickness to a full thickness burn.
Once a patient has been hospitalized, the immediate treatment focuses on cardio-
respiratory function, treatment of pain, wound care, and emotional support. Wound care focuses
on protection from infection and further injury of burned areas. Protective coverings are used to
avoid pathogens from entering the wound. Deep third degree burns are usually treated by excision
and skin grafts. Any incisions must be done timely before eschar formation can cause hypoxia and
necrosis of the underlying tissues and organs. Skin grafts are surgically implanted as soon as
possible, often at the same time the burn tissue is excised. Full thickness skin grafts include the
entire thickness of the dermal layer. They are used primarily for reconstructive surgery or for deep,
small areas. Other treatment measure including positioning, splinting and physical therapy to
prevent contractures to maintain muscle tone.
Medications. The goal of medication administration for burn patients is to assist with
pain management, provide protective barriers against microbes and pathogens and to reduce
swelling and inflammation (Meyers Medical Pharmacy, 2014). For major burns, various
medications and products are used to promote healing. Some of these treatments and medications
include water-based therapy, fluids to prevent dehydration, pain and anxiety medications, burn
creams and ointments, dressings, drugs that fight infection and a recommended tetanus shot
(The Mayo Clinic, 2015). Antimicrobial ointments used on burn patients include, but are not
limited to: sulfadiazine, mafenide and silver nitrate. Sulfadiazine is applied 1-2 times daily in a
layer that is 1.5 mm thick. Its indication is prevention of wound sepsis in patients with second
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and third degree burns (Deglin and Vallerand, 2009). Mafenide and Silver nitrate are also topical
ointments that are applied 1-2 times a day 1.5 mm thick. The goal for these medications is to
prevent infection in the exposed tissue (2009).
If the patient develops an infection or if the patient’s risk of developing an infection is
high, I.V. antibiotics will be administered to the burn victim. Some antibiotics used such as
oxacillin, mezlocillin and gentamicin help treat infection. Oxacillin is administered via
intravenous infusion in doses of 250-2000 mg every four to six hours and up to twelve grams a
day. Most broad spectrum antibiotics are used to treat the most common types of bacteria
(Deglin and Vallerand, 2009).
Since pain and anxiety are priorities in the treatment of a burn victim, various pain and
anti-anxiety medications are often used. An example of a pain medication would be a
nonsteroidal anti-inflammatory drug (NSAID). Ketoprofen is and NSAID that belongs to this
group and works by helping reduce the hormones that cause inflammation and pain in the body
(Meyers Medical Pharmacy, 2014). During dressing changes especially, NSAIDS will be used
along with an anti-anxiety medication to help reduce the amount of discomfort to the affected
burn sight(s) (2014).
Nursing Care
Two appropriate nursing diagnoses for a patient with a severe burn injury are impaired skin
integrity and risk for infection. The first diagnoses is impaired skin integrity related to thermal
injury evidenced by disruption of the skin surface and destruction of the skin layers. Some
appropriate interventions would be to assess the patient’s degree of injury and available blood
supply to affected area, assess pain level, assess nutrition status and assess for signs of infection
(Nursing Central, 2012). Nursing actions for this diagnoses would include to assist with
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debridement and care of the affected areas, to administer pain medication and antibiotics when
schedule or before wound care, and supply adequate nutrition and fluid therapy to prevent further
fluid (Gulanick and Myers, 2007). The second nursing diagnosis is risk for infection related to
inadequate primary defenses as evidenced by destruction of skin layers. Nursing goals should be
to reduce risk for infection and to observe for signs and symptoms of infection. Beneficial
interventions for a severely burned patient would be to provide isolation when necessary,
implement proper hand hygiene, administer intravenous antibiotics if applicable, and provide
appropriate wound coverings and wound care to the patient (2007). Providing defense techniques
against infection and providing comfort to the patient are the most beneficial ways to help the
patient to have more success in the healing process after a severe burn (Nursing Central, 2012).
Most cases involving burn victims are caused by unforeseen circumstances. There are a
multitude of ways in which a person can become severely burned and some cases can be avoided
with proper patient education. It is important for both healthcare workers and citizens to become
aware of the factors that may play a role in putting one at risk for being a burn victim. Healthcare
workers play an important role in the overall healing and prevention of infection in severely burned
patients. With an understanding of how to properly care for burn patients, healthcare workers can
make a difference in the outcomes of these patients.
Personal Story
It was merely a week ago when my life completely changed. It was roughly 4pm and I
was driving home from school Thursday after my geriatrics class ended. I remember sitting in
my car in traffic on the 91 freeway, making a mental to-do list of homework, chapters I needed
to read and what I was going to make for dinner tonight since my husband was going to be home.
Suddenly, I felt and heard a huge crash behind my car. A pickup truck had smashed into the back
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of my car and before I could blink my car swerved and crashed directly into one of the cars in the
lane next to me. I couldn’t process what was happening, I was in shock as I witnessed the front
of my car billow up in flames. I tried to recompose myself and open my door, but the door was
stuck. The flames were coming toward me as I reached for the passenger’s door with my right
arm. That’s when my right arm caught on fire. I screamed in pain, but no one could hear me. I
managed to open the door and trample out of the passenger’s side of my car. Screaming and
helpless I tried to think to myself “remember what you learned in grade school: stop, drop and
roll”. I ran away from my burning car and, with my heart racing, I dropped to the ground and
rolled back and forth until I became weak and lethargic. I think the flame on my arm was
extinguished right before I blacked out.
I woke up that evening in the hospital and remembered looking at my arm and noticing it
was covered in white bandages. The doctor came and told me what had happened. He told me I
have suffered a Full-Thickness third degree burn to my right arm. I couldn’t really process was
he was saying because I was still in shock. He explained to me that because of the extent of my
burns, I would have to undergo a series of procedures, skin grafting and physical therapy. He
told me that my arm would never look the same or function as it did before. I remembered
saying, “how could this happen? Why did this have to be my right arm, my good arm? How will
I ever finish school or graduate this year?” The doctor mentioned that I would need to put
nursing school on the back burner. I was distraught and thoughts began to flood my mind about
my entire life. How will I be able to afford paying off these loans without a proper education and
career? How can I go through life with this impairment? Will I ever be able to play guitar again?
Or feel in my arm again? My husband will never be able to look at me the same when he sees my
hideous arm and my scars…I hope no one called him because I don’t want to see his reaction.
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Now what am I good for? I am so disappointed that I allowed something like this to happen. If I
would’ve stayed after class to study with my nursing friends, then maybe this would’ve never
happened! I am literally scarred for life. Even if I can go back to school how would I be able to
learn to do IV’s when my arm is not capable of fine motor skills anymore? I am hopeless and
lost. How can this happen God? What is your purpose in allowing this to happen? I feel so
drained and depressed by this awful circumstance.
During my stay in the burn unit, the only thing that has kept me alive inside is one of the
nurses that has been caring for me. I broke down just yesterday, and she sat by my side and held
my hand. She gave me no false hope or wishful thinking, but she did listen to me and pray for
me. I was comforted by the fact that she was willing to set aside the to-do list for my care and
pay attention to how I was feeling inside. Parse refers to this type of listening as “true presence”,
where the nurse was able to simply be there for me during this difficult time.
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References
Centers for Disease Control and Prevention (2012). Burns: Treatment and Prevention. Mass
Trauma Fact Sheets, 60(32), 703-709. Retrieved September 29, 2013 from
http://www.cdc.gov/masstrauma/factsheets/public/burns.pdf
Deglin, J., & Vallerand, A. (2009). Davis’s drug guide for nurses (11th ed.). Philadelphia, Penn.:
F.A. Davis.
Gulanick, M., Myers, J. L., (2007). Nursing care plans: Nursing diagnosis and intervention (6th
ed.). St. Louis, MO: Elsevier Mosby.
Mayo Clinic (2015). Burns. Retrieved October 2, 2015 from
http://www.mayoclinic.org/diseases-conditions/burns/basics/treatment/con-20035028
Morton, P. G. & Fontaine, D. K., (2012) Critical Care Nursing: A Holistic Approach (10th ed.).
Philadelphia, PA: Lippincott Williams & Wilkins.
Nursing Central (2012) http://nursing.unboundmedicine.com/nursingcentral/ub/
Parse, R. R. (2014). The humanbecoming paradigm: A transformational worldview. Pittsburgh,
Pennsylvania: A Discovery International Publication.
Porth, C., & Grossman, S. (2014). Pathophysiology: concepts of altered health states (9th
ed.). Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins.
Meyers Medical Pharmacy (2014). Treatment for Burns. Retrieved October 1, 2015 from
http://www.myersmedicalpharmacy.com/custom-medications/treatments/burns.php