"Understanding Burns: A Comprehensive Overview" This presentation provides a comprehensive overview of burns, covering their classification, causes, symptoms, and treatment options. From minor burns to severe injuries, we explore the various degrees of burns and the associated complications. Additionally, we delve into preventive measures and first aid techniques for burn management. Whether you're a healthcare professional or simply interested in learning more about burns, this presentation offers valuable insights into this common yet often misunderstood injury.

1. TOPIC:-
BURN AND SCALDS

2. Contents:-
Definition of burn.
Definition of scalds.
Types of burn.
Classification of burn.
Rule of Nines.
Difference between 1st, 2nd and 3rd degree burn.
Causes of burn and scalds.
Clinical feature of burn.
Management of burn.
Complications of burn.
Criteria of hospitalized burn patient.
Agents used for burn.

3. Concepts of burn and scalds:-
Burn and scalds are damage to the skin caused by heat.Both are treated in the
same way. A burn is caused by dry heat-by an iron or fire. A scald is caused by
something wet,such as hot water or steam.

4. Definition of burn:-
According to WHO – “A burn is an injury to the skin or other organic tissue
primarily caused by heat or radiation, radioactivity, electricity or chemicals as
well as respiratory damage resulting from smoke inhalation are also considered to
be burn”.
“OR’’
A burn is the destruction of tissue by dry heat. E.g:- Fire, Acid, Electricity and so
on.

5. Definition of scalds :-
Scalds is a form of thermal burn injury resulted from heated fluids such as
boiling water or steam.

6. Types of burns:-
• Thermal injury-it is due to dry heat.
• Electrical injury.
• Scald injury-it is moist heat,e.g:- hot water or steam.
• Chemical burns-Acid, Alkali.
• Cold injury-by frost.
• Ionizing radiation.

7. A. Depending on the percentage of burn.
B. Depending on the thickness of skin involved.
Classification of burns:-

8. A.Depending on the percentage of burn :-
1. Mild burn:- Partial thickness burn <15 % in adults Or < 10% in children.
2. Moderate burn :- Second degree of 15-25 % burns in adult and 10-20% in
children.
*Burns which are not involving eyes, ears, feet, perineum.
3. Severe or Major burn:-Second degree burns more then 25% in adults and in
children more then 20%.

9. B. Depending on the thickness of skin involved:-
• First-degree burns (Superficial burns):
• These burns affect only the outer layer of the skin, the epidermis.
• Symptoms include redness, minor swelling, and pain.
• They often heal within a week without scarring.
• Second-degree burns (Partial-thickness burns):
• These burns affect both the outer layer (epidermis) and the underlying layer
of skin (dermis).
• Symptoms include redness, swelling, blistering, and severe pain.
• They may take several weeks to heal and can result in scarring.

10. • Third-degree burns (Full-thickness burns):
• These burns extend through all layers of the skin and may also damage
underlying tissues, such as muscle and bone.
• Symptoms may include white or blackened, charred skin, numbness due to
nerve damage, and severe pain.
• Healing typically requires medical intervention such as skin grafts, and
scarring is often significant.
• Fourth-degree burns:
• These are the most severe burns, extending beyond the skin into muscles,
tendons, and even bone.
• Symptoms include charring, deep tissue destruction, and potentially life-
threatening complications.
• Extensive medical treatment, including surgery and rehabilitation, is
necessary for recovery.

12. Rule of nines:-
• Front and back of the head and neck:9% each
• Front and back of each arm and hand: 9% each
• Chest: 9%
• Abdomen: 9%
• Upper and lower back: 9% each
• Front and back of each leg and foot: 18% each
• Genital area: 1%
• Total=100%

14. Difference between 1st,2nd and 3rd degree burn
Traits First degree Second degree Third degree
1.Depth Epithelium Epithelium and top aspects
of the dermis.
Epithelium and dermis
2.How the wound looks No blister,dry pink Moist,oozing bliters,moist
white,pink to red.
Leathery,dry,no elasticity,
charred appearance.
3.Causes Sunburn,scald,flash
flame.
Scalds, flash burns,
chemical.
Contact with flame, hot surface,
hot liquids,chemical,electric.
4.Pain level Painful,tender and sore. Very painful. Very little pain or no pain
5.Healing time Two to five days Superficial-5 to 21 days.
Deep-21-35 days.
Small areas may take months to
heal;large areas need grafting.
6.Scarring No scarring, may have
discoloration.
Minimal to no scarring,may
have discoloration.
Scarring present.

15. Causes of burn :-
• Dry heat like fire.
• Contact with hot metals.
• Chemicals, acids, ammonia, caustic soda..
• Electricity.
• Radiation.
• Flames.
• Lighting.
• Friction.

16. Causes of scalds :-
• Boiling water.
• Steam from boiling water.
• Any other hot liquid such as tea,coffee,hot oil e.t.c.

17. Clinical features:-
• Blister.
• Pain.
• Redness.
• Peeling skin.
• Swelling.
• Numbness or Reduced Sensation.
• Skin Texture Changes.
• White or charred skin.
• Wheezing.
• Change in voice.
• Difficulty in breathing.(in Inhalation Injuries)
• Shock.

18. Management of burn:
First aid management
Nursing management
Medical management

19. First Aid Management:-
1. Stop the burning process, patient should be removed from the source of burn
and clothing should be removed.
2.Cool the area with tap water by continuous irrigation for 15-20 minutes(not too
cold water which may cause hypothermia).
3.Immediately wrapped the affected area with a clean moist towel or sheet.
4.Keep the patient in a clean environment.
5.Monitoring the patients pulse, BP, respiration and urine output.
6.Do not puncture the blisters.
7.Never apply topical home remedies or creams to a newly burned area.
8.Transfer the patient to the nearest hospital.

20. Nursing Management:

21. Initial assessment:-
1.History taking: Age of the patient, time of burn, type of burn, site of burn,
possibility of smoke inhalation.
2.Physical Examination:
• Assessment of vital signs: Pulse, blood pressure, temperature, respiratory rate.
• Assessment of extent of burn by rule of nines.
• Assessment of depth, degree of burn, partial thickness or full 1st degree,2nd
degree,3rd degree.

22. 3.Initial Management:-
The principle of managing an acute burn injury -
A=Airway control.
B=Breathing and ventilation.
C=Circulation.
D=Disability.
E=Exposure with environmental control.
F=Fluid resuscitation.

23. Medical Management

24. Fluid replacement Therapy:-
In 1st 24 hours:-Crystalloid solution:-Hartman solution.
Dose:-The amount of fluid volume in ml 1st 24 hours = 3-4(ml of IV
fluid)×body wt (kg)× % total burned surface area.
• Adult : 4ml/kg/percent of burned surface area.
• Child: 3ml/kg/percent of burned surface area.

25. Amount:-
• ½ fluid is given in 1st 8 hours.
• ¼ fluid is given in 2nd 8 hours.
• ¼ fluid is given in 3rd 8 hours.
In 2nd 24 hours:- Colloid solution added with crystalloid solution.
e.g: Plasma, albumin, Dextran.
• Dose: 0.35-1 ml/kg/percent of burned surface area.

26. • Example:-
If weight is 70 kg and burn is 30%
Total fluid needed=4*70*30 ml=8400ml
1st 8 hours= 4200 ml,2nd 8 hours=2100 ml,3rd 8 hours = 2100 ml.
Antibiotic. e.g:-Flucloxacillin, Penicillin, erythromycin etc.
Analgesics. e.g:-Morphine, Ibuprofen etc.
Provide nutritional support.
Maintain electrolyte imbalance.
Administer tetanus prophylaxis if necessary.
Monitor vital signs, fluid balance and urine output.
Blood transfusion.

27. Local treatment:-
• Strict asepsis-local antiseptic cream.
(1% silver sulphadiazine)
• Clean room with temperature 75-80F and low humidity.
• Dressing should be done.
• Skin grafting-in full thickness burn.

28. Complications of burn:-
A. Immediate complications:-
• Shock
• Fluid overload
• Renal dysfunction
• Pulmonary dysfunction
• Hypothermia
• Multiple organ dysfunction
• Electrolyte imbalance

29. B. Delayed complications:
• Wound infection
• Delayed wound healing
• Hypertrophic scarring
• Contractures
• Chronic pain
• Septicemia
• Cerebral damage
• Failed skin graft
• Loss of function

30. Agents used for burn:
• Silver sulfadiazine 1%
• Mafenide acetate 5%-10%
• Silver nitrate 0.5%
• Silver- impregnated.
• Bismuth-impregnated petroleum gauze.
• Chlorhexidine.
• Povidone-iodine
• Dakin's solution.(sodium hypochlorite solution)

31. • Partial thickness burns covering 10% of total body surface area or greater.
• Burns involving the face, hands, feet, genital area or major joints.
• Third degree burns.
• Electrical burn including lightning injury.
• Chemical burns.
• Inhalation injury.
• Burn injury in pts with preexisting medical disorders.
• Any pts with burns and concomitant trauma.
• Pts who will require special social emotional or log term rehabilitation.
Criteria of hospitalization burn pts

32. Exercise

33. 1. Which layer of the skin is primarily affected in a first-degree burn?
a. Epidermis
b. Dermis
c. Subcutaneous tissue
d. Muscle
Answer: Epidermis.
2. What is the recommended initial treatment for a minor burn injury?
a. Application of ice directly on the burn
b. Covering the burn with butter or oil
c. Immerse the burn area in cold water for 10-15 minutes
d. Apply antiseptic cream without cooling the burn
Answer: Immerse the burn area in cold water for 10-15 minutes.
3. Which type of burn is characterized by damage to the epidermis and part of the dermis, causing
redness, blistering, and pain?
a. First-degree burn
b. Second-degree burn
c. Third-degree burn
d. Fourth-degree burn
Answer: Second-degree burn.

34. 4. What is the "rule of nines" used for in assessing burns?
a. Estimating the severity of a burn injury
b. Determining the number of days until a burn heals
c. Calculating the amount of burn cream needed for treatment
d. Identifying the shape of the burn area
Answer: Estimating the severity of a burn injury
5. Which factor is NOT considered in determining the severity of a burn injury?
a. Age of the patient
b. Depth of the burn
c. Size of the burn area
d. Time of day when the burn occurred
Answer: Time of day when the burn occurred
6. Inhalation injury is a significant concern in burn cases. Which of the following statements about inhalation injury is
true?
a. Inhalation injury only occurs in electrical burns.
b. It can result from exposure to smoke or toxic gases.
c. Inhalation injury does not affect the respiratory system.
d. Inhalation injury is easily diagnosed without specialized tests.
Answer: It can result from exposure to smoke or toxic gases.

35. 7. What is the leading cause of death in burn patients?
a. Sepsis
b. Respiratory failure
c. Cardiac arrest
d. Organ failure
Answer: Sepsis
8. Which type of burn requires immediate medical attention and is characterized by damage to all layers of the
skin, nerves, muscles, and possibly bones?
a. First-degree burn
b. Second-degree burn
c. Third-degree burn
d. Fourth-degree burn
Answer: Third-degree burn
9. Which age group is at the highest risk for burn injuries?
a. Children under 5 years old
b. Teenagers
c. Adults between 30-50 years old
d. Elderly individuals over 65 years old
Answer: Children under 5 years old

36. Thank you for watching