7 Burn

Chapter Seven
Burns
Burns of the Body
Learning Objectives
After studying the material in this chapter, the student

will be able to:-
1. Define burn injury
2. Differentiate different causes of burn in different
areas.
3. Identify different classifications and degrees of
burn.
4. Recognize first aid measures for different degrees
of burn. 2
Introduction
• Fire is an accident that causes frequent great damage
to life and properties.
• Children are the most vulnerable to burn.
• Burns that occur around the mouth and nose and in

general in the face are more dangerous and can
cause death.
3
Burns are…
• Traumatic
• Painful
• Dehumanizing
• Embarrassing
• Holistic
• Disfiguring
• Incapacitating
• Fatal
4
Burn Etiology
• Burn injuries occur when there is direct or indirect
contact with a heat source.
– Electrical wiring, hot liquid, lightning, sun, caustic
chemicals, fire
• No matter the cause, the burn injury results in loss of
skin integrity.
• Inhaling smoke causes injury to the lung known as an
inhalation injury
5
Causes of burns
• Fire, boiled water, steam, boiled oil/milk etc.
• Sun-rays
• Electric and thunder accidents &
• Different chemicals
6
Types of Burns
• Thermal
– Most often from fire
– Extent depends on the length of exposure and temperature of
the heat source
• Scald
– Type of thermal burn caused by hot food or liquid
– Extent depends on the length of exposure and temperature of
the heat source
• Electrical
– Tend to be deeper than other burns
– Extent depends of amount of voltage, length of exposure, type of
current, pathway of flow, and local tissue resistance.
– Difficult to assess damage
7
• Radiation
– Result from overexposure to the sun, radiation treatment,
industrial accidents
– Extent depends on how close the individual was to the source
and length of exposure.
• Chemical
– Occur when the skin contacts a caustic agent
– Extent depends on length of exposure
• Inhalation Injury
– Result from inhaled smoke and heated air
– The majority of deaths from burn injuries are due to smoke
inhalation
– Signs include: burns to the face and neck, singed nasal hair, dry
cough, bloody sputum, labored respiration. 8
Effects/hazards of the burn accident
Immediate effects/hazards
• Burns and wounds of the body
• Severe pain
• Oozing and reduction of body fluid from the
wound
• Difficulty in breathing because of suffocation
from smoke, severe burns around the throat and
face; &
• Drowziness, restlessness and unconsciousness.
9
Delayed effects/hazards
• Infections of the wound, septicemia, and high

fever
• Disability
• Scar
• Contracture &
• Tetanus
10
Classification of burns
• Burns are usually classified in three levels based

on the depth or degree of skin damage.
These are:-
• First degree burn
• Second degree burn &

• Third degree burn.
11
Classification of burn
• Based on the depth of injured body parts & extent of body
surface area injured.
1. Superficial partial thickness /1st degree burn
• Epidermis is damaged
• Manifested as erythematous, mild pain and mild swelling
• No vesicles or blisters
• Most of the time it is self limited
• Tingling, hyperesthesia
• Pain that is soothed by cooling
• Redness or discoloration
• Rapid healing. 12
2. Deep partial thickness/2nd degree
burn
Greater depth than first degree burns
• Redness and mottled appearance
• Formation of blisters or fluid filled vesicles
• Swelling
• Prone to infection
• Damages the epidermis and varying depth of
dermis
• Severe pain due to nerve endings have been
injured and exposed
• Mild to moderate edema
• During healing phase dryness and itching is
common 13
3. Full thickness/3rd degree burn
- All skin layers and nerve endings, tissues are destroyed

- Dry, waxy, white, leathery or hard skin
- Pain free
- Possible involvement of muscles, tendons and bones
- Shock, hematuria
14
Measuring Body surface area
(BSA)burned
% BSA involved Morbidity and mortality
• To measure BSA burned we use

 Rule of Nines
 Rule of Palms
Good for estimating small patches of burn wound.
Palmar surface = 1% of the BSA
15
DETERMINATION OF SIZE OF BURN in adults
RULE OF NINES
 Quick estimate of percent of
burn
 Developed by Pulaski and
Tennison
Head: 9%
Anterior: 18%
Posterior: 18%
Arms: 9% each
Legs: 18% each
Perineum: 1%
Total 100% 16
Rule of nine in adults
17
Rule of nine in children
18
19
First-aid measures
1. If the victim is burning with fire apply cold
applications, immerse the burned area in cold water
role the burned person on the ground, or cover with
water socked thick cloth or blanket and put out the
fire.
2. If the accident is of electric source, quickly
disconnect at the electric meter or check point, or use
rope, wooden stick, dried cloth etc. to disconnect.
3. Move the victim from the accident place to avoid

further injury.
20
First-aid measures …
4. Loosen and/or remove burned dresses and lay down

the victim on his/her back and let him/her breathe
fresh air and ensure that no foreign objects have
entered and blocked the passage of the respiratory
system.
5. If the victim is not breathing properly, initiate mouth

to mouth artificial respiration.
6. Thoroughly check the wound to determine the size,

and the degree of burn.
21
Measures for 1st degree burn
• Apply cold water application or submerge the burned
area in cold water.
• If the wound is minor and small, clean daily the area

with boiled cold water cover it with clean cloth to
prevent contact with flies, if the wound located in a
joint, immobilize the joint area until the wound is
cured;
• If the wound is from boiled water, chemical (acid),

take out his/her dress and cover it with clean cloth.
22
2nd and 3rd degree burn
• Cover the wound with clean cloth

• If the victim is conscious, his/her respiratory parts such
as mouth, nose and throat are free from burn injury and
give him/her frequently plenty of liquid such as ORS or
similar solution (prepare the solution from eight tea
spoons of sugar, one spoon salt in one litre of boiled cold
water).
• If the victim is a child below two years old give it one

spoon every two minutes and if the child is over two
years give it with a cup or glass in small amount every
two minutes. 23
• Advise the victim or his family to get tetanus
toxoid vaccine/TAT.
• If the victim is unconscious, and has burns on face

and respiratory organs, him/her down and without
giving him/her anything by mouth quickly bring
him/her to the near by health facility.
24
Take immediately to a nearby health facility burn victims with the following signs
• First degree burn with sizeable/large area

• 2nd and 3rd degree burns
• If the victim is drowsy, restless and has breathing
problem
• If the victim has burns on his face, eye, extremities,
joints and around genital organs
• If the source of the burn is electrical, chemical
• If the patient has chronic disease such as epilepsy,
diabetes etc.
• If the burn accident is on elderly persons or children.25
Fluid replacement Indications
• Burns greater than 20% of the total BSA in adult
• Burns greater than 10% of TBSA in children
• Pt older than 65 years of age or younger than 2

years of age
• Pt with preexisting diseases (cardiac, pulmonary or
diabetic disease).
26
Fluid Resuscitation for burn patient
• Approximate the amount of fluid needed by using
the Consensus formula.
– During the first 24 hours, the patient will need:
• 4 Ml × Body weight (in kg) × Percentage of

body surface burned
– Half is given during first 8 hours.
– Half is given over the subsequent 16 hours.
27
Example:
Using Parkland formula calculate the amount of fluid
required for a patient weighing 70 kg with a 50 % TBSA
burn:
Solution:
 4Ml x 70Kg x 50 = 14,000 ml needed in 24 hours.
7000 ml are needed in the first 8 hours.
The remaining 7000 ml should be given within 16 hours.
28
Thanks!!!
29

7 Burn

Uploaded by

Copyright:

Available Formats

7 Burn

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

7 Burn

Uploaded by

Copyright:

Available Formats

Chapter Seven

After studying the material in this chapter, the student

• Children are the most vulnerable to burn.

• Burns that occur around the mouth and nose and in

• Fire, boiled water, steam, boiled oil/milk etc.

• Electric and thunder accidents &

• Infections of the wound, septicemia, and high

• Burns are usually classified in three levels based

• Second degree burn &

- All skin layers and nerve endings, tissues are destroyed

% BSA involved Morbidity and mortality

• To measure BSA burned we use

3. Move the victim from the accident place to avoid

4. Loosen and/or remove burned dresses and lay down

5. If the victim is not breathing properly, initiate mouth

6. Thoroughly check the wound to determine the size,

• If the wound is minor and small, clean daily the area

• If the wound is from boiled water, chemical (acid),

• Cover the wound with clean cloth

• If the victim is a child below two years old give it one

• If the victim is unconscious, and has burns on face

• First degree burn with sizeable/large area

• Burns greater than 20% of the total BSA in adult

• Burns greater than 10% of TBSA in children

• Pt older than 65 years of age or younger than 2

• 4 Ml × Body weight (in kg) × Percentage of

You might also like

Pfad - The Proxy pFad of © 2024 Garber Painting. All rights reserved.