EXIT HESI: BURNS WITH SOLUTIONS

EXIT HESI: BURNS WITH SOLUTIONS


Tissue injury or necrosis caused by transfer of energy from a heat source to the body

Categories: - ✔✔thermal, radiation, electrical, chemical

Tissue destruction results from: - ✔✔Coagulation

Protein denaturation

Ionization of cellular contents

Critical systems affected include - ✔✔Respiratory

Integumentary

Cardiovascular

Renal

GI

Neurologic

Severity is determined by burn depth

First degree - ✔✔SUPERFICIAL partial thickness (sunburn)

Injury to the epidermis

Leaves skin pink or red, but NO blisters

Dry

Painful (relieved by cooling)

Slight edema

No scarring and skin grafts are not required

Second degree - ✔✔DEEP partial thickness destruction of epidermis and upper layers of dermis

Injury to deeper portions of the dermis

Painful (sensitive to touch and cold air)

, Appeared RED or WHITE, WEEPS FLUID, Blisters present

Hair follicles intact (i.e. hair does not pull out easily)

Very edematous

Blanching followed by capillary refill

Heals without surgical interventions, usually does not scar

Third degree - ✔✔Full thickness and deep full thickness; involves total destruction of dermis and
epidermis

Skin CANNOT regenerate

Requires skin grafting

Underlying tissue (fat, fascia, tendon, bone) may be involved

Wound appears dry and leathery as eschar develops

PAINLESS

Severity is determined by extent of surface area burned.

Rule of nines: - ✔✔Head and neck 9%

Upper extremities 9% each

Lower extremities 18% each

Front trunk 18%

Back trunk 18%

perineal area 1%

Head and neck - ✔✔9%

Upper extremities each - ✔✔9%

Lower extremities - ✔✔18% each

Front trunk - ✔✔18%

back trunk - ✔✔18%

Perineal area - ✔✔1%