Describe thermal burns.
Result of flash, scald, or contact with hot objects and flames.
Associated accelerant use (gasses) can increase severity of burn
and inhalation injury due to added chemical insult.
What are the common causes of thermal burns?
House fires, car fires, cooking accidents, injury from smoking.
Note: Contact burns are thermal in nature and associated with
cooking and heating accidents, scald injuries are most prevalent
among the young and associated with accidents or abuse
Describe electrical burns.
Can result in a wide spectrum of injuries from mild to lethal,
majority are work related
Describe chemical burns.
Three subclasses include acids, alkaline, and organic
compounds, both injury and household
Describe radiation burns.
Least common type of burn injury, severity of complications
depend on type, dose, and length of exposure.
What are the some cause of radiation burns?
,Often associated with industry of ionizing radiation, nuclear
accidents, and therapeutic radiation treatment. Sunburn is also
considered radiation by UV radiation.
Burn Depth: Describe the superficial layer.
Only affect epidermal layer of skin
Note: Sunburn is the most common type.
What are the characteristics of the superficial layer?
Mild erythema and hypersensitivity, typically resolve in 24-72
hours. Heal quickly and typically do not require medical
intervention or admission to a burn center, don't usually result in
scarring.
Burn Depth: Describe the superficial partial thickness layer.
Involves epidermis and the superficial/minimal layers of dermis,
exposed nerve endings in the dermal later often make these
burns painful.
What are the characteristics of the partial thickness layer?
Wet, weeping blisters and pink in color, capillary refill time on
open areas of blisters remain normal, patient is sensitive to touch
and air currents when the wound is exposed. Heals in 1-2 weeks
with minimal to no scarring.
Burn Depth: Describe deep partial thickness layer.
Involves epidermis and extends into deeper portions of bottom
layers of dermis
Describe the characteristics of deep partial thickness layer.
, Appear waxy and do not have weeping blisters, light pink or
cherry red, capillary refill is decreased or absent, patient reports
varying areas of pain and decreased sensation
Burn Depth: Describe the full-thickness layer.
Muscle and bone involvement.
Describe the rule of palms.
Size of hand, including fingers is 1% TBSA, useful for very
small and/or very large burns, scattered burns, and in mass
casualty situations where time is of the essence
Describe the rule of nines.
Most commonly used in pre-hospital setting, body surface areas
broken into percentages and is modified for infants and children,
concern is that all people have the same distribution of body
surface area percentages.
Describe the Lund and Browder classification.
In hospital setting and majority of burn centers, most widely
accepted and accurate method. Measurements take into account
surface area related to age and are assigned to each body part
Describe the fluid replacement formula (Parkland)
2-4ml/hr x TBSA x weight in kgs = Total fluid resuscitation in
the first 24 hours
Remember: 50% needs to be infused in first 8 hours. The
remaining 50% over the next 16 hours.
Concentric Zones: Describe coagulation.