1
EMERGENCY TRAUMA AND ENVIRONMENTAL INJURIES TRIAGE, CARE,
AND MANAGEMENT ACUTE & CHRONIC HEALTH DISRUPTIONS IN
ADULTS III (ARIZONA COLLEGE OF NURSING) 2026-27 VERSION
,2
Med Surg 3 Exam 4
Classification of Burns
1. Thermal: Scalds (most common), flame.
➢ Thermal burns result from flash, scald, or contact with
hot objects or flames, commonly caused by house fires,
car fires, cooking accidents, or smoking. Use of accelerants like
gasoline or propane can worsen the injury by adding a chemical component.
Contact burns often occur during cooking or heating, while scald injuries, most
common in children, may result from accidents or abuse. The depth of thermal
burns depends on the temperature of the heat and the length of exposure.
2. Electrical: High voltage, lightning, AC/DC.
➢ Electrical injuries range from mild to fatal and often involve deep
internal damage despite minimal skin injury. They can cause
cardiac, neurological, and organ damage, often requiring long hospital
stays and multiple surgeries.
Injuries occur through direct contact, electrical arcs, or flame ignition. Severity
depends on current type, strength, duration, and path through the body.
Alternating current can cause muscle tetany, prolonging contact, while direct
current (lighting, batteries) may lead to sudden cardiac or respiratory arrest.
Electricity tends to follow bone surfaces, damaging surrounding tissues.
Occupational exposure is common in adults, and newer risks include electric
vehicle chargers
3. Chemical: Acids, alkalis, organic compounds.
➢ Chemical burns make up about 3% of burn center admissions and can occur in
both industrial and household settings. They are classified as acid, alkaline, or
organic compound burns. Common sources include cement, gasoline, lime,
hydrofluoric acid, and bleach. The severity depends on the type, concentration,
amount, and duration of contact with the chemical.
4. Radiation: Sunburn, radiation therapy.
➢ Radiation burns are rare and vary in severity based on the type, dose, and
exposure time. They are seen in industrial settings, nuclear accidents, or radiation
therapy. Sunburn is the most common type, caused by UV radiation. Local
radiation burns resemble thermal burns with redness, swelling, blisters, and pain.
,3
Prolonged full-body exposure may cause systemic symptoms like nausea,
vomiting, diarrhea, fatigue, headache, and fever.
Burn Depth
Superficial: Mild erythema and hypersensitivity
Superficial partial thickness: Painful, wet weeping blisters and pink
Deep partial thickness: Painful, loss of sensation, waxy, light pink or cherry red, decreased or
absent capillary refill
, 4
Blisters debrided
Burn Depth Tissue Wound Pain Healing
Involvement Characteristics Assessment
Superficial Minimal Dry/No blisters Hypertensive 3-7 days with no
Damage to the Pink or Red scaring
Epidermis Blanches easily
Superficial ENTIRE BLISTERS Hypersensitive 7-14 days with no
Partial Epidermis that may be scarring
Thickness Minimal Open and
damage to the weeping. Pink or
Dermis Red
Mild Edema
Blanches easily
Deep Partial Entire Blisters that may Hypersensitive Healing may take
Thickness Epidermis be closed or around the 3-6 weeks and
And DEEPER open. Waxy wound but may may leave
layers of the appearance. be sensitive to scarring, or
Dermis Cherry red, pressure only in wound may have
Mottled, or pale the center to be surgically
in the center. excised and
Edema. grafted.
Sluggish or no
blanching
Full Thickness Destruction of Dry, Leathery, No pain in the NEEDS
Entire Pale, White, center of the SURGERY Wil
Epidermis and Brown, Tan, wound, May l not heal without
Dermis, May Black, Charred, be sensitive to surgical excision
involve No blanching. and grafting.
subcutaneous May be
pressure
fat, muscle, contracted if
and/or bone. muscle
involvement
Care of the Superficial and Minor Partial Thickness Burn
Superficial Burns from sun, no blistered noted.
Blisters Partial Thickness
Superficial
• DO NOT APPLY ice or submerge in water
EMERGENCY TRAUMA AND ENVIRONMENTAL INJURIES TRIAGE, CARE,
AND MANAGEMENT ACUTE & CHRONIC HEALTH DISRUPTIONS IN
ADULTS III (ARIZONA COLLEGE OF NURSING) 2026-27 VERSION
,2
Med Surg 3 Exam 4
Classification of Burns
1. Thermal: Scalds (most common), flame.
➢ Thermal burns result from flash, scald, or contact with
hot objects or flames, commonly caused by house fires,
car fires, cooking accidents, or smoking. Use of accelerants like
gasoline or propane can worsen the injury by adding a chemical component.
Contact burns often occur during cooking or heating, while scald injuries, most
common in children, may result from accidents or abuse. The depth of thermal
burns depends on the temperature of the heat and the length of exposure.
2. Electrical: High voltage, lightning, AC/DC.
➢ Electrical injuries range from mild to fatal and often involve deep
internal damage despite minimal skin injury. They can cause
cardiac, neurological, and organ damage, often requiring long hospital
stays and multiple surgeries.
Injuries occur through direct contact, electrical arcs, or flame ignition. Severity
depends on current type, strength, duration, and path through the body.
Alternating current can cause muscle tetany, prolonging contact, while direct
current (lighting, batteries) may lead to sudden cardiac or respiratory arrest.
Electricity tends to follow bone surfaces, damaging surrounding tissues.
Occupational exposure is common in adults, and newer risks include electric
vehicle chargers
3. Chemical: Acids, alkalis, organic compounds.
➢ Chemical burns make up about 3% of burn center admissions and can occur in
both industrial and household settings. They are classified as acid, alkaline, or
organic compound burns. Common sources include cement, gasoline, lime,
hydrofluoric acid, and bleach. The severity depends on the type, concentration,
amount, and duration of contact with the chemical.
4. Radiation: Sunburn, radiation therapy.
➢ Radiation burns are rare and vary in severity based on the type, dose, and
exposure time. They are seen in industrial settings, nuclear accidents, or radiation
therapy. Sunburn is the most common type, caused by UV radiation. Local
radiation burns resemble thermal burns with redness, swelling, blisters, and pain.
,3
Prolonged full-body exposure may cause systemic symptoms like nausea,
vomiting, diarrhea, fatigue, headache, and fever.
Burn Depth
Superficial: Mild erythema and hypersensitivity
Superficial partial thickness: Painful, wet weeping blisters and pink
Deep partial thickness: Painful, loss of sensation, waxy, light pink or cherry red, decreased or
absent capillary refill
, 4
Blisters debrided
Burn Depth Tissue Wound Pain Healing
Involvement Characteristics Assessment
Superficial Minimal Dry/No blisters Hypertensive 3-7 days with no
Damage to the Pink or Red scaring
Epidermis Blanches easily
Superficial ENTIRE BLISTERS Hypersensitive 7-14 days with no
Partial Epidermis that may be scarring
Thickness Minimal Open and
damage to the weeping. Pink or
Dermis Red
Mild Edema
Blanches easily
Deep Partial Entire Blisters that may Hypersensitive Healing may take
Thickness Epidermis be closed or around the 3-6 weeks and
And DEEPER open. Waxy wound but may may leave
layers of the appearance. be sensitive to scarring, or
Dermis Cherry red, pressure only in wound may have
Mottled, or pale the center to be surgically
in the center. excised and
Edema. grafted.
Sluggish or no
blanching
Full Thickness Destruction of Dry, Leathery, No pain in the NEEDS
Entire Pale, White, center of the SURGERY Wil
Epidermis and Brown, Tan, wound, May l not heal without
Dermis, May Black, Charred, be sensitive to surgical excision
involve No blanching. and grafting.
subcutaneous May be
pressure
fat, muscle, contracted if
and/or bone. muscle
involvement
Care of the Superficial and Minor Partial Thickness Burn
Superficial Burns from sun, no blistered noted.
Blisters Partial Thickness
Superficial
• DO NOT APPLY ice or submerge in water
