Burn Classification
Burn of the Epidermis (Sunburn). Over 2 to 3 days the erythema and pain subside.
What is a Superficial (or First Degree) Burn?
Look for entry/exit wound, cardiac monitoring, watch for rhabdo/compartment syndrome. Type of burn.
What is an Electrical Burn?
Fluid and electrolyte imbalances, circulatory failure, vascular compromise, sensory loss, ARDS, hypovolemic shock.
What are systemic complications?
Under 5 and over 65, alcohol/drug use, smoking, physical/mental disabilities, occupation
What are risk factors?
Rules of 9
Arm - 9% Leg - 18% (upper leg 9%, lower leg 9%)
Anterior Trunk - 18% (upper 9%, lower 9%)
Posterior Trunk - 18%
Head - 9% Palmar Surface of Hand - 1%
What is Total Body Surface Area (TBSA)?
Reaches the papillary dermis. Blisters with fluid form at the interface of the epidermis and dermis. Tissue is pink and wet. Heals in less than three weeks.
What is a Superficial Partial-Thickness (or Second Degree) Burn?
Treatment for burn shock
What is Fluid Resuscitation?
Exposure to asphyxiants, smoke, and hot gases.
What are risk factors for airway complications?
WBC - initial increase, then decrease. Blood Glucose - elevated
ABGs - slight hypoxemia. pH - Metabolic Acidosis
H/H - elevated initially, then decreased. Sodium - decreased.
Potassium - increased during initial fluid shift then decreased after fluid mobilization
What are resuscitation phase lab values?
Fluid (mL) for 24 hr = 4 X Weight (kg) X % of TBSA
What is the Parkland Formula?
Reaches the reticular dermis, has blisters, tissue is molted and dry, decreased sensation. Heals in 3 to 9 weeks.
What is a Deep Partial-Thickness (or Second Degree) Burn?
Prevents circumferential constriction of the torso or extremities, removal of eschar with scalpel or electrocautery. Prevents complications of circumferential burns.
What is an Escharotomy?
Forms with full thickness burns, acts as a tourniquet, impairs circulation, can cause body parts to become gangrenous.
What is eschar?
causing factors: inhaling smoke, steam, superheated air, or toxic fumes.
What are Airway Burns?
What is the most important form of treatment?
Burns through all layers of the dermis. Burn is leathery, firm and has no sensation. Does not blanch with pressure, develops a burn eschar. Heals only by wound contracture, epithelialization, or skin grafting.
What is a Full-Thickness (or Third Degree) Burn?
Remove clothing, irrigate with water, shower with soap and water. Type of burn.
What is a Chemical Burn?
Suspected when patient has singed facial, scalp, or nasal hair or presence of charring, edema and blisters along mucosal lining. Peaks within 24-48 hours of injury, ominous signs of hoarseness, labored breathing, or stridor
What is airway obstruction/edema?
High voltage electrical, chemical, and inhalation burns, individuals with circumferential burns.
What are life threatening burns?
Stress ulcer secondary to systemic burns (more than 30% TBSA)
What is a Curling's Ulcer?
Burns through skin, subcutaneous fat, muscle, and bone.
What is a Deep Full-Thickness (or Fourth Degree) burn?
The primary solution for fluid resuscitation
What is Lactated Ringers?
Full-thickness burn affects entire circumference of an extremity, digit, or torso. Can cause compromised perfusion, airway obstruction, and poor respiratory effort.
What is a Circumferential Burn?
Protects against infection, prevents loss of body fluids, regulates body temperature, sensory contact with environment.
What are skin functions?
IV narcotics, benzos, wound management.
What is pain management?