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1
Q

Categorization of Burns

A

Tissue injuries caused by:
Thermal // Electrical // Chemical // Irradation
that results in:
Cell Death // Denaturing // Permeability // Vasodilation

American Burn Association:
Major // Moderate-Uncomplicated // Minor
determined by:
% BSA Affected + Burn Depth

“Rule of Nines”

2
Q

When to Consult a MD
for BURNS

A

If burn is:
Superficial Partial Thickness or GREATER
AND
Covers more than:
1% BSA

“rule of nines”

if it involves the:
Eyes / Face / Ears / Perineum

3
Q

Rule of 9’s

A

Legs = 9% Each

Back = 18%

Arms & Head = half of 9 = 4.5%

4
Q

Superficial Burn
Classification of Burn

A

Epidermis

  • *Local Pain**
  • no blisters or scars*
5
Q

Superficial Partial Thickness
​Classification of Burn

A

Epidermis
& the most superficial portion of dermis

SEE MD

local pain / red
ELEVATED VESICLES

6
Q

Deep Partial Thickness
​Classification of Burn

A

Entire Depth of Dermis & Epidermis

SEE MD

Extensive damage

Leathery Appearance
Infections / Scarring

7
Q

Full Thickness
​Classification of Burn

A

SEE MD

ALL LAYERS OF SKIN + MUSCLE

Charred / Dry

Infections / Skin Grafting

8
Q

Thermal Burns

A

From Flame / heat / Sun / Scald

COOL TAP WATER
to prevent blister fromation
decreases EDEMA

OTC analgesic PRN

9
Q

Electrical Burns

A

Visible at Point of ENTRY & EXIT

Underlying tissue damage

SEE MD

10
Q

Chemical Burns

A

Remove Clothing
on or near Affected area

Wash area with WATER

Irrigate Eye(s)

CALL POISON CONTROL

DO NOT ATTEMP TO NEUTRALIZE THE BURN

11
Q

When to use Antibiotics for Burns?

A

Infections

Use ABx PROPHYLAXIS for:
Moderate –> Severe Burns

Use Systemic ABx in Rare Instances

12
Q

Cleansing Burns

A

Cleanse are with Water + Bland Soap

Non-adherant dressing may be applied
may use a
Skin protectant / Lubricant

if a Weeping Burn:
Soak in Water SEVERAL Times daily

for superficial partial thickness burns:
Cleanse Daily

13
Q

Ideal Dressing

A

REMOVE excess exudate

Maintain a moist environment

permeable to Oxygen

Thermally insulate & Protect the wound

free of particulate & easily removalble

14
Q

Antimicrobial
Types of Wound Dressings

A

When wounds are Colonized / Infected

SILVER & IODINE

Acticoat / Actisorb / Iodoflex

15
Q

Nonadherent
Types of Wound Dressings

A

DO NOT stick to the wound bed
Affordable / Widely Available

Effective on FLAT wounds

Adaptic

Nexcare Pads

Release Dressings

16
Q

Primary
Types of Wound Dressings

A

Placed DIRECTLY on the wound surface

ABSORB Exudates

Provide Protection + Support

Telfa

Comfeel Plus

Aquacel

17
Q

Secondary
Types of Wound Dressings

A

Provide Additional:
Absorption / Protection / Compression

can secure primary dressings to wound

Kerlix / Kling / Confrom

18
Q

Specialty
Types of Wound Dressings

A

Absorb Moisture
Kaltostat / Repel / Melpilex / Actisorb

Maintain Moisture
Exuderm / Suresite

Provide Moisture
AzuaSite / FlexiGel

19
Q

Adhesive Bandages
Types of Wound Dressings

A

Beneficial for SUPERFICIAL Wounds
PREFERRED by patients

Waterproof + Antimicrobial properties

Liquid Adhesive Bandages = Liquiderm

20
Q

Surgical Tape
Types of Wound Dressings

A

Holds Bandages in place

Should be easy to remove

Clear / Paper / Cloth
Types

21
Q

Dressing Burns
Types of Wound Dressings

A

Sterile + NON-Adherent Gauze Dressings
for Small Burns

Self-Adhesive + Waterproof
Dressings

CHANGE DRESSING DAILY

When pain subsides & healing begins –> D/C DRESSINGS

22
Q

Protectants
for BURNS

A

Makes wound area less painful / systomatic relief

Choose a product that:
Prevents DRYNESS & provides LIBRUCATION

Alantoin / Cocoa Butter
Shark Liver Oil / Petrolatum

AAA PRN** for up to **<7 days

23
Q

Systemic Analgesics
for BURNS

A

Aspirin / Ibuprofen / Naproxen
NSAIDS

DECREASE Erythema & Edema
especially in the first 24 hours

APAP will NOT decrease inflammation

24
Q

Topical Anesthetics
for BURNS

A

Benzocaine & Lidocaine
MOST COMMON
benzocaine hypersensitivity in 1% of people

HIGH Conc. –> Intact Skin

low conc –> broken skin

AAA 4xDay

25
Q

Concentrations for Topical Analgesics

A

HIGHER CONC. for INTACT SKIN

Use LOWER CONC. for BROKEN SKIN

26
Q

First Aid Antiseptics

A

DECREASES the Infection Rate

Used to DISINFECT only INTACT skin surrounding the wound

  • *AFTER**
  • *removal of all other matter**

Types:
Hydrogen Peroxide 3% // Ethyl Alcohol
Isopropyl Alcohol // Iodine + Povidone
Camphorated Phenol

27
Q

Hydrogen Peroxide
Types of First Aid Antiseptics

A

Hydrogen Peroxide 3% Topical Solution

Effervescent / Mechanical
cleansing
action

DO NOT apply bandage until area dries

little benefit over soapy water

28
Q

Ethyl Alcohol
Types of First Aid Antiseptics

A

Good BacteriCIDAL Activity

Can cause tissue irritation

1-3 times a day

do NOT apply a bandage until area dries

29
Q

Isopropyl Alcohol 70%
Types of First Aid Antiseptics

A

70%

Used for cleansing + antiseptic effects on INTACT skin

Strong Astringent

STRONGER BacteriCIDAL activity

30
Q

Iodine 2%-2.5%
Types of First Aid Antiseptics

A

Antiseptic for superficial wounds

avoid bandaging wound after application

STAIN the skin

31
Q

Povidone / Iodine
Types of First Aid Antiseptics

A
  • *9-12% Iodine**
  • *BETADINE** Skin cleanser liquid = Povidone/Iodine 7/5%

NON-Irritating to skin

Absorbed SYSTEMICALLY

DO NOT USE on _Severe Burns / Large Wounds_

32
Q

Camphorated Phenol
Types of First Aid Antiseptics

A

Phenol 4%
Campho-Phenique Gel/Liquid
= Camphor 10.8% / Phenol 4.7%
Unguentine Ointment = Phenol 1%

Apply only to Dry + Intact Skin

AVOID bandaging wound after application

33
Q

Topical Steroids
for BURNS

A

Hydrocortisone 1% cream/ointment

for Minor Burns covering a small area

CAUTION IF SKIN IS BROKEN
= INFECTIOUS

34
Q

Topical Antimicrobials
for BURNS

A
  • *CRUCIAL TO MAJOR BURN THERAPY**
  • if skin is INTACT, of LIMITED use*

BACITRACIN / NEOMYCIN / POLYMIXIN B

  • *RX** topical ABx for MAJOR burns:
  • *Silver Sulfadiazine (SSD)**
  • questionable efficacy / MAY DELAY wound healing*
35
Q

Vitamins for BURNS

A

Commonly used for severe burns
C-A-B /// E is bad

C = Collagen Synthesis

A = Enhances Healing

B = Promote Wound Healing

E = may DELAY wound healing

36
Q

Self-Treatment GOALS of
Minor Superficial Burns

A

Relieve PAIN associated w/ burn

AVOID Maceration of tissue

Prevent DRYNESS

Provide a favorable environment for HEALING
that MINIMIZES the chances of INFECTION & SCARRING

37
Q

Self-Treatment Recommendation
for BURNS

A

for Minor Superficial Thickness Burns
< 1% BSA

DO NOT cover extensive area

  • DO NOT INVOLVE:*
  • *Eyes / Ears / Face / Perineum**