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1

Categorization of Burns

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

When to Consult a MD
for BURNS

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

Rule of 9's

Legs = 9% Each

Back = 18%

Arms & Head = half of 9 = 4.5%

4

Superficial Burn
Classification of Burn

Epidermis

Local Pain
no blisters or scars

5

Superficial Partial Thickness
​Classification of Burn

Epidermis
& the most superficial portion of dermis

SEE MD

local pain / red
ELEVATED VESICLES

6

Deep Partial Thickness
​Classification of Burn

Entire Depth of Dermis & Epidermis

SEE MD

Extensive damage

Leathery Appearance
Infections / Scarring

7

Full Thickness
​Classification of Burn

SEE MD

ALL LAYERS OF SKIN + MUSCLE

Charred / Dry

Infections / Skin Grafting

8

Thermal Burns

From Flame / heat / Sun / Scald

COOL TAP WATER
to prevent blister fromation
decreases EDEMA

OTC analgesic PRN

9

Electrical Burns

Visible at Point of ENTRY & EXIT

Underlying tissue damage

SEE MD

10

Chemical Burns

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

When to use Antibiotics for Burns?

Infections

Use ABx PROPHYLAXIS for:
Moderate --> Severe Burns

Use Systemic ABx in Rare Instances

12

Cleansing Burns

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

Ideal Dressing

REMOVE excess exudate

Maintain a moist environment

permeable to Oxygen

Thermally insulate & Protect the wound

free of particulate & easily removalble

14

Antimicrobial
Types of Wound Dressings

When wounds are Colonized / Infected

SILVER & IODINE

 

Acticoat / Actisorb / Iodoflex

15

Nonadherent
Types of Wound Dressings

DO NOT stick to the wound bed
Affordable / Widely Available

Effective on FLAT wounds

Adaptic

Nexcare Pads

Release Dressings

16

Primary
Types of Wound Dressings

Placed DIRECTLY on the wound surface

ABSORB Exudates

Provide Protection + Support

Telfa

Comfeel Plus

Aquacel

17

Secondary
Types of Wound Dressings

Provide Additional:
Absorption / Protection / Compression

can secure primary dressings to wound

Kerlix / Kling / Confrom

18

Specialty
Types of Wound Dressings

Absorb Moisture
Kaltostat / Repel / Melpilex / Actisorb

Maintain Moisture
Exuderm / Suresite

Provide Moisture
AzuaSite / FlexiGel

19

Adhesive Bandages
Types of Wound Dressings

Beneficial for SUPERFICIAL Wounds
PREFERRED by patients

Waterproof + Antimicrobial properties

Liquid Adhesive Bandages = Liquiderm

20

Surgical Tape
Types of Wound Dressings

Holds Bandages in place

Should be easy to remove

Clear / Paper / Cloth
Types

21

Dressing Burns
Types of Wound Dressings

Sterile + NON-Adherent Gauze Dressings
for Small Burns

Self-Adhesive + Waterproof
Dressings

CHANGE DRESSING DAILY

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

22

Protectants
for BURNS

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

Systemic Analgesics
for BURNS

Aspirin / Ibuprofen / Naproxen
NSAIDS

DECREASE Erythema & Edema
especially in the first 24 hours


APAP will NOT decrease inflammation

24

Topical Anesthetics
for BURNS

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

HIGH Conc. --> Intact Skin

low conc --> broken skin

AAA 4xDay

25

Concentrations for Topical Analgesics

HIGHER CONC.  for INTACT SKIN

 

Use LOWER CONC. for BROKEN SKIN

26

First Aid Antiseptics

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

Hydrogen Peroxide
Types of First Aid Antiseptics

Hydrogen Peroxide 3% Topical Solution

Effervescent / Mechanical 
cleansing
 action

DO NOT apply bandage until area dries

little benefit over soapy water

28

Ethyl Alcohol
Types of First Aid Antiseptics

Good BacteriCIDAL Activity

Can cause tissue irritation

1-3 times a day

do NOT apply a bandage until area dries

29

Isopropyl Alcohol 70%
Types of First Aid Antiseptics

70%

Used for cleansing + antiseptic effects on INTACT skin

Strong Astringent

STRONGER BacteriCIDAL activity

30

Iodine 2%-2.5%
Types of First Aid Antiseptics

Antiseptic for superficial wounds

avoid bandaging wound after application

STAIN the skin