Burns Injury

Question 1

Define Burns Injury

Answer 1

When tissue damage occurs by thermal, electrical or chemical injury

Question 2

What are the causes and risk factors?

Answer 2

Caused by contact with hot objects, electricity, UV light, irradiation and chemicls

High risk patients - young and old

Question 3

What is the epidemiology of Burns injuries?

Answer 3

The UK has >12,000 admissions per year

Question 4

What is important to find out in the History?

Answer 4

• the circumstances of the burn
• the time, temperature and length on contact with the agent
• the risk of smoke inhalation and carbon monoxide poisoning

Question 5

What are the signs of a Burns Injury?

Answer 5

Check for inhalational injury or airway compromise:
- Stridor
- Dyspnoea
- Hoarse voice
- Soot in nose
- Singed nose hairs
- Carbonaceous sputum
Check site, depth and distribution of burn
Size is described as a % of body surface area

Question 6

Identify the signs of different burns injuries

Answer 6

Partial Thickness burn:

• Superficial: red and oedematous skin + painful. Heals within around 7 days with peeling of dead skin
• Deep: blistering and mottling + painful. Heals over 3 weeks, usually without scarring

Full Thickness burn:

• Destruction of the epidermis and dermis
• Charred leathery eschars
• Firm and painless with a loss of sensation
• Healing will occur by scarring or contractures and requires skin grafting

Question 7

What are the appropriate Investigations for a Burns Injury?

Answer 7

Bloods:
- O2 sats, ABG and carboxy haemoglobin (if inhalation injury)
- FBC, U&Es, group and save
For electrical burns:
- Serum CK
- Urine myoglobin (to check for muscle damage)
- ECG