Flashcards in Burns & Scalds Deck (21)
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1
Definition of a burn
A thermal insult which damages the skin and/or underlying structures
2
Types of burn and scald
Flame or radiation (thermal)
Dry heat
Wet heat
Electricity
Friction
Corrosive chemicals
3
Scalds - caused by wet heat
Water
Steam
Fat
Hot liquid chemicals
4
Three main dangers of a burn
The burn itself
Flesh wounds
Infection
5
Dangers of an electrical burn
Safety of yourself and the patient - isolate electrical current before proceeding
Surface are of the burn may be misleading with possibility of deeper layers of tissue being affected
Shock, infection, damage to; respiratory, cardio-vascular and nervous system
Possibility of two burn sites - entry and exit wound
6
Dangers of a chemical burn
Safety of yourself and the patient
Toxic fumes
Chemical still burning
Dangers as for a thermal burn
7
Classification of burns
Superficial burns (1st degree)
Partial thickness burns (2nd degree)
Full thickness burns (3rd degree)
8
Assessment of burns
Scene assessment
Mechanism of burn
Surface area
Patient type
Complex burns
Pre existing conditions
Extremes of age
9
Superficial burns
Injury to the epidermis only.
Red, inflamed skin, painful to touch.
Generally no treatment required.
10
Partial Thickness burns
Injury to both the epidermis and the dermis.
Skin presents with reddened areas, blisters or open weeping wounds.
Patient complains of a great deal of pain.
Significant fluid loss occurs with subsequent shock.
11
Full thickness burns
Injury to the epidermis, dermis and subcutaneous tissue, possibly deeper.
May look charred or leathery.
Not painful (although associated 2nd degree burns will cause pain).
No capillary refill.
12
Body surface area (adult)
rule of nines
The adult body configuration is divided into anatomic regions that represent 9% or multiples of 9%.
Head 9%
Left Arm 9%/Right arm 9%
Front of torso 18%
Back 18%
Groin 1%
Left Leg 18%/Right Leg 18%
13
Body surface area (infant or child)
rule of nines
The infant or child head represents a larger portion of the surface area. The lower extremities a lesser portion.
Head 18%
Left Arm 9%/Right arm 9%
Front of torso 18%
Back 18%
Left Leg 14%/Right Leg 14%
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Time critical Burn
Any Major ABCD problems
Any signs of airway burns
History of hot gas inhalation
Circumferential burns
Facial burns
Surface area >25%(12.5% children)
Presence of other major injuries
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Evaluation of critical burn areas
Burns to the hands, feet, genitalia, or face and burns that completely encircle body areas are considered to have high priority.
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Factors to determine burn severity
Depth of the burn
Body surface area involved
Age of the patient (%+age=>100=poor outcome)
Pulmonary injury
Associated injuries
Pre-existing disease
17
Complications of burns
Airway/inhalation injury
Fluid loss/shock
Pain
Carbon monoxide poisoning/cyanide poisoning
Hidden injury
Hypothermia
Circumferential burns
18
Management of thermal injury
Determine scene safety
Stop the burning process
Cool burn area with water
Do not induce hypothermia
Conduct primary survey ABCDE
Expose
Analgesia as required
Remove constricting clothing and jewellery
Do not apply anything but water to a burn
Do not delay transport on time critical burns.
19
Airway burns - management
High index of suspicion
High concentration of oxygen
Management of the airway
Paramedic interventions may be required (needle cric' if airway obstructed)
Rapid transport
20
Consider the consequences - for the patient
Long term physical and psychological challenges.
Extensive rehabilitation.
Long term consequences with: thermoregulation, motor function and sensory function
21
