Burns: Injury to tissues caused by the contact
with heat, flame, chemicals, electricity, or radiation. First degree
burns show redness; second degree burns show vesication (blisters); third
degree burns show necrosis through the entire skin. Burns of the
first and second degree are partial-thickness burns, those of the third
are full-thickness burns.
A major burn necessitates painful treatment and a long period of rehabilitation.
Often fatal or permanently disfiguring, it can cause both emotional and
physical incapacitation.
Cause: Thermal burns, the most common type, can result
from residential fires, motor vehicle accidents, playing with matches,
improperly stored gasoline, space heater or electrical malfunctions, scalding
accidents, kitchen accidents, or child abuse.
Chemical burns can result from contact with or ingestion, inhalation,
or injection of acids, alkalis, or vesicants.
Electrical burns may result from contact with faulty electrical wiring
or with high-voltage power lines, or from young children chewing on electric
cords.
Friction or abrasion burns result from harsh rubbing of skin against
a coarse surface.
Sunburn results from excessive exposure to sunlight
Symptoms:
Varies depending on severity and depth of burn–Although most burns
are a combination of different degrees and thickness
First degree burn: Damage is limited to the epidemics,
causing erythema (redness) and pain
Second degree burn: The epidemis and part of the
dermis are damaged, producing blisters and mild to moderate edema and pain
Third degree burn: The epidemis and dermis are damaged.
No blisters appear, but white, brown, or black tissue and thrombosed vessels
are visible
Fourth degree burn: Damage extends through deeply
charred subcutaneous tissue to muscle and bone
Another way to assess burns is to estimate the size of a burn.
Size is usually expressed as the percentage of body surface area (BSA)
covered by the burn. Called The Rule Of Nine Chart: a correlation
of the burn’s depth and size permits an estimate of its severity.
Major: Third degree burns on more than 10% of BSA;
second degree burns on more than 25% of adult BSA (more than 20%
in children); burns of hands, face, feet, or genitalia; burns complicated
by fractures or respiratory damage; electrical burns; all burns in poor
risk patients.
Moderate: Third degree burns on 2% to 10% of BSA;
second degree burns on 15% to 25% of adult BSA (10% to 20% in children).
Minor: Third degree burns on less than 2% ;of BSA;
second degree burns on less than 15% of adult BSA (10% in children)
Other important factors:
Location: Burns on the face, hands, feet, and genitalia are most
serious, because of possible loss of function
Configuration: Circumferential burns can cause total occlusion
of circulation in an extremity as a result of edema. Burns on the
neck can produce airway obstruction, whereas burns on the chest can lead
to restricted respiratory expansion
History of complication medical problems: Disorders that impair peripheral
circulation, especially diabetes, peripheral vascular disease, and chronic,
alcohol abuse
Other injuries sustain at the time of the burn
Patient age: Victims under age 4 or over age 60 have a higher
incidence of complications and, consequently, a higher mortality
Pulmonary injury can result from smoke inhalation
WHEN TO CALL FOR AN AMBULANCE:
Burns involving breathing difficulty
Burns covering more than one body part
Burns to the head, neck, hands, feet, or genitals
Burns (other than a very minor one) to a child or elderly person
Burns resulting from chemicals, explosions, or electricity
Care: First Aid (Taken from American Red Cross)
Check the scene and the victim
Send someone to call for an ambulance if necessary
Stop the burning. Put out flames and remove person from source
of the burn
Cool the burn. Use large amounts of cool water. Do no use
ice or ice water except on small surface burns
Apply soaked towels, sheets, or other wet cloth to the face or other
areas that cannot be immersed
Keep cloth cool by adding more water
Cover the burn. Use dry, sterile dressings or a clean cloth.
Loosely bandage dressing in place ot prevent infection and reduce pain
or cover burned area with dry sheet
BURNS – SPECIAL SITUATIONS
Sunburn: Cool the burn
Protect from further damage by staying out of sun or wearing a protective
lotion
Protect unbroken blisters with loose bandages and keep broken blisters
clean to prevent infection
Electrical Burns: Check the scene and the victim
Send someone to call for an ambulance if necessary
Never go near a victim until the power is turned off
If a power line is down, wait for the fire department or power company
Check breathing and pulse if person is unconscious.
Give rescue breathing or CPR if needed
Do not move person unnecessarily because there may be internal injuries
Check for possibility of two wounds; entrance and exit burns
Do not cool burn
Cover burn with dry, sterile dressing
Chemical Burns:
Send someone to call for an ambulance, if necessary
Flush both skin and eyes with large amounts of cool running water until
ambulance arrives. Always flush away from the body
Remove clothing and jewelry that may trap chemical against the skin
or on which chemicals may have spilled
Smoke Inhalation:
Move the person to fresh air
Send someone to call for an ambulance
Check breathing and pulse
Support the person in the position in which it is easiest to breathe
If person is unconscious, place on side and monitor breathing closely