chapter 11 burns
TRANSCRIPT
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Chapter 11Burns
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Burns
• Burns occur in every age group and in a variety of settings.
• Skin death and injury occur as applied heat exceeds body’s ability to disperse the heat.• Damage depends on:
• Heat’s intensity• Duration of contact• Skin’s thickness
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Types of Burns (1 of 3)
Thermal burns• Caused by:
• Flames • Hot objects• Flammable vapor • Steam• Hot liquids
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Types of Burns (2 of 3)
• Chemical burns• Caused by wide range of chemicals
• Acids• Alkalis• Organic compounds
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Types of Burns (3 of 3)
• Electrical burns• Caused by contact with electric current• Injury depends on:
• Type of current• Voltage• Area exposed• Duration of contact
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Evaluating a Thermal BurnDetermine Depth (1 of 3)
• First-degree (superficial) burns affect skin’s outer layer.• Redness• Mild swelling• Tenderness• Pain
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Evaluating a Thermal BurnDetermine Depth (2 of 3)
• Second-degree (partial-thickness) burns extend through entire outer layer and into inner layer of skin.• Blisters• Swelling• Weeping of fluids• Severe pain
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Evaluating a Thermal BurnDetermine Depth (3 of 3)
• Third-degree (full-thickness) burns penetrate skin layers into the underlying fat and muscle. • Leathery, waxy, pearly gray skin• Dry appearance
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Evaluating a Thermal BurnDetermine Extent (1 of 3)
Estimate how much body surface area (BSA) the burn covers. • The rule of nines for adults:
• The entire head = 9%• One complete arm = 9%• Front torso = 18%• Complete back = 18%• Each leg = 18%
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Evaluating a Thermal BurnDetermine Extent (2 of 3)
• The rule of nines for small children and infants:• The entire head =
18%• Each leg = 14%
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Evaluating a Thermal BurnDetermine Extent (3 of 3)
• A hand, including the fingers and the thumb held together, represents about 1% of a victim’s total body surface.
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Evaluating a Thermal BurnDetermine Burned Body Parts
• Burns on the face, hands, feet, and genitals are the most severe.
• Circumferential burns are more severe than noncircumferential burns.
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Evaluating a Thermal BurnDetermine Respiratory Involvement
• Superheated air can be absorbed by the upper respiratory tract.
• Swelling occurs in 2 to 24 hours.
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Evaluating a Thermal BurnDetermine Other Injuries
• Determine: • Other injuries• Preexisting medical problems• If the victim is older than 55 years• If victim is younger than 5 years
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Evaluating Thermal Burns Determine Burn’s Severity
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Care for Thermal Burns (1 of 2)
Burn care aims to:•reduce pain.•provide physical protection.•provide a favorable environment for healing that minimizes the chances of scarring and infection.
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Care for Thermal Burns (2 of 2)
• Stop the burning process.• If clothing is burning, have the victim
stop, drop, and roll. • Smother the flames with a blanket or
douse the victim with water.• Remove all hot or smoldering clothing
and jewelry.• Monitor the victim’s breathing.
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Care for First-Degree Burns
• Apply cold water or cloth.
• Give ibuprofen.• Have the victim
drink water.• Apply aloe vera or
other lotion.• Keep burn raised.
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Care for Small Second-Degree Burns• Apply cold water or cloth.• Give ibuprofen.• Have the victim drink water.• Apply antibiotic ointment.• Cover burn with a nonsticking, sterile
dressing.• Seek medical care if the burn covers more
than 10% BSA.
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Care for Large Second-Degree Burns
• Apply cold and monitor for hypothermia.
• Give ibuprofen.• Have the victim drink water. • Cover the burn with a dry,
nonsticking, sterile dressing.• Treat for shock.• Seek medical care.
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Care for Third-Degree Burns
• Cover the burn with a dry, nonsticking, sterile dressing.
• Treat the victim for shock.• Seek medical care.
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Aftercare for Thermal BurnsFollow physician’s recommendations.
• Wash hands before changing dressing.• Leave unbroken blisters intact.• Change dressings daily.• Watch for signs of infection.• Elevate burn for first 24 hours.
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Scald Burns
• The result of contact with hot liquids• Immersion burns: area of the body is fully
immersed in a hot liquid.• Spill burns: liquid spills, drops, or is thrown on
a person.
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Sunburn (1 of 2)
• The skin’s response to the trauma of ultraviolet radiation
• Can result in first- or second-degree burns
© E. M. Singletary, M.D. Used with permission.
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Sunburn (2 of 2)
Various skin types respond differently.• Type I skin—always burns; never tans• Type II skin—burns easily; tans slightly• Type III skin—sometimes burns; always tans
gradually and moderately• Type IV skin—minimally burns; always tans well• Type V skin—rarely burns; tans deeply• Type VI skin—does not burn
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Care for Sunburns• Apply cool compress for up to 45 minutes.• Take cool showers and baths.• Do not use benzocaine.• Use ibuprofen to reduce pain and
inflammation.• Drink a lot of water.• Use aloe vera or another body lotion to
keep the skin moist.
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Sunburn Aftercare
• Apply antibiotic ointment to a second-degree sunburn.
• If blisters break, gently wash twice daily.• Seek medical care if infection occurs.
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Chemical Burns
• Result of an acid or an alkali substance touching the skin
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Care for Chemical Burns• Flush body portion
with water.• Remove
contaminated clothing and jewelry.
• Flush for 20 minutes or longer.
• Cover burn.• Seek medical care.
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Electrical Burns
• Thermal burn (flame)
• Arc burn (flash)• True electrical
injury (contact)© Chuck Stewart, MD.
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Care for Electrical Burns• Make sure the area is safe. • Check breathing. • Check for a spinal injury.• Treat the victim for shock.• Place dry, sterile dressings on all burn
wounds.• Place blankets under and over victim. • Seek immediate medical care.
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Contact With Outdoor Power Line• Power must be turned off. • A tingling sensation signals that you are
on energized ground. • Raise one foot off ground, turn around, and
hop to safe area.• Do not attempt to move any wires.
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Contact Inside Buildings
• Turn off electricity.• Unplug appliance.• Do not touch
appliance or victim until current is off.
• Damage occurs under skin.