A type of injury to the skin caused by heat, electricity, chemicals, light, radiation or friction.

This can be complicated by shock, infection, multiple organ dysfunction, syndrome, electrolyte imbalance and respiratory distress.

types of burn injury

THERMAL BURN INJURIES

CHEMICAL BURNS

ELECTRICAL BURNS

THERMAL BURN INJURIES

BACK

- The result of contact with heat sources such as fire, steam, hot liquids, hot metals and hot objects

o Fire/Flame Injury- Explosions, Home & other structural fires & Car accidents can cause fire injury

o Scalding Injury- Hot water, hot beverages, steam and hot food can all cause scalding.

Chemical burns

- Chemical burns occur when certain acids, alkaloids and other caustic chemicals come into contact with the skin.

E.g.o Household cleaners that contain

lye (paint cleaners), sulfuric acid (toilet bowl cleaners), phenol (deodorizers), or sodium hypochlorite (disinfectants and bleaches) BACK

Electrical burns

-Electrical burns occur when electric current passes through the body, causing both external and internal injuries. Most of the damage from electric current occurs beneath the surface of the skin.Low Voltage -when a low-voltage electric current (less than 500 volts) passes through the body, it generally does not cause severe burnsHigh Voltage- High voltage burns occur when an electric current of more than 1000 volts passes through the body. Electrical burn complications can be very serious

RISK FACTORS

AGE DRUG USE GENDER

SMOKING SOCIO-ECONOMIC STATUS SUN EXPOSURE

SEASONAL

UNSAFE HEATING PRACTICES

Signs & symptomsParts: Minor- painful and cause reddening and blistering of the skin

Severe- painless causes white or charred area

Classifications of Burns:

-Traditionally classified

as 1st, 2nd, and 3rd degree

-Now classified as superficial,

partial thickness and full

thickness

First degree (superficial burn)

Signs & Symptoms• Reddened skin• Pain at burn site• Involves only epidermis

Involves the epidermisCharacterized by

reddeningTenderness and PainIncreased warmthEdema may occur,

but no blisteringBurn blanches under

pressureExample - sunburnUsually heal in ~ 7 days

SECOND DEGREE(PARTIAL THICKNESS)

Signs & Symptoms-Intense pain

• White to red skin• Blisters• Involves epidermis & dermis

• Damage extends through the epidermis and involves the dermis.

• Not enough to interfere with regeneration of the epithelium

• Moist, shiny appearance• Salmon pink to red color• Painful• Does not have to blister to be 2nd

degree• Usually heal in ~7-21 days

Third degree(Full Thickness)

Signs & Symptoms Dry, leathery skin (white, dark brown, or charred) Loss of sensation (little pain) All dermal layers/tissue be involved

Both epidermis and dermis are destroyed

Thick, dry appearance Pearly gray or charred black

color Painless - nerve endings are

destroyed Pain is due to intermixing of 2nd

degree May be minor bleeding Cannot heal and require grafting

DIAGNOSTIC TESTThese techniques enable doctors to analyze the depth and severity of the burn beyond what a standard clinical evaluation can reveal.

BIOPSY- removing and studying sample tissue, it examines the extent of collagen damage to the skin, vascular damage to the tissue, and damage to cell proteins in the skin.

THERMOGRAPHY- studies of burn temperature, determine the exact depth of a burn wound, deeper wounds are cooler than more superficial wounds. There is reduced vascular perfusion, or blood circulation, to the deeper wounds, leading to a lower temperature.

VIDEO ANGRIOGRAPHY- measures changes in the perfusion of tissues by injecting a substance called indiocyanine green intravenously. Damaged tissues have poor circulation, which is visualized by the videography.

Treatment for Burns(First Degree)

1. Run cool water on burned area for 5 - 10 minutes or cover the area with a cool compress.

2. Don't apply oil, butter, or ice to the burn.

3. Take ibuprofen or acetaminophen to relieve pain and swelling.

4. Any burn to the eye requires immediate emergency help.

Treatment for Burns(Second Degree)

1. Do not break blisters.2. Do not remove clothing that is stuck to the skin.3. Run cool water on burned area for 5 - 10 minutes,

or cover the area with a cool compress then carefully remove clothing that is not stuck to the skin.

4. Elevate burned area above the heart.5. Take ibuprofen or acetaminophen to relieve pain

and swelling.6. If not near a medical facility, apply bacitracin

ointment or honey on broken blisters to prevent infection (this is the only situation in which bacitracin or honey should be applied to burned skin).

7. If the burn is near the mouth, nose, or eye, seek emergency medical help immediately.

The Treatment of Critical Burns at the Hospital

Fluid Replacement- replace lost fluids with intravenous fluids

Infection Control- prescribe oral or intravenous antibiotics to prevent infection

Debridement- debride severe burns to remove damaged or contaminated tissue

Skin Grafts- taking skin from an area of the body that has not been burned and transplanting it to the area that has been burned

Pain Management- prescribe intravenous morphine for the first 24 to 48 hours after admission or surgery and then prescribe oral narcotic medication.

Physical and Occupational Therapy- provide physical therapy for burn patients that have difficulty with large motor tasks such as walking & occupational therapy for patients that have difficulty with activities of daily living and small motor tasks like using their hands.

Prevention

1. Supervise children closely around fires, hot items, and electrical outlets.

2. Have smoke alarms installed in your home.

3. Have a fire extinguisher available in your home.

4. Set your water heater at 120° F or less.5. Teach children to stop, drop and roll.6. If a person is on fire, smother the fire

with a blanket or other clothing item.

Complications Minor burns deeper burns can cause scar tissue to form, usually

superficial and do not cause complications

Severe burns Dehydration Shock develops if dehydration is severe Chemical imbalances Destruction of muscle tissue (rhabdomyolysis)

sometimes occurs with deep third-degree burns. Infection;Sometimes the infection can spread

throughout the bloodstream and cause severe illness or death.

Thick, crusty surfaces (eschars) Eschars can become too tight, cutting off blood supply to healthy tissues or impairing breathing.