By: Tony Tucker

A burn is damaged tissue caused by: Heat Chemicals Electricity Sunlight Nuclear Radiation.

Scalds Building Fires Flammable Liquids Gases

First Degree (Superficial) Affect only the epidermis. Usually Painful. Heal quickly Cause a red mark on the skin.

Second Degree (Partial Thickness) Affect the epidermis as well as the dermis. Painful Rarely require medical attention. Damages blood vessels leading to blisters.

Third Degree (Full Thickness) Involve damage or complete destruction of

all skin layers and underlying tissue. Usually not painful. Require immediate medical attention. Can cause melting and charring of skin.

TBSA Used to determine

extent of burns.

Currently 1.5 million people seek medical attention because of their burns.

45,000 of these require hospitalization. 22,500 are admitted to specialty units. 4,500 of these die. An additional 10,000 die of burn

related infections.

Mid-1970’s 9,000 individuals died of burns each year.

Now 4,500 individuals die of burns each year.

Mid-1970’s most died of burns over 20% Now people survive with burns over 90% Inhalation burn drastically increases the

risk of mortality.

Most deaths are caused by multiple organ distress or Adult Respiratory Distress Syndrome.

Older adults (over 65) represent the highest fire risk group.

Over 1,200 older adults die of burns each year.

Comprise 25% of fire deaths for all ages. Comprise 30% of fire deaths in the home. Fires and burns are the leading cause of

death from unintentional injury among older adults.

House fires injure 3,000 older adults each year.

Smoking is the leading cause of fire death.

Cooking is leading cause of burn injury. Fire Death Rate

65-75 = 2x national average 75-85 = 3x national average Over 85 = 4x national average

1/5 are bedridden or have physical impairment.

2/3 occur while victim is sleeping. 25% involve clothing ignition. Many have cognitive impairments also.

Apply ice Apply antibiotic

3 Phases Acute Healing Rehabilitation

Resuscitation Fluid replacement Initial wound debridement. Lasts 3-4 days.

Lasts several weeks Goal to accomplish healing Includes:

Debridement Dressing changes Pain Management Grafting

1 or more years Scar tissue decreases. Tissue collagenases cease remodeling. Includes:

Therapy Pain management

Contractures Hypertrophic scarring Weakness Heterotrophic ossification Amputation Nervous system injuries Thermoregulation Metabolism Pruritus Pain

Pain related to burns is considered to be worst type of pain.

2 types of Pain Management Non-pharmacological Pharmacological

Benzodiazepines Opiates (Morphine) NSAID’s (Acetaminophen) General anesthesia (Propofol)

Anxiety Depression Self-esteem Community reintegration

Pain management Distraction Music Relaxation

ROM exercises Physical therapy Community reintegration

Lower water heater temp. to 120˚. Use timers while cooking to remember

to remove food. Do not smoke in bed or while tired. In homes older than 10 years have

wiring inspected. Check smoke detectors regularly.

For those with hearing deficits special smoke detectors are available.

Electric blankets need overheat protection

Use only UL approved appliances and electronics.

Do not smoke around oxygen tanks. Keep space heaters at least 3 ft. from

combustible materials.

Fireplaces need tempered-glass doors. Understand escape plan. Have a fire extinguisher.

Watch for warning signs. Minor burns Dementia

Check for smoke detectors and check water heater temp.

If older adult receives a severe burn seek medical attention immediately.

If supervision is needed during cooking remove knobs.

Plan escape plan.

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