The document discusses different types of burns including thermal, chemical, electrical, and radiation burns. It covers the pathophysiology of burns including the four stages: emergent, fluid shift, hypermetabolic, and resolution phases. Assessment methods like the Rule of Nines and management of burns is outlined including airway control, breathing, circulation, fluids, nutrition, infection control, topical treatments, and dressings. Classification of burns from first to fourth degree is provided.
4. THERM
AL
BURNS
Scald burn
Most frequent in home
injuries like hot water ,
liquids and food are most
common cause.
Temperature above than
136F causes burn.
Temperature less than 111F
tolerated for long periods
5. CHEMIC
AL
BURN
Common in industries
and factories but can
occur at homes also.
Caused by concentrated
acids or alkalis.
Acids are more common
than alkali.
6. ELECTRIC
AL BURNWorse than other types
of burn with entry and
exit wounds.
May stop the heart and
depress the respiratory
system.
May cause thrombosis
and cataracts.
8. PPHYSIOLO
GY
OF BURNS
FLUID SHIFT
Period of inflammatory response.
Vessels adjacent to burn injury dilates
inc. hydrostatic pressure and inc.
capillary permeability.
Continuous leak of plasma from
intravascular space to interstitial space.
Associated imbalances of fluids,
electrolytes and acid-base occur.
Hemoconcentration
Lasts 24-36 hours.
9. PPHYSIOLO
GY
OF BURNS
FLUID REMOBILIZATION
Capillary leak ceases and fluid shifts
back into the circulation.
Restores renal perfusion and fluid
balance.
Increase urine formation and diuresis.
Continued electrolyte imbalances.
Hyponatremia
Hypokalemia
hemodilution
11. BODYS
RESPON
SE TO
BURN.
FLUID SHIFT PHASE (STAGE
2)
Length 18-24 hours.
Begins after emergent phase
Reaches peak level in 6-8 hours.
Damaged cells initiate
inflammatory response.
Increased blood flow to cells
Shift of fluid from
intravascularto extravascular
space
12. BODYS
RESPON
SE TO
BURN.
HYPERMETABOLIC PHASE (
STAGE 3)
Last for days to weeks
Large increase in bodys need for
nutrients as it repairs itself
RESOLUTION PHASE (STAGE
4)
Scar formation
General rehabilitation and
progression to normal function.
14. 1ST
DEGREE
BURN
Reddened skin
Pain at burn site
Involves only epidermis
Blanch to touch
Have an intact epidermal
barrier
Do not result in scaring
EG: sunburn , minor accident
Treatment with topical
soothing agents or NSAIDS
15. 2ND
DEGREE
BURNS
Intense skin
White to red skin
Blisters
Involves dermis and papillary layers of
dermis
Spares hair follicles , sweat glands etc.
Erythematous and blanch to touch.
Very painful/sensitive.
No or minimal scarring
Spontaneously re-epithelize from
retained epidermal structures in 7-14
days.
16. SECOND
DEGREE
BURN
Injury to deeper layers of
dermis-reticular dermis
Appear pale and mottled
Do not blanch to touch
Capillary return sluggish or
absent.
Take 13 to 45 days to heal
Requires excision or skin
grafting.
17. 3RD
DEGREE
BURN
Dry, leathery skin (white ,
dark , brown or charred)
Loss of sensation (little
pain)
All dermal layers/tissues
may be involved.
Always require surgery.
19. ASSESEM
ENT OF
BURNS
RULE OF NINES
Best used for large surface areas
Expedient tool to measure extent
of burn
RULE OF PALMS
Best used for burns <10 % BSA
20. MANAGEM
ENTPRE HOSPITAL CARE
Ensure rescuer safety
Stop the burning process :
stop , drop and fall.
Check for other injuries
A standard ABC (AIRWAY ,
BREATHING ,
CIRCULATION) check
followed by a rapid secondary
survey.
22. HOSPIT
AL
CARE
A : Airway control
B : Breathing and ventilation
C : Circulation
D : Disability neurological
status
E : exposure with environmental
control
F : fluid resuscitation
23. AIRW
AYRECOGNISATION OF THE
POTENTIALLY BURNED AIRWAY
A history of being trapped in the
presence of smoke and hot gases .
Burns on the palate or nasal
mucosa ,or loss of all the hairs.
In the nose: Deep burns around
the mouth and neck.
24. AIRW
AYBurned airway
Early elective intubation is
safest.
Delay can make intubation very
difficult because of swelling.
Be ready to perform an
emergency cricothyroidotomy if
intubation is delayed.
26. CIRCULATI
ONMaintain iv line with
wide bore cannula
peripherally.
One central line.
Escharotomy of limbs if
circulatory compromise
in circumferential
burns.
27. FLUIDS
FOR
RESUSCITAT
ION
In children with burns over
10% TBSA and adults with
burns over 15%TBSA , consider
the needs for iv fluid
resuscitation.
If oral fluids are to be used ,
salt must be added.
Fluids needed can be calculated
from a standard formula.
The key is to monitor unit
output.
28. FLUIDS
FOR
RESUSCITAT
ION
PARKLAND FORMULA
% TBSA Weight (KG)4 = Volume
(ml)
Half this volume is given in first eight
hours.
Second half is given in the
subsequent 16 hours.
Crystalloid : ringer lactate
Hypertonic saline
Human albumin solution
Colloid resuscitation
29. NUTRITI
ONBurnt patient need
extra feeding
A nasogastric tube
should be used in all
patients with burn over
15% of TBSA
Removing the burn and
achieving healing stops
the catabolic drive.
31. MONITORING
AND
CONTROL OF
INFECTION
Burn patients are
immunocompromised.
They are susceptible to infections
through many routes.
Sterile precautions should be
taken.
Swabs should be used regularly.
A rise in WBC count
,thrombocytosis, and increase
catabolism are warnings of
infections.
32. TOPICAL
TREATMEN
T OF DEEP
BURNS
1% silver sulphadiazine
cream.
0.5% silver nitrate
solution.
Mafenide acetate cream.
Serum nitrate, silver
sulphadiazine and cerium
nitrate.
33. PRINCIPLES
OF
DRESSINGS
FOR BURNS
Full thickness and deep
dermal burns need
antibacterial dressings to
delay colonization prior to
surgery.
Superficial burns will heal
and require simple dressings.
An optimal healing
environment can make a
difference to outcome in
borderline depth burns.