Minor Sunburns and Burns

Thermal burn

result from skin contact with flames, scalding liquids, hot objects, or smoke inhalation

chemical burns

occurs secondary to exposure to corrosive or reactive chemicals that cause tissue damage, ulceration, and sloughing

electrical burn

electricity flows through the body from an entry point to an exit point and the heat of the current damages the skin

sunburn

caused by too much UVA/UVB light produced from natural sunlight, commercial tanning beds, and tanning lamps

burns we can treat OTC only involve what layers of the skin?

epidermis and dermis

we can treat what stages of burns?

stage 1 and stage 2

we should refer what stages of burns?

stage 3 and stage 4

what are the 3 treatment goals for burns ?

- relieve pain

- provide physical protection

- provide favorable environment for healing that minimizes the chances of infection and scaring

during initial assessment of a burn what should we ask?

- has the burn occured in the last 3 hours

- is the patient experiencing pain

if the burn has occurred in the last 3 hours....

irrigate with tepid water for ~20 minutes

if the patient is experiencing pain....

use systemic analgesics

reassess in _________

24-48 hours after initial assessment

Exclusions for self-treatment of burns

- burn to BSA of >2%

- burns involving eyes, ears, face,or perineum

- chemical burns

- electrical or inhalation burns

- persons of advanced age

- patients with uncontrolled diabetes or multiple medical disorders

- immunocompromised patients

what should be done with a chemical burn?

use first aid measure then seek medical attention

Nonpharmacologic therapy of burns

- stop the burn

- cool the burn

- provide pain relief

- cover the burn

what should you avoid with burns?

ice and ice cold water

Rule of 9

- face / head = 4.5%

- torso= 18%

- genitals = 1%

- legs= 9%

- arms = 4.5%

If burn is dry....

apply skin protectant ointment

If the burn is weeping ....

soak in cool tap water 3-6 times per day 15-20 minutes then apply skin protectant

All burns managed with self-care should be...

covered

Pharmacological therapy

- skin protectants

- systemic analgesics

- topical analgesics

- antiseptics

- antimicrobial

- vitamins

- complementary therapies

Ibuprofen (Advil, Motrin)

200-400 mg every 4-6 hours

Naproxen sodium

220 mg every 8-12 hours

Acetaminophen

325-400 mg every 4-6 hours

complementary therapy

- honey

- calendula officinalis

- aloe vera

ointments

oleaginous base, provides a protective film to keep skin from drying

when are ointments most appropriate?

minor burns and wounds when the skin is still intact

creams

water based emulsions

when are creamed prefered?

when the skin is broken

lotions advantage

spread easily and easy to apply to large area

some lotions produce powder, when should be we not use these lotions?

on the wound bed because they dry the area

sprays advantage

no need to physically touch the affected area

What is the prefered choice for burn/ wound irrigation?

saline

patient counseling for burns

- determine if the burn / wound is eligible for self treatment

- be sure the address immediate concerns

- counsel patient on timeline of burn / wound healing, potential aggravating factors, things to avoid

- reassessment of burn/ wound

Burns should be reassessed after....

24-48 hours after initial assessment

after reassessing the burn/wound, if worsening / progression is seen....

the patient should be referred

wounds/burns should be reassessed after

24-48 hours then again in 7 days

What are some warning signs for burns that need to be further evaluated ?

- foul odor

- worsened inflammation

- increased pain/ swelling

- cellulitis

- tissue infection