burns

Overview of Burns

• Burns can be classified based on severity, type, and area affected.

Types of Burns for Adults

Minor Burns

• Full Thickness Burns: Less than 2% Total Body Surface Area (TBSA)

• Partial Thickness Burns (2nd Degree): Less than 15% TBSA

• Superficial Burns: Less than 50% TBSA (e.g., sunburn)

Vulnerable Age Range

• Older Adults: 50 years old and above are considered at greater risk.

• For those aged 50+, criteria for burns changes:

  • Full Thickness: 2-10% TBSA considered moderate.

  • Partial Thickness: 15-30% TBSA considered moderate.

  • Superficial: More than 50% TBSA considered moderate.

Severity Classification for Older Adults

• Moderate Burns:

  • Full Thickness: 2-10% TBSA

  • Partial Thickness: 15-30% TBSA

  • Superficial: More than 50% TBSA

• Severe Burns:

  • Full Thickness: Over 10% TBSA

  • Partial Thickness: Over 30% TBSA

Critical Areas for Burns

• Burns on critical areas are classified as severe regardless of percentage:

  • Face

  • Airway

  • Hands

  • Feet

  • Genitalia

• Circumferential burns and burns affecting joints are also classified as severe due to complications such as mobility loss.

Assessing Burns

• Inhalation Burns:

  • Symptoms include singed nasal hairs, soot around face/throat, and hoarseness.

  • Treatment includes administering humidified oxygen and cold packs around the neck if skin is unburned.

Signs of Severity in Burns

• Look for:

  • Difficulty swallowing or breathing

  • Lack of pain in severe burns (possible nerve damage)

  • Signs of shock

Management Principles for Burns

• Primary Treatment Goals:

  • Stop active burning process

  • Remove jewelry and clothing to avoid constriction as swelling occurs.

  • Treat for shock if necessary.

Types of Thermal Burns

• Common Sources:

  • Fire and open flames

  • Scalding from hot liquids (thermal burns)

  • Contact burns from hot objects

  • Flash burns from brief, intense heat (e.g., lightning)

Specific Treatment Strategies

• Use a dry sterile dressing for second and third-degree burns.

• If no visible skin burns, apply cool compresses as a first aid measure.

• Document observations and treatments for potential legal purposes, especially with tourniquets and severe cases.

Pediatric Considerations

Vulnerability Age Range

• Children under five years old are at greater risk.

Severity Classification for Children

• Minor Burns: Partial thickness less than 10% TBSA.

• Moderate Burns: Partial thickness between 10%-20% TBSA.

• Severe Burns: Full thickness considered always severe.

Electrical and Chemical Burns

• Electrical Burns:

  • Can cause significant internal damage despite small visible injuries.

  • Important to ensure the electrical circuit is not live before rescue efforts.

• Chemical Burns:

  • Rinse chemical burns for 15-20 minutes, depending on the chemical type.

  • For dry chemicals, brush off first before irrigation.

Conclusion

• Thorough knowledge of burn classifications and treatment protocols is essential for effective patient care in emergency situations involving burns.

Overview of Burns

Burns can be classified based on severity, type, and the area affected. Understanding these classifications is crucial for effective treatment and management in medical settings.

Types of Burns for Adults

1. Minor Burns: Minor burns are typically manageable and include the following classifications:

   • Full Thickness Burns: Less than 2% Total Body Surface Area (TBSA). These burns affect all layers of the skin and may not present with painful sensations due to nerve damage.

   • Partial Thickness Burns (2nd Degree): Less than 15% TBSA. These burns damage the outer layer and part of the underlying skin, resulting in pain, swelling, and blisters.

   • Superficial Burns (1st Degree): Less than 50% TBSA, such as sunburns, affecting only the outer layer of skin, leading to redness and pain without blisters.

Vulnerable Age Range

• Older Adults: Individuals aged 50 years and above are at greater risk for severe burn injuries. For this demographic, the criteria for burn classification are:

  • Full Thickness Burns: Considered moderate if they cover 2-10% TBSA.

  • Partial Thickness Burns: Considered moderate if they cover 15-30% TBSA.

  • Superficial Burns: More than 50% TBSA is regarded as moderate, which is a significant change from younger populations, who often have different thresholds for severity.

Severity Classification for Older Adults

• Moderate Burns:

  • Full Thickness: 2-10% TBSA

  • Partial Thickness: 15-30% TBSA

  • Superficial: More than 50% TBSA

• Severe Burns:

  • Full Thickness: Over 10% TBSA, which poses a high risk of complications.

  • Partial Thickness: Over 30% TBSA, requiring medical intervention.

Critical Areas for Burns

Burns located on critical areas are classified as severe regardless of the percentage of TBSA burned:

• Face: Risk of respiratory impairment and cosmetic deformity.

• Airway: Risk of difficulty in breathing and airway obstruction.

• Hands and Feet: Potential for loss of function and mobility.

• Genitalia: Increased risk of complications and infection.

• Circumferential Burns: Burns that encircle a limb or certain areas can lead to compartment syndrome and necessitate surgical intervention.

• Burns affecting joints can lead to long-term mobility issues, adding to their severity classification.

Assessing Burns

Inhalation Burns:

• Symptoms include singed nasal hairs, soot around the face/throat, coughing, and hoarseness. Patients with inhalation injuries require immediate attention.

• Treatment includes administering humidified oxygen and cold packs to the neck if the skin is unburned, to mitigate swelling and pain.

Signs of Severity in Burns

Monitor for the following signs that can indicate severe burns:

• Difficulty swallowing or breathing may signal airway involvement.

• A lack of pain in severely burned areas could suggest nerve damage or complete skin destruction.

• Signs of shock, including rapid pulse, weakness, and confusion, should be taken seriously as potential indicators of systemic failure.

Management Principles for Burns

Primary Treatment Goals:

1. Stop the active burning process by moving the person away from the heat source.

2. Remove any jewelry or clothing to prevent constriction as swelling occurs from the burns.

3. Treat for shock promptly if symptoms arise, such as pallor or faintness.

Types of Thermal Burns

Common Sources include:

• Fire and open flames, leading to devastating thermal burns.

• Scalding from hot liquids, which can cause severe injury within seconds.

• Contact burns from hot objects can lead to localized or extensive damage depending on duration of contact.

• Flash burns from brief, intense heat (e.g., lightning strikes) typically cause superficial injuries but can have long-term effects.

Specific Treatment Strategies

• Use a dry sterile dressing for second and third-degree burns to protect the area and prevent infection.

• If no visible skin burns, applying cool compresses can provide relief and reduce inflammation as a first aid measure.

• Documentation of observations and treatments is essential, especially for legal records regarding severe cases or the use of tourniquets, ensuring accountability and clear treatment history.

Pediatric Considerations

Vulnerability Age Range:

• Children under five years old are at greater risk of burns due to their lack of understanding of danger and their smaller body size.

Severity Classification for Children:

• Minor Burns: Partial thickness burns covering less than 10% TBSA.

• Moderate Burns: Partial thickness burns between 10%-20% TBSA, requiring careful observation and potential escalation of care.

• Severe Burns: Full thickness burns are considered always severe due to the potential for extensive damage and complications.

Electrical and Chemical Burns

Electrical Burns:

• Electrical burns can cause significant internal damage even if externally the injuries appear minor. Assessment of cardiac and neurological function is crucial, as these injuries can disrupt normal body processes.

• Ensure that the electrical circuit is not live before starting rescue efforts to avoid further accidents.

Chemical Burns:

• Rinse chemical burns immediately with water for 15-20 minutes, adjusting the duration based on the chemical type involved, as some require prolonged irrigation.

• For dry chemicals, carefully brush off any residue before irrigation to minimize skin damage and systemic absorption.

Conclusion

A thorough knowledge of burn classifications and treatment protocols is essential for effective patient care in emergency situations involving burns. Swift identification of the burn severity and appropriate management can significantly impact patient outcomes, thus proficiency in these concepts is critical for healthcare providers.