[Trisha: 63-95] • Clothes that catch fire

BURN INJURIES

HEALTH PROMOTION BURN PREVENTION

• Caution against removing the radiator cap from a

hot car engine.

• Recommend avoidance of overhead electrical wires

and underground wires when working outside. 2. CHEMICAL BURNS

• Advise that hot irons and curling irons be kept out of - caused by tissue contact with strong acids,alkalis or organic
the reach of children. compounds

• Caution against running electric cords under carpets
or rugs.
• Recommend storage of flammable liquids well away
from a fire source.
• Advocate caution when cooking, being aware of
loose clothing hanging over the stove top.
• Recommend having a working fire extinguisher in
the home and knowing how to use it.
- systemic toxicity from cutaneous absorption can occur
- are commonly seen in the home but especially in the
workplace.
- these chemicals can produce local tissue injury and some
have potential to be absorbed resulting in body poisoning
• Sulfuric acid- as found in toilet cleaners
• Sodium hypochlorite as found in bleach

• Halogenated hydrocarbons as found in paint

remover

TYPES OF BURNS

1. THERMAL BURN – caused by exposure to flames, hot

liquids, steam or hot objects.

• Residential fires

• Automobile accidents

• Playing with matches

• Improper handling of firecrackers

• Improper handling of gasoline

• Scalding and kitchen accidents

• Abuse (most common in children and elderly

patients)

• Self inflicted
 ACID BURN ALKALI BURN

• Devastating effects can cause lifelong neurovascular

problem

• High voltage(more than 100,000 volts) injury can

cause tissue and bone destruction resulting in
amputations and possible loss of life as a result of
cardiac and respiratory abnormalities

• There is an entrance and exit wound

• Accidental electrical contact with faulty electrical

wiring or high voltage lines

• Most of the damage is beneath the skin surface and

therefore the actual injury can easily be
underestimated

3. RADIATION BURNS –exposure to UV light, x-rays or

radioactivity

4. ELECTRICAL BURN – caused by heat generated by electrical

energy as it passes through the body.

The damage may be minor skin damage or may cause

damage to internal organs

LIGHTING BURNS result from energy caused

by lightning strikes, and are characterized by a unique
pattern of skin lesions. These tree-like lesions resemble
feathering or ferning, and are also called “Lichtenberg figures
 FIRST AID FOR MINOR BURNS

• Run cool water over the burn continuously for 10 -15

min

• Apply cool compresses if continuous water flow is

not available

• Do not apply ice, ice water, butter or ointments

• Do not pop blisters

• Cover loosely with a sterile gauze bandage

• Take ibuprofen or acetaminophen for pain

ELECTRICAL BURNS

• Prone to acute renal failure - release of myoglobin

from the destruction of muscle and tissue.
Myoglobin is released into the bloodstream.

• Myoglobin – can occlude the renal tubules, acute

tubular necrosis and acute kidney injury will occur.

• Neurovascular complications for as long as 2 years

after the incident can occur.

BURN SIZE

• Small Burns

- localized to the injured area

• Large or extensive burns

- 25% or more of the total body surface area

- Response of the body to the injury is systemic

- Burn affects all major systems of the body

A. Central Inner Zone (Zone of Coagulation or

necrosis)
 • Involves injury to the epidermis, blood supply to the
dermis is still intact

• Color – pink to red (mild to severe erythema)

• Edema - mild

• Blisters – no

• Pain – yes with tingling sensation, eased by cooling

• Eschar – no

• Eschar - piece of dead tissue that is cast off from the

surface of the skin, particularly after a burn injury, 

• Healing time – 3-5 days (discomfort 48 hrs) no

scarring occurs

• Grafts required – no,

B. Intermediate Zone (Zone of stasis)
• Example – sunburn, flash burns

C. Outer Zone (Zone of hyperemia)

BURN INJURY

Classification of Burns according to Depth

1. Superficial thickness – 1st degree

2. Superficial partial thickness – 2nd degree

3. Deep partial thickness – 2nd degree

4. Full thickness – 3rd degree 2. Superficial Partial thickness (2nd degree)

5. Deep full thickness - 3rd degree • Injury deeper into the dermis, blood supply is
reduced

• Color – pink to red, broken epidermis with wet, shiny

1. st
Superficial thickness( 1 degree) and weeping surface
• Edema - mild to moderate

• Blisters – yes, may cover an extensive area.

• Pain – yes, sensitive to cold air

• Eschar - no

• Healing time – approximately 2 weeks

• Grafts required – no

• Example – scalds, flames, brief contact with hot

objects
4. Full thickness (3rd degree)

• Injury and destruction of the epidermis and dermis

• Color – black, brown, yellow, waxy white, red

• Edema – severe, under the eschar

• Blisters – no

• Pain – yes and no, sensation is reduced/absent due

to nerve ending destruction

• Eschar – yes, dry, hard and inelastic

• Healing time – weeks to mos.

• Grafts required – yes, may develop scarring and

wound contractures

• Example – scalds, flames, prolonged contact with hot

objects, tar, grease, chemicals,
ELECTRICITY

3. Deep Partial thickness (2nd degree)

• Extends deeper into the dermis

• Color – red to white

• Edema - moderate

• Blisters – rare

• Pain – yes

• Eschar – yes, soft and dry

• Healing time – 2 - 6 weeks

• Grafts required – can be used if healing is prolonged

• Example – scalds, flames, prolonged contact with hot

objects, tar, grease, chemicals
 • Face – corneal abrasions

• Ear – auricular chondritis

• Hands and joints – require intensive therapy to

prevent disability

• Perineal area – prone to autocontamination by urine

and feces

5. Deep Full thickness (3rd degree) • Circumferencial burns of the

• Injury extends beyond the skin into the underlying - extremities – compartment syndrome
fascia and tissues, and muscle, bone, and tendons
are damaged. - thorax – inadequate chest wall expansion, pulmonary
complications
• Color – black

• Edema - absent

• Blisters – no

• Pain – absent

• Eschar – yes, hard and inelastic

• Healing time – weeks to mos.

• Grafts required – yes

• Example – flames, tar, grease, chemicals,

ELECTRICITY
INHALATION INJURIES

Smoke inhalation injury – respiratory injury that occurs when

the victim is trapped in an enclosed, hot smoked filled space

BURN LOCATION

• Head, neck and chest – associated with pulmonary

complications
Assessment:

• Facial burns

• Erythema

• Swelling of oropharynx and nasopharynx

• Singed nasal hairs

• Flaring nostrils

• Stridor, wheezing and dyspnea

• Hoarse voice

• Tachycardia

• Agitation and Anxiety

Inhalation injuries

• Carbon monoxide poisoning

• Smoke poisoning – caused by the inhalation of the

byproducts of combustion

- colorless,odorless and tasteless gas

- affinity for hemoglobin 200 times greater than that

of oxygen

- Oxygen molecules are displaced and carbon

monoxide reversibly binds to hemoglobin to form
carboxyhemoglobin → TISSUE HYPOXIA