BURNS

WHAT IS A BURN?
•Burns are one of the most common
household injuries, especially among
children.
•The term “burn” means more than the
burning sensation associated with
this injury.
•Burns are characterized by severe
skin damage that causes the affected
skin cells to die.
 Three Primary Classification Of
Burns
First-degree burns: red, non blistered skin

Second-degree burns: blisters and some thickening

of the skin

Third-degree burns: widespread thickness with a

white, leathery appearance

There are also fourth, fifth, six-degree burns. This

type of burns includes all of the symptoms of a
third-degree burn and also extends beyond the skin
into tendons and bones.
FIRST DEGREE BURN
cause minimal skin damage.
also called “superficial burns” because they affect the
outermost layer of skin.

Signs of a first-degree burn include:

• Redness
• Minor inflammation, or swelling
• Pain
• Dry, peeling skin occurs as the burn heals

SIGNS AND SYMPTOMS: disappear once the skin cells shed.

First-degree burns usually heal within 7 to 10 days without
scarring.
 Treatments for a first-degree burn
include:
Soaking the wound in cool water for five
minutes or longer taking acetaminophen
or ibuprofen for pain relief applying
lidocaine (an anaesthetic) with aloe Vera
gel or cream to soothe the skin using an
antibiotic ointment and loose gauze to
protect the affected area
SECOND DEGREE BURNS

- more serious because the damage extends beyond the

top layer of skin. This type burn causes the skin to blister
and become extremely red and sore.

Some blisters pop open, giving the burn a wet or

weeping appearance. Over time, thick, soft, scab-like
tissue called fibrinous exudate may develop over the
wound.

Due to the delicate nature of these wounds, keeping the

area clean and bandaging it properly is required to
prevent infection. This also helps the burn heal quicker.
Some second-degree burns take longer than three weeks to
heal, but most heal within two to three weeks without
scarring, but often with pigment changes to the skin.

The worse the blisters are, the longer the burn will take to
heal. In some severe cases, skin grafting is required to fix
the damage. Skin grafting takes healthy skin from another
area of the body and moves it to the site of the burned skin.
THIRD DEGREE BURN

- are the most severe, cause the most damage, extending through
every layer of skin.

There is a misconception that third-degree burns are the most

painful. However, with this type of burn the damage is so extensive
that there may not be any pain because of nerve damage.

Depending on the cause, the symptoms third-degree burns can

exhibit include:

waxy and white color

char
dark brown color
raised and leathery texture
blisters that do not develop
Without surgery, these wounds heal with severe scarring
and contracture. There is no set timeline for complete
spontaneous healing for third-degree burns.

Most people can recover from burns without serious health

consequences, depending on the cause and degree of
injury. More serious burns require immediate emergency
medical care to prevent complications and death.
• Fourth, fifth, or sixth degree burns exhibit many similar
symptoms to third degree burns, but with a few additional
characteristics. Primarily, these burns result in charring and loss of
function of the affected area.

Charring: Charring is a process where exposure to high heat burns

the hydrogen and oxygen from the skin, leaving a black substance
composed almost entirely of carbon. The presence of char in a burn
is indicative that the burn will require grafting and leave scars.
Charring is possible in third degree burns, but is more common with
deeper burns that have had longer exposure to the heat source.

Loss of Function: These burns also complete destroy the skin’s

protective capabilities and begin to damage the underlying muscle.
The body does not regrow muscle or bone in the same manner that it
regrows skin. Damage to the muscle often requires excision and
leads to long-term loss of function of the affected area. Loss of
function generally leads to amputation.
 TREATMENT

The first priority is getting the patient stabilized and rehydrated. Burn
victims are often dehydrated because of the amount of fluids lost while
sustaining the burn and from the wound afterwards. Liquids are usually
administered intravenously to get them into the body quickly. Medical
staffs also work to stabilize the patient and ensure proper circulation and
breathing.

While being stabilized, it is common for the patient to begin receiving

antibiotics to prevent infection. Infection is one of the most common
complications and can lead to a variety of complications if not treated.
Depending on the patient’s condition and the location of the burn,
antibiotics are administered orally, intravenously, topically at the site of
the burn injury.

While the burn itself may not be painful, patients are often given pain
medication because treatment can be painful. Once a patient has been
stabilized, excision can begin. Excision, also called debridement, is the
process of removing dead and damaged skin from the burn injury. The
dead skin is highly susceptible to infection and prevents the body from
healing.
Amputation is nearly always required for burns this deep.
Amputation is the process of removing part or all of an
extremity. Amputation allows medical staffs to control pain
and disease. Because these burns cause loss of function,
amputation often removes tissue that would not be
recoverable in anyhow.

Finally, skin grafts are used to begin the process of re-

growing skin in the burned area. The body cannot replace
the skin on its own because these burns completely destroy
all three layers of the skin, so healthy skin is surgically
removed from other areas of the body. If there is not
sufficient healthy skin available on the victim, other forms
of grafting may need to be used while the patient’s own skin
grafts are grown in a lab.
 TYPES OF BURNS
•Thermal Burns
•Radiation Burns
•Chemical Burns
•Electrical Burns
•Friction Burns
 THERMAL BURNS
A type of burn that resulting from
making contact with heated object.

Scalds are the most common type of

thermal burns suffered by children
but for adults, thermal burns are most
commonly caused by fire.
 Causes of Thermal Burn
Causes of thermal burn
Boiling water
Steam
Hot cooking
Fire
Heated appliances (e.g. Iron)
Hot object
ETIOLOGY OF THERMAL BURN

It is caused by exposure or

contact with flame, hot liquids,
semi liquids, semi solids or hot
object.

Treatment for thermal depends

on the location and severity of the
burn.
 Nursing Management of Thermal Burn

Put out any fire or flames and stop contact with the hot or
heated source.
Use cold water to cool the burned area.
Do not use ice, as it may further damage the skin
For mild burns, you can find pain relief by applying a cool,
wet compress or taking acetaminophine or ibuprofen as
directed on the bottle, later, burn cream and ointment can
help those burn heal
For more severe burn, loosely apply a sterile bandage or
clean cloth to the burned area
Do not remove part of your skin or pop blister
Seek medical attention for further treatment.
ELECTRICAL BURN
Is the burn that result from
electricity passing through the
body causing rapid injury.

It happens when the body

come in contact with an
electric current
A burn may appear on your skin if an electric runs through
your body.
These burn can be treated like a thermal or Chemical burn.
However, if you come in contact with an electric current, you
should seek emergency medical attention immediately.
Electricity can affect internal tissues and muscles and have
long term negative effect on your health.
Electrical burn may differ that they cause much more sub-
dermal damage
In extreme cases, electricity can cause shock to the brain,
strain to the heart and injury to the other organs.
 CAUSES OF ELECTRICAL BURNS

Touching or grasping
electrically live objects
Short circuiting
Inserting fingers into
electrical sockets
Falling into electrified water
 CHEMICAL BURNS
A chemical burn is irritation
and destruction of human
tissue caused by exposure
to a chemical. It can occur
in the home, at work or
school, or as a result of
accident or assault.
You may receive a chemical burn if
your skin and/or eyes come in
contact with a harsh irritant, such
as acid. Substances that cause
chemical burns include:
Chlorine
Ammonia
Bleach
Battery Acid
Strong or harsh cleaners
 SIGNS AND SYMPTOMS
Redness, irritation, or burning at the
site
Pain or numbness at the site
Formation of blisters or black dead
skin at the site
Vision changes if the chemical gets
into the eyes
Cough or shortness of breath
Vomiting
Take these steps if you have been burned by a
chemical:
Rinse the burned area under running water for
at least 10 minutes. if the chemical has entered
your eye, rinse your eye for about 20 minutes to
remove traces of the chemical. Then go to the
hospital if the burn is:
Larger than three inches
On your face, hands, feet, groin, or buttocks
Still very painful after taking OTC pain
medication
On a major joint, like the knee.
 CHEMICAL BURNS PREVENTION

Secure all chemicals.

People should always
follow directions and safety
precautions.
Wear safety gloves
clothing and eye
protection.
 RADIATION BURNS
It is a damage to the skin or other
biological tissue as an effect of
radiation.
Cancer patients undergoing radiation
therapy may suffer from an injury
known as radiation burn.
High-energy radiation is used to kill
cancerous cells and when it passes
through the body skin cells may be
damaged.
 TYPES OF RADIATION BURNS
RADIATION DERMATITIS - also known as radiodermatitis. It
is a skin disease associated with prolonged exposure to
ionizing radiation. Radiation dermatitis occurs to the
patients receiving radiation therapy, with or without
chemotherapy.

ACUTE RADIODERMATITIS – occurs when an “erythema

dose” of ionizing radiation is given to the skin. It will be
visible erythema appears up to 24 hours after.

CHRONIC RADIODERMATITIS – occurs with chronic

exposure to “”sub-erythema” doses of ionizing radiation
over a prolonged period.
 CARE FOR RADIATION BURNS
INCLUDES:

Cleaning and moisturizing wounds

Avoiding sunlight
Wearing loose clothing or bandages
over the wound
You may also have internal
complications and should seek medical
treatment immediately.
 FRICTION BURNS
FRICTION- can occur when skin repeatedly
rubs against another surface or is scraped
against hard surface.
NURSING MANAGEMENT

Gently apply pressure to the wound to help stop any

bleeding.
Once bleeding stops, rinse the wound with plain water and
pat the area dry with a cloth. Make sure to remove any
dirt, grass, or debris from the sore. It maybe difficult to
clean a turf burn due to pain, this process is necessary to
avoid infections. Take your time and don’t apply too much
pressure.
Apply an anti-septic ointment to the wound. Aloe vera can
reduce inflammation and provide a cooling sensation.
You may want to cover the abrasion with a hydrogel
dressing and a sterile gauze.
Continue to apply antiseptic ointment and a new bandage
daily until the abrasion heals.
The best home remedies for burns
Mild burns typically take around a week or two to completely heal and
usually don’t cause scarring. The goal of burn treatment is to reduce
pain, prevent infections, and heal the skin faster.
1. Cool water
The first thing you should do when you get a minor burn is run cool (not
cold) water over the burn area for about 20 minutes. Then wash the
burned area with mild soap and water.
2. Cool compresses
A cool compress or clean wet cloth placed over the burn area helps
relieve pain and swelling. You can apply the compress in 5- to 15-minute
intervals. Try not to use excessively cold compresses because they may
irritate the burn more.
3. Antibiotic ointments
Antibiotic ointments and creams help prevent infections. Apply an
antibacterial ointment like Bacitracin or Neosporin to your burn and
cover with cling film or a sterile, non-fluffy dressing or cloth.
4. Aloe vera
Aloe vera is often touted as the “burn plant.” Studies show evidence that
aloe vera is effective in healing first- to second-degree burns. Aloe is
anti-inflammatory, promotes circulation, and inhibits the growth of
bacteria.a
Apply a layer of pure aloe vera gel taken from the leaf of an aloe
vera plant directly to the affected area. If you buy aloe vera in a
store, make sure it contains a high percentage of aloe vera and
avoid products that have additives, especially coloring and
perfumes.
5. Honey
Honey just got sweeter. Apart from its delicious taste, honey may
help heal a minor burn when applied topically. Honey is an anti-
inflammatory and naturally anti-bacterial and anti-fungal.
6. Reducing sun exposure
Do your best to avoid exposing the burn to direct sunlight. The
burned skin will be very sensitive to the sun. Keep it covered with
clothing.
7. Don’t pop your blisters
As tempting as it may be, leave your blisters alone. Bursting a
blister yourself can lead to infection. If you’re worried about
blisters that have formed due to your burn, see a medical
professional.
8. Take an over-the-counter pain reliever
If you have pain, take an OTC pain reliever such as ibuprofen
(Motrin, Advil) or naproxen (Aleve). Be sure to read the label for
the correct dosage.
Remedies to stay away from Bizarre home remedies and old
wives’ tales for treating burns are widespread, but not everything
your grandma tells you to do is good for you. The following
common home burn remedies should be avoided:

1. Butter
Don’t use butter on a burn. There’s little to no evidence
supporting the effectiveness of butter as a burn remedy. On top
of that, it may actually make your burn worse. Butter retains heat
and also may be harboring harmful bacteria that can infect the
burned skin. Save your butter for your bread.

2. Oils
Contrary to popular belief, coconut oil does not heal everything.
For the same reason why you shouldn’t apply butter to your
burns, oils, such as coconut oil, olive oil, and cooking oils, hold
heat in and can even cause the skin to continue to burn.
Lavender oil is reported to help heal burns, but there is little
published evidence to support this claim. Studies conducted in
rats, for example, have not shown any benefit of using lavender
oil to heal a burn.

3. Egg whites
Another folk tale, uncooked egg whites carry a risk of bacterial
infection and shouldn’t be placed on a burn. Eggs can also
cause an allergic reaction.

4. Toothpaste
Never apply toothpaste to a burn. This is another folk tale with
no evidence to back it up. Toothpaste could irritate the burn and
create a more favorable environment for infection. Toothpaste
isn’t sterile.

5. Ice
• Ice and very cold water can actually irritate your burn area
more. Ice may even cause a cold burn if used improperly