BURNS

HOMEOSTATIC IMBALANCES
• Burns
- Tissue damage and cell death
- Causes: heat, electricity, UV radiation, chemicals
- Results in loss of body fluids and invasion of bacteria
- Associated dangers
 Dehydration- fluid shifting
 Electrolytes imbalance
 Circulatory shock- low fluid

SEVERITY OF BURNS
• First- degree burns
- Skin is usually still intact
- May appear to be red, very warm or hot to touch
- Epidermis was damage

• Second-degree burns
- Extremely painful
- Very red
- Fair amount of swelling
- Epidermis and dermis was damage
• Third-degree burns
- Dry or leathery skin texture
- All layers of skin (grey, white)
- Painless

RULES OF NINES

What is the parkland formula?

- Use to calculate initial fluid requirements in burn patient

4mL x Body weight (kg) x TBSA(%) =

Total crystalloid fluids in first 24 hours

 Half given in first 8 hours

 Half given in next 16 hours

IMPORTANT: first 8 hours is from the time of the burn injury, it is from the time of evaluation and
calculation.

INFECTION OF ALLERGIES
• Contact dermatitis
- Exposure cause allergic reaction
• Impetigo
- Bacteria infection
• Psoriasis
- Cause unknown

SYMPTOMS OF VARIOUS SKIN INFECTION AND ALLERGIES:

 Redness
 Blisters/lesions
 Bumps oozing pus
 Itching
 Burning
 Patches
 Scales
 Peeling skin

COMMON SKIN INFECTION

• Athlete’s foot (tinea pedis)

◦Cause: fungal infection

• Boils and carbuncles

◦Cause: bacterial infections (usually staphylococcus)

•Cold sores
◦Cause: herpes simplex virus I or II

SKIN CANCER

- Almost everyone has several benign tumors of the skin. However, skin cancers, which are more
dangerous, are most common form of cancer.

Actinic Keratosis
- is a premalignant scaly area on the skin.
- It is an indication that sun damage has occurred.
- In a small proportion of untreated individuals, it can lead to squamous cell carcinoma. In contrast
Basal cell carcinoma
- a cancer that originates in the stratum basale, is the most common skin cancer.
- cancers appear in body areas subjected to chronic UV exposure.
Squamous cell carcinomas
- are less common, but almost totally restricted to areas of sun-exposed skin.
- Metastasis (spread to distant sites) seldom occurs in treated squamous cell carcinomas and basal
cell carcinomas, and most people survive these cancers.
 - The usual treatment involves the surgical removal of the tumor, and 95% of patients survive for
five (5) years or longer after treatment.

Unlike these common and seldom life-threatening cancers, Malignant Melanomas are extremely
dangerous. In this condition, cancerous melanocytes grow rapidly and metastasize through the lymphatic
system. If the cancer is not detected until extensive metastasis has occurred, survival rate drops to 14%.

ABCD RULE
- helps to easily remember skin cancer’s key characteristics.

➢ A is for Asymmetry: Melanomas tend to be irregular in shape.

➢ B is for Border: The border of the melanoma is generally irregular, and in some cases notched.
➢ C is for Color: A melanoma is generally mottled, with any combination of tan, brown, black, red, pink,
white and blue tones.
➢ D is for Diameter: Any skin growth more than about 5mm in diameter, or approximately in the area
covered by the eraser on a pencil, is dangerous.

BASAL CELL CARCINOMA MELANOMA