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PRESENTATION
 PRESENTATION
TOPIC : Burn
SUBJECT : Emergency & Critical Care Nursing
SUBMITTED TO : Insafe hanna , Nursing Instructor,
CNC....
SUBMITTED BY :
Name
1. Mst. Suma Khatun.
2. Tania Sultana.
3. Kakuli Begum.
4. Ani Akter Ruma.
5. Jannatul Mokarrama.
6. Muntaher Ema.
7. Hosneara Begum.
 BURN
Introduction :
A burn is a type of injury to the skin or fle
sh that is caused by heat,friction,chemicals or radiati
on. Burns that are extensive or deep can be fatal but
modern treatment methods have improved the outc
ome & the long-term outcome generally depends on
the size of the burn & the age of the patient. Only th
e epidermis, which is the uppermost layer of the skin,
has the ability to regenerate. So burns that are deepe
r can cause permanent scarring.
Definition :
Burn may be defined as injuries resulting fr
om the application of thermal, electrical,chemical or
radioactive substance to the external or internal surf
ace of the body resulting in more or less destruction
of the tissue.
Pictures of burn :
Causes of burn :

1. Household fire
2. Hot water or liquid
3. Hot object - Cigarette,Iron,Cooking appliances
4. UV rays
5. Electricity
6. Flammable gas
7. Flammable liquid
8. Gas explosion
9. Gasoline spills
10. Industrial accident
11. Motor vehicles fire
12. Rongent or X-ray
13. Inhalation of hot air
14. Semisolid tar.
Types of burn :

1.Thermal burn :-- Flame, Flash, Scalds.

2.Chemical burn :-- Nitric acid, Oxalic acid.
3.Electrical burn :-- Electrical current.
4.Radiation burn :-- Alpha,Beta,Gamma ray.
5.Tar burn :-- Semisolid hot tar.
6.Inhalation burn :-- Inhalation of smoke,CO gas.
Sign & symptoms of burn :

1. Degeneration of tissue
2. Discoloration of skin
3. Localized pain
4.Edema
5.Respiratory distress
6.Decrease muscle coordination
7.Restlessness
8.Redness
9. Severe tenderness
10. Blister formation
11.Tachycardia
12. Hypotension
13. Loss of sensation in case of severe burn
14. Loss of fluid
15. Impaired sensory function.
Risk factor :

1. Burn > 30%

2. Full thickness burn
3. Extreme in age (very young & very old)
4. Preexisting disease, such as DM
5. Virulence & antibiotics resistance of
colonizing organism
6. Failed skin graft
7. Improper initial burn wound care
8.Prolonged open burn wound.
Determination of severity of burn :
Severity of burn is determined by ----
• Burn depth.
• Burn size percentage.
a) According to burn depth :
1.1st degree burn :
- Skin appears red & painful
- Local edema
2. 2nd degree burn :
- Fluid filled blister
- Pink moist & mottled
3. 3rd degree burn :
- Epidermis & dermis are destroyed
- Not painful due to nerve damage
4. 4th degree burn :
- Reaches deeper than skin
- Affect the organ (muscle, ligament,
tendon)
5. 5th degree burn :
- Affect all soft tissue & all organ
- May damage the bone
6. 6th degree burn :
- Bones are badly damaged
- Person is dead
b) According to burn size extent :
The rule of nine(9)
• Head & neck --- 9%
• Arms ( both) --- 9%
• Anterior trunk --- 18%
• Posterior trunk--- 18%
• Legs ( both ) --- 18%
• Perineum --- 1%
Complication :

1. Infection
2. Cellulites
3. Amputation
4. Gangrene
5. Scarring
6. Contracture
7. Bone & joint problem
8. Decrease BP
9. Breathing problem
10. Shock
11. Cerebral damage
12. Heart failure
13. Pulmonary edema
14. Sepsis
15. Acute respiratory failure
 CASE STUDY
 Demographic data :
• Pt's name : Priya
• Bed no. : 23
• Ward : Burn unit (36)
• Age : 22 years
• Gender : Female
• Address : Dharmapur, Feni.
• Date of admission : 24/10/2016
 Past history :
• No physical problem.
 Present history :
• 30% Thermal burn with inhalation injury
 Objective data :
• Temperature -- 102° F
• Pulse -- 105 b/min
• BP -- 60/40 mmHg
• Respiration -- 25 / min
• Anemia --- (+++)
• Cyanosis --- (+)
• Dehydration ---(+++)
• Edema --- (+)
• Jaundice --- ( - )
• Bowel & bladder -- N/D
 Doctor's planning :
• Diet :-- High protein diet with NG tube
• Oxygen inhalation :-- 4 L/min
• Inf. Hartsol
- 3L running within 4 hours
- 3L 50 drops/min
- 2L 25 drops/min
• Inj. Ceftron 1gm I/V 12 hourly
• Inj.Pathedin + Inj.Phenergon 4cc I/V 6 hourly
• Inj. Ometid 40 mg I/V daily
 Investigation :
• CBC (Hb%) --- 7 gm/dl
• Serum Albumin --- 2.2 gm/dl
• Blood grouping --- B+
• HBsAg screening --- Negative
•
•
 Nursing management :
• Assess pt airway,breathing, circulation.
• Initiate CPR if necessary.
• Administer high flow oxygen by musk.
• Establish I/V line with large gauge needle.
• Administer I/V fluid.
• Remove pt clothing.
• Determine depth,extent & severity of burn.
• Cover the burn site with dry sterile dressing.
• Monitor vital sign with heart rate & rhythm.
• Monitor level of consciousness.
• Assess for any other injury,e.g. Fracture.
• Placement of indwelling catheter.
• Placement of NG tube.
• Pain management.
• Tetanus immunization.
• Take care of wound.
• Give psychological support.
• Take measure to control infection.
• Provide nutritional support by high protein diet.
 NURSING CARE PLAN

Assess Diagno Plannin Imple Evalua

ment sis g menta tion
tion
1. Pain Pain r/t Reduce • Assess level Pain
damage of pain of pain. reduced
• Give
the skin & NSAIDs.
tissue • Encourage
in relaxation
techniques.
2. Loss of Fluid Maintain • Give I/V Fluid
fluid volume fluid fluid. volume
• Give high
deficit r/t volume protein diet. restored
to • Maintain
continues tissue
secretion integrity.
& loss of
protein
3.Infection Risk for Prevent • Give Infection
infection infection antibiotic. reduced
• Provide
r/t skin care.
presence • Maintain
of personal
secretion hygiene.
 ANY
QUESTION ?
THANKS
TO
ALL