BURNS

WHAT IS A BURN?
- Damage to skin injury
- Can be minor medical BURNS INJURY DEPTH
problems or life-threatening
emergencies 1st
Degre
e SUPERFICIAL
TYPES OF BURNS • Epidermis
• Pink & painful (still has nerves)
• No scarring
• Blanching: present
• Heals: few days
THERMAL

Superficial heat 2nd

Degree
SUPERFICIAL PARTIAL THICKNESS
Examples: flames, steam, liquid
• Epidermis & dermis
• Blisters, shiny, & moist
CHEMICAL • Painful
• Blanching: present
• Heals: 2-6 weeks
Burn caused by a toxic substance
Can be Alkali or Acidic
Examples: bleach, gasoline, paint thinner 3rd
Degre
e FULL THICKNESS
• Epidermis, dermis, & hypodermis
RADIATION • May look black, yellow, red, & wet
• No pain/limited pain (nerve fibers are destroyed)
Prolonged exposure to ultraviolet rays of the • Skin will not heal (need skin grafting)
sun (sunburn) & cancer treatment (radiation • Eschar: dead tissue, leather; must be removed
therapy)

ELECTRICAL
Electrical current that passes through the LAYERS OF
body causing damage within either
alternating current (AC) or direct current (DC) THE SKIN

BURN LOCATION
RESPIRATORY DISABILITY
• Face • Hands INHALATION INJURY
• Neck • Feet
• Chest • Joints Damage to the respiratory system
• Torso • Eyes
SIGNS OF CARBON
TROUBLE HEARING INFECTION INHALATION INJURY MONOXIDE (CO)
• Poor blood supply Any open area where bacteria can POISONING
• Diabetes only appear
Carbon monoxide travels faster
• Infection • Perineum Hair singed than oxygen, making it bind to
• Ears Around the face, neck, or hgb first.
• Eyes torso
Now oxygen cannot bind to
hgb = HYPOXIC
COMPARTMENT SYNDROME Trouble talking
• In the extremities Soot in the nose or Classic Symptoms: cherry red
Tight skin such as eschar acting like a band around mouth skin
the skin cutting off blood circulation Confusion or anxiety Treatment: 100% O2
NOTE: Oxygen saturation
may appear normal
Phases f Burn Management
 FLUID RESUSCITATION FOR BURNS

THE PARKLAND FORMULA RULE OF NINES

Used to calculate the total volume of fluids
(mL) that a patient needs 24 hours after
experiencing a burn
Apply only in 2nd and 3rd degree burns

4 mL x TBSA (%) x Body weight (kg) = total mL of fluid needed

Give half of the solution Give half of the solution

for the FIRST 8 HOURS for the NEXT 16 HOURS

RULE OF NINES
Quick estimate of the % of the total body surface
area (TBSA) has been effected by a partial & full-
thickness burn in an adult client.

PRACTICE QUESTIONS

A 25 year old male patient who weighs 79 kg Back of right arm – 4%

has sustained burns to the back of the right Posterior trunk – 18% ANSWER:
arm, posterior trunk, front of the left leg, and Front of left leg – 9% 36%
their anterior head and neck. Using the Rule of Anterior head & neck – 4.5%
Nines , calculate the total body surface area
percentage that is burned.

4 mL x 36% x 79 kg = 11, 376 mL

Use the Parkland formula to calculate the total

amount of Lactated Ringer’s solution that will
be given over the next 24 hours 11, 376 / 2 = 5, 688 mL 11, 376 / 2 = 5, 688 mL
FIRST 8 HOURS NEXT 16 HOURS

Keep in mind: the question coud ask you for mL given in the
first 24 hours, the first 8 hours, etc., so read the question
carefully.