BURNS

Mrs. RIYANKA GANGULY

Assistant Professor
NIMS College Of Nursing
Neyyattinkara
 DEFINITION
Burns is defined as injury to the skin caused

by thermal, Chemical, Electrical, Radioactive, the

effect may be local result in cell injury or cell

death.

Tabers medical dictionary

Classification

Superficial partial thickness

burns or first degree burns

Deep partial thickness burns

or second degree

Full thickness burns or third

degree
Superficial partial thickness burns
 Epidemis is destroyed or injured and a portion of dermis may

injured

 The wound appears reddish , blanches with pressure, dry,

minimal or no edema and possible blisters occurs.

 Patient experience severe pain, it is soothed by cooling.

 Complete recovery occurs in a week , no scars occurs.

Deep partial thickness burns
 Destruction of the epidermis and upper layer of dermis and

injury to the deeper portion of dermis.

 Burn wound will be pain, hyperesthesia to cold air.

 Blisters, edema occurs

 Infection may convert full thickness burns, recovery in 2-4

weeks.
Full thickness burns
 Total destruction of epidermis, dermis and in some cases

destruction of underlying tissues, muscles, bones.

 Wound color ranges from pale white to red , brown or charred

black.

 The burned area is painless, lacks sensation because nerve fibres,

sweat glands, hair follicles are destroyed.

 The wound requires skin grafting for healing.

 Estimation of burns

1. Rule of nines

2. Lund and
Browder method
3. Palm
method
 Palm method

The size of patients palm not including the

surface area of the digits is approximately 1%TBSA.

LUND AND BROWDER METHOD
Zone of burn injury
Zone of • Cellular death occurs sustains the
coagulation most damage area

Zone of • Has a compromised blood supply,

stasis inflammation, tissue injury

Zone of • Sustains the least damage area

hyperemia
Thermoregulatory alteration
Loss of skin results in inability to maintain body

temperature , so patient may have low body

temperature in the early hours of post burn period

Cardio vascular system
Due to Hypovolemia

Low cardiac output and low BP

Decreased perfusion and O2 delivery to organs

Sympathetic nervous system activated & release

catecholamine's

Increase the peripheral vascular resistance

Increase in pulse rate

Fluid & electrolyte alteration
 Immediately after burns hyperkalemia develops from

massive cell destruction

 Later hypokalemia occurs due to fluid shift.

Inflammation & Healing:

 Burns injury causes coagulation , necrosis whereby tissues

and vessels are damaged and destroyed

Respiratory system
 Cough

 Dyspnoea

 cyanosis

 Airway obstruction

 laryngeal edema

 Bloody sputum
 Diagnostic evaluation
 History collection – witness at the scene, time of burn injury, place where the burn

occur, how long the patient was in the burn situation, how the burn is treated at

the scene, any history of jumping, falling.

 Physical examination

 complete blood count

 serum electrolytes

 Chest X ray

 ECG

 Urine analysis- Myoglobulinuria