1. FIRST AID AND EMERGENCY CARE LECTURE 8
BURNS

2. Definition
Burn is a type of injury that affect only the Epidermal tissue and the Dermis, and rarely the deeper tissues such as as muscles, bones, and blood vessels due to exposure to physical form of energy, certain chemicals or radiation.

3. CAUSES Of Burn Injuries
Heat
Steam
Flame
Electricity
Chemicals
Light
Radiation
Friction

4. CLASSIFICATION OF BURNS
CLASSIFICATION BY DEPTH Burns are described according to the depth of injury to the dermis and are classified into first, second, third and fourth degrees

5. This (degree of burn) is determined by:
The nature of the agent such as temperature and concentration
The length of contact
The tissues resistance to injury such as the skin vascularity and thickness

6. First Degree Burns
Involves only a partial thickness of the skin (The Epidermis)
Characterized by dryness and erythema (redness) of the skin and slight edema
Pain which subsides in 48 hours
Epidermis peels off in small scales in five to ten days
Has no complications or scarring

7. First degree of burns

8. Second Degree Burns Superficial Partial Thickness
Extends into superficial (papillary) Dermis
Characterized by redness with clear blisters, and subcutaneous edema, paleness with pressure
Painful
Lasts from 2-3 weeks
Complications include local infection (Cellulitis)

9. Deep Partial Thickness
Extends deep into (reticular) Dermis
Characterised by red-and-white skin colour, less paleness
Moist and painful
Lasts many weeks and may progress to third- degree burn
Complications include scarring, contractures and may required excision and skin grafting

10. Second degree of burns

11. Third Degree Burn Extends through the entire Dermis
Characterized by stiff and white/brown skin, dry, leathery
No pain
Complications include scarring, contractures, amputation
Requires excision

12. Third degree of burns

14. Fourth Degree Burn
Extends through skin, subcutaneous tissue and into underlying muscles and bones
Characterised by black, charred skin with eschar (slough and dead skin)
Dry painless (no pain)
Complications include amputation and significant functional impairment
Requires excision

15. Fourth degree of burns

16. Assessment of area of burn
This is done using the "rule of nines".
The body is divided up into eleven areas, each representing 9% of the total body surface.

17. Body Area
Percentage Of Burn
Head and Neck 9%
Anterior Trunk
18%
Posterior Trunk
Rt. Lower Extremity
Lt. Lower Extremity
Rt. Upper Extremity
Lt. Lower Extremity
Ext. Genitalia and Perineum 1%

18. Guide To Management
Minor burns (less than 10%) can be treated in the hospital on out-patient basis
Moderate and severe burns should be hospitalized for treatment
Adult patients sustaining more than 20% burn require intravenous therapy.

19. First Aid Treatment
Place the burning person in a horizontal position and roll him over in a blanket
In case of respiratory arrest, do positive breathing, using the mouth-to-mouth or mouth- to-mask technique. CPR
Apply cold bath using Normal Saline that is kept at 10 to 15C
Cover the wound to minimize contamination and inhibit pain by preventing air to come in contact with the injured surface ( Clean cloth)

20. Medications or home remedies should not be applied
Facilitate transport to a hospital of severely burned patients

21. Burn Therapy For Severe Burns
Assure an adequate airway
Look for and treat immediate life-threatening conditions
Perform venipuncture with large bore needle
Remove patients clothing
Obtain history (Cause, time, place of burn, allergies, tetanus, diabetes, cardiac, renal and liver disease)
Insert indwelling catheter

22. Clean wound by removing any dirt, irrigate with cooling water to prevent further damage
Estimate % and depth of burn in a chart
Provide adequate analgesic as needed
Calculate fluids intake and output
Dressings on superficial partial-thickness burns can be changed after 3-5 days in the absence of infection.

23. Do not open blisters.
Do not add ice to burn.