1. BURN & SCALD

2. BURN –Dry burn is the tissue damage by dry heat of –Open flame, –Hot object, –Molten metal –Electricity –Friction with rapid moving Machine, Rope, Conveyer belt –Cold burn due to contact of –Liquid gas (Oxygen, Carbon dioxide) SCALD – Scald is caused due to moist heat of –Boiling water –Steam –Hot oil –Hot coal tar

3. Factors influencing severity of burn Area of burn Rule of nine for calculating body surface burn – Head & Neck 9% – Chest 9% – Abdomen 9% – Front of both leg (9X2 ) 18% – Back of both leg (9X2 ) 18% – Both hand (9X2 ) 18% – Back side 18% – Genital area 1% Total 100% Minor < 5 % Moderate 5%-30% Serious > 30 %

4. Factors influencing severity of burn Depth of burn – First degree, (Erythema or redness) Surface skin exposed to excess heat. Skin looks red. Tissue is not damaged. Very painful. – Second degree (Superficial) Upper layers of the skin are affected. Blisters may be present on the skin. Pain is severe. The scald is usually superficial – Third degree (Deep) Whole skin layer may be damaged. Underlying fat, muscles and even bones may also affected. If skin is completely damaged pain is less.

5. Factors influencing severity of burn Causative agent – Fire, Molten Metals, Hot gas Cause serious type of burn – Strong alkalis and acids Cause deep burns – Electricity Deep burn and destroys deeper tissues. – Hot water / Hot oil Superficial burn – Steam More extensive due to presence of talent heat

6. Factors influencing severity of burn Period of contact with the body –Damage is proportional to the period of contact Part of the body affected –Face, hands and genital area more serious Age of the victim –Children women and very old person react very badly to severe burns.

7. Difference between Burn & Scald BurnScald Cause :Dry heatMoist heat Depth :DeepSuperficial Pain :LessMore Blister :Not commonMost common Healing:DelayedQuick Scar :RemainsNo scar Complications : More chancesPossible First Aid : Cold waterCold water

8. Managaement of burn case ► Put out the fire from the body  by lie down on the floor  by cover the body with blanket / cloth ► Take the casualty to a safe place ► Remove the burnt clothes quickly, ► Remove anything constrictive such as  rings, bracelets, bangles, belts or boots before swelling of the part ► Prevent shock and avoid infection and relieve pain. ► Apply sufficient cold water or tap water over the affected area ► Cover the area with a sterile gauze piece soaked in cold water. ► Apply water gel dressing, liquid paraffin or cold cream for soothing.

9. Management of burn case ►Do not allow to run the burnt patient ►Do not pull out the burnt clothing from body ► Do not pick or punctured the blisters. ► Do not remove any portion of the skin. ► Do not apply a bandage ► Do not introduce infection by touching it with unclean hands Never use water to put out the source of fire, if it is due to kerosene, petrol, oil, gas or electricity.

10. Management of other burn case ► Chemical burn  Burn due to Chemicals such as strong acid or alkalis on skin or eye.  Wash thoroughly and repeatedly with running water or wash bottle to dilute the chemicals  Put little liquid paraffin on the surface of burn ►Electric burn  Burn may be caused in very small area but damage to the deeper structure.  Treat as open flame burn.

11. Complications of the burn ► Infection ►Do not handle with unclean hand ►Do not apply dirty things like grease ►Once infected, healing is delayed ►May be an extensive scar ► Contracture ►Burn heals with a contracture if there is extensive burn and skin is damaged. ►This may hamper the normal function of the body. ►Contracture of the hand or face is more serious ► Ulcers and Keloid ►A particular type of ulcer may develop later on over the burnt area Always handle with clean hands and use sterile materials for dressing