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Burn InjuryFunctions of SkinoProtects against infectionoPrevents loss of body fluidsoControls body temperatureoFunctions as excretory organoFunctions as sensory organLayers of InjuryoEpidermisoDermisoSubcutaneousoMusclesoBoneLayers of InjuryMechanism of InjuryoA burn occurs when there is injury to the tissues of the body by:HeatChemicalsElectrical currentRadiationStatisticso40,000 are hospitalizedo25,000 are admitted to Burn ICUo4,000 people die annuallyoMortality rate: 4.9%
StatisticsoMost burns are preventableoMost common cause of fires in the home:Cigarette carelessnessHot water heaters set > 140°Cooking accidentsCombustibles: Gas and charcoal lighter fluidSteam burns from radiatorsChemicalsStatisticsoHighest fatality rates occurs in children and older adultsoNurses can be instrumental in providing safety educationGerontologic ConsiderationsoIncreased riskReduced mobility, coordination, strength, sensation and vision changesMorbidity and mortality rates associated with burns are greater in elderly vs. youngAge 60 with 60% TBSA= 96 % overall mortality rateComorbidities4 Major GoalsoPreventionoInstitution of lifesaving measuresoPrevention of disability and disfigurementoRehabilitation through reconstructive surgeryClassification of Burn InjuryoTreatment of burn related to severity of injury:Depth of burnExtent of burn (TBSA)Depth of BurnoSuperficial Partial-Thickness SunburnLow intensity flash oDeep Partial-Thickness Scalds, flame, contactoFull Thickness Flame, prolonged exposure to hot liquids, chemical, electrical currentSuperficial partial thicknessoEpidermis destroyedoDermis may be involvedoTingling, hyperesthesia
oPain soothed by coolingoReddened, blanches with pressureoDryoMinimal or no edemaoPossible blistersoComplete recoveryDeep partial thicknessoEpidermis, upper dermis, portion of deeper dermisoPain hyperesthesiaoSensitive to cold airoBlistered, mottled red baseoWeepingoEdemaoRecovery 2-4 weeksoScarring, contracturesoInfection may convert to 3rd degreeFull thicknessoEpidermis, entire dermisoSometimes subcutaneous tissueoMay involve connective tissues, muscle, boneoDry, pale white, leathery or charredoBroken skin with fat exposedoEdemaoGrafting necessaryoScarring/loss of contour and functionoContracturesoLoss of digits/extremitySuperficial Partial-Thickness BurnSuperficial and Deep Partial-Thickness Burns