BURNS.docx - BURNS RISK FACTORS o Young children and the...

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BURNS RISK FACTORS o Young children and the elderly; especially thermal burns o Electrical appliances o Cooking, scald injuries, grease o Work related injuries o Inhaled injury LIFESPAN CONSIDERATIONS o Gerontologic Considerations include reduced mobility changes in vision decreased sensation in the feet and hands scald and flames that the elderly have difficulty extinguishing chronic illness in the elderly HEALTH PROMOTION o Burn Prevention in the community: matches, lighters and candles never leave children alone smoke detectors home fire drills water temperature no smoking in bed flammable liquids electrical wires have a fire extinguisher at home SKIN-REVIEW o Layers o Functional elements Anatomy o Epidermis o Dermis Nerve endings Blood vessels Hair follicles Sebaceous glands Sweat glands o Subcutaneous Adipose Functional Elements o Protection o Temperature regulation o Fluid regulation o Sensory reception FUNCTIONS LOST o Temperature regulation o Sweat and sebaceous gland function o Sensory function o Metabolism increases to maintain body heat Eyes o Especially sensitive Cornea Sclera Eye lashes
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Eye lids Eye brows Airway Burns o Heat burns the airway tissue, nasal hair o Swelling due to burns in the upper airway can be fatal o Swelling of the vocal cords can obstruct the airway completely o Patient may need to be intubated o Look for appearance of sputum, wheezing hoarseness o Carbon monoxide inhalation: airway edema sloughing of respiratory tract mucosa, pink or cherry red skin ETIOLOGY OF BURN INJURY o Thermal Burns Scald Contact Flame Steam o Chemical Burns o Electrical Burns o Radiation Burns Sources of Chemical Burns o Acids o Alkalines (bases) o Oxidizers o Phosphorus o Vesicants Electrical Burns o Types I: Contact burns Most common, direct contact o Type II: Flash burns Arcing o Type III: Flame burns Ignites clothes and surrounding o Complications Asphyxia Cardiac arrest Neurological Seizures RADIATION BURN o Sunburn or radiation treatment for cancer o Outer layers of skin o Radioactive burns are more severe BURN ASSESSMENT o Plan of care for survival is determined by Age of the patient Depth of tissue destruction/ 3 classifications Amount of surface area (TBSA measured) Presence of inhalation injury Presence of other injuries Special areas burned: face hands, feet, perineum Burn Classification o Depth of Burn Injury- Classified by depth of tissue destruction
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Superficial partial-thickness (first degree) Deep partial-thickness (second degree) Full thickness (third degree) SUPERFICIAL PARTIAL- THICKNESS o Epidermis only o Least destruction o Erythema, > sensitivity o Heat o Painful soothed by cooling o Mild edema o Peeling of skin in 2-3 days o Heals in 3-5 days o No clinical consequences o Example: sunburn
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  • Spring '14
  • Brinkley
  • eschar,  RADIATION BURN,  matches

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