Topic TISSUE INTEGRITY Chapter 62 Management of Patients With Burn Injury SCR 290 Medical Surgical Nursing II
On completion of this chapter, the learner will be able to: • Discuss the incidence of burn injury in the United States. • Describe the factors that affect the severity of burn injury. • Describe the local and systemic effects of a major burn injury. • Identify priorities of care and potential complications for each phase of burns. • Identify fluid replacement requirements during the emergent/resuscitative and acute phases of a burn injury. • Discuss the nurse’s role in burn wound management during the acute/intermediate phase of burn care. • Use the nursing process as a framework of care for the patient with burns during the emergent/resuscitative and rehabilitation phases of burn care. • Describe the psychosocial challenges associated with burn injuries and identify strategies for intervention. Learning Objectives 2
• Burn injuries are painful, costly, disfiguring, require intensive and extensive rehabilitation therapy, and may be associated with long-term disability. • Larger burns are associated with morbidity and mortality disproportionate to their initial appearance. • A burn injury can affect people of all ages and socioeconomic groups. • An estimated 450,000 people are treated for burns annually. • 68% had injuries that occurred at home, 10% had industry-related injuries, 5% had recreationally related injuries, and 17% had injuries from other sources. Overview of Burn Injury 3
• Of all these injuries, approximately 44% were flame related, 33% were scald injuries, 9% were from direct source contact, 4% were electrical, 3% were chemical, 1% were inhalation only, and the remaining were from unspecified or miscellaneous categories • Patients with burns have particularly prolonged lengths of hospital stay. • Men have more than twice the incidence of burn injury than women; for both men and women, the most frequent age group for burns is between 20 and 30 years. Overview of Burn Injury 4
Overview of Burn Injury 6
• Many factors contribute to a lengthy length of stay. For example, many of these patients require surgical interventions, extensive pain control, immobilization and rehabilitation, and prolonged intravenous (IV) medication regimens, especially with antibiotics and opioids. • In addition, patients with smoke inhalation and electrical injuries require particularly lengthy care regimens • The strongest predictors for mortality in burn injuries included increased percent of TBSA burned, presence of inhalation injury, and increased age. Overview of Burn Injury 7
• Burns are classified according to the depth of tissue destruction. • First-degree burns are superficial injuries that involve only the outermost layer of skin.
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- Burn Injury