Unformatted text preview: Ch. 24Burn Emergencies 1 Assessment of Burns Depth of the burn Percentage of the body burned Severity of the burn Location of the burn Accompanying complications (such as preexisting physical or mental conditions) Age of the victim 2 Degrees of Burns Superficial (firstdegree) Partialthickness (seconddegree) Fullthickness (thirddegree) 3 Superficial (firstdegree) a burn that involves only the epidermis, or outer layer of 4 skin, characterized by pain and redness Partialthickness (seconddegree) a burn that involves both the epidermal and dermal layers of the skin, characterized by blistering, swelling, and pain 5 Fullthickness (thirddegree) a burn involving all layers of the skin as well as fat, muscle, and bone; a thirddegree burn is characterized by dry, leathery, charred skin 6 Severity of Burns Rule of Nines A method of estimating how much body surface was burned by mentally dividing the body into regions, each representing 9 percent (or a multiple of 9 percent) of the body surface Palmar surface method A method of using the size of the victim’s palm to estimate the percentage of body surface that has been burned
7 8 Burn Management Airway or respiratory difficulties Toxic inhalation Related musculoskeletal injuries Loss of body fluids, contributing to shock Pain, contributing to shock Anxiety, contributing to shock Swelling Infection due to destruction of skin tissue
9 General Care Most common burns are thermal (from flames) and radiant (sun) Most burn injuries in children are from scalding Fatalities are usually due to airway closure or inhalation of smoke, or trauma Complications include infection and fluid loss Goal is to prevent further injury, manage airway, and care for burn
10 10 First Aid Care
1. Remove the victim from the source of the burn. 2. Eliminate the cause of the burn—put out the fire, wash away the chemicals… 3. Assess ABCDs, and manage respiratory and cardiac complications. 4. Activate the EMS system as soon as possible. 5. Continue to assess the victim’s vital signs until medical help arrives. 6. Stop the burning process by applying cool water to the burn. 7. Never apply water to a burn that covers more than 10% of the body surface
11 11 First Aid Care
For Burns with less than 10% involvement the following may be used: Cool or cold water Wet dressings A cool compress Aloe vera gel 12 12 First Aid Care Never break any blisters Apply dry sterile dressings to the burned area It is important to keep the area clean and uncontaminated Use breathable dressings Do not apply butter, grease or fat Burns with over 10% involvement need medical attention Separate burned fingers and toes with gauze
13 13 Electrical Burn Statistics 3,000 electrical burns per year 40% are fatal 14 14 Electrical Burns
Protecting Yourself and the Victim Look for downed wires whenever a vehicle has struck a power pole. If it is dark, use a flashlight to inspect the poles and the surrounding area. Never attempt to move downed wires! Notify the power company and request an emergency crew. If a downed power line is lying across a wrecked vehicle, do not touch the vehicle, even if the victims inside are seriously injured. If the victims in the car are conscious, warn them not to leave the vehicle. If a victim is holding a power tool, look for cords; the tool does not have tobe on to present an electrical hazard. If a victim is in a pool, turn off all power at the main switch before entering the water. If a victim is found in a bathtub with an electrical appliance that has energized the water, pull the plug of the appliance before you touch the victim.
15 15 Types of Electrical Burns Thermal burn A burn caused by flames from electricity, electricity does not pass through the body Contact burn A burn caused by touching either a live electrical circuit. The electrical current enters and exits the body. Arcing injury (flash burn) An injury caused when an electrical current jumps from one surface to another; nearby skin is burned, but electricity does not actually pass through the skin
16 16 Severity of Electrical Shock Voltage and amperage of the current Amount of time the victim was exposed to the shock Amount of moisture on the victim Amount of the victim’s body surface that is in contact with water Amount of insulation worn by the victim Area of the body through which the current passes Type of current (AC or DC) 17 17 Dazed and confused condition Obvious and severe burns on the skin surface Unconsciousness Weak, irregular, or absent pulse Shallow, irregular, or absent breathing Possibility of multiple severe fractures due to intense muscular contractions Signs and Symptoms of Electrocution 18 18 1. Activate the EMS system immediately. 2. Your first priority is to protect yourself. Do not approach the victim unless you can do so safely. 3. Check the victim’s breathing and pulse; immediately start CPR and apply the AED if available, even if you are unsure about the extent of injury. 4. If the victim fell or was thrown, treat for spinal injuries. 5. If the victim is conscious and his or her condition is not urgent, provide basic burn care for source and ground wounds and splint fractures. 6. Treat the victim for shock. First Aid Care for Electrical Shock 19 19 Lightening Lightening National Weather Service Reports 3,000 deaths per year related to lightening strikes Most deaths caused by cardiac arrest Lightening fatalities by State Lightning Injuries
Lightning strike victims usually sustain injury to the following body systems: The nervous system The skin The heart and the vascular system 22 22 First Aid Care
Goal is to oxygenate the heart and brain until the body resumes circulation. 1. Activate the EMS system immediately. 2. Survey the scene, assess what happened, and make sure the victim is safe from further injury. Remove debris that has fallen on the victim, and move the victim away from any source of electricity. 3. Assess breathing and pulse; if appropriate, begin CPR. Apply an AED if pulse is absent. The key to survival is early, vigorous, prolonged resuscitation efforts. 4. Stabilize the victim’s neck to prevent aggravating a possible cervical spine injury. 5. If the victim is conscious, check movement in all extremities; determine the victim’s reaction to pain. 6. While waiting for medical help to arrive, assess the victim for open wounds or fractures, and provide appropriate care.
23 23 Avoiding Lightening Avoiding Lightening Avoid being outside in open spaces during thunderstorms. Take cover from storms, avoiding the highest elevation areas and tall objects. Do not carry or hold tall metal objects during thunderstorms. Drop any golf clubs, fishing poles, or baseball bats. Realize that lightning can strike the same place twice. If you cannot find shelter, crouch down in a catcher's stance. Put your hands on your knees or place them over your ears to protect against hearing damage from thunder. If other people are with you, stay 15 feet apart. A fully enclosed metal vehicle such as a car or school bus can be a good shelter. Close all windows and do not touch anything metal connected to the vehicle. If you are inside a building, close all windows and stay away from them. Do not use the landline telephone or electrical appliances including computers. Wait at least 30 minutes after the last observed lightning strike or thunder before you venture outside your sheltered area. ...
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- Fall '07
- Victim, Prime number, Electrical burns