BurnManagement-1

BurnManagement-1 - Burn Management Lynn Kemp, R.N. Trauma...

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Unformatted text preview: Burn Management Lynn Kemp, R.N. Trauma Coordinator St. Barnabas Hospital Incidence Approx. one million burn patients/annually in the United States 3-5% cases are life-threatening 60,000 hospitalized / 5,000 die Fires are the 5 th most common cause of death from unintentional injury Deaths are highest among children < 5 yr. and adults > 65 yr. Functions Skin is the largest organ of the body Essential for:- Thermoregulation- Prevention of fluid loss by evaporation- Barrier against infection- Protection against environment provided by sensory information Types of burn injuries Thermal: direct contact with heat (flame, scald, contact) Electrical A.C. alternating current (residential) D.C. direct current (industrial/lightening) Chemical Frostbite Epidermis Outermost layer, composed of cornified epithelial cells. Outer surface cells are dead and sloughed off. Dermis Middle layer, composed primarily of connective tissue. Contains capillaries that nourish the skin, nerve endings and hair follices Hypodermis Layer of adipose and connective tissue between the skin and underlying tissues. Classification Burns are classified by depth, type and extent of injury Every aspect of burn treatment depends on assessment of the depth and extent First degree burn Involves only the epidermis Tissue will blanch with pressure Tissue is erythematous and often painful Involves minimal tissue damage Sunburn Second degree burn Referred to as partial-thickness burns Involve the epidermis and portions of the dermis Often involve other structures such as sweat glands, hair follicles, etc. Blisters and very painful Edema and decreased blood flow in tissue can convert to a full-thickness burn Third degree burn Referred to as full-thickness burns Charred skin or translucent white color Coagulated vessels visible Area insensate patient still c/o pain from surrounding second degree burn area Complete destruction of tissue and structures Fourth degree burn Involves subcutaneous tissue, tendons and bone Burn extent % BSA involved morbidity Burn extent is calculated only on individuals with second and third degree burns Palmar surface = 1% of the BSA Measurement charts Rule of Nines: Quick estimate of percent of burn Lund and Browder: More accurate assessment tool Useful chart for children takes into account the head size proportion. Rule of Palms: Good for estimating small patches of burn wound Lab studies Severe burns: CBC Chemistry profile ABG with carboxyhemoglobin Coagulation profile U/A Type and Screen CPK and urine myoglobin (with electrical injuries) 12 Lead EKG Imaging studies CXR Plain Films / CT scan: Dependent upon history and physical findings Criteria for burn center admission Full-thickness...
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This note was uploaded on 12/27/2011 for the course STEP 1 taught by Professor Dr.aslam during the Fall '11 term at Montgomery College.

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BurnManagement-1 - Burn Management Lynn Kemp, R.N. Trauma...

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