●
Keep
emergency numbers
near the phone.
●
Have a
family exit and meeting plan
for fires. Reinforce
that no one
should ever re-enter
a burning building.
●
Follow the principles of
“stop, drop, and roll”
to
extinguish fire on clothing or skin.
●
Store
matches and lighters out of reach
and out of
sight of children and adults who lack the ability to
protect themselves.
●
Reduce the setting on water heaters to
48.9° C (120° F).
●
Have an
annual professional inspection and cleaning
of
the chimney and fireplace.
●
Turn handles of pots and pans
to the side
, or use
back burners.
●
Don’t leave hot cups
on the edge of the counter.
●
Cover
electrical outlets.
●
Keep
flammable objects away
from heat sources
(candles, space heaters).
●
Wear gloves when handling chemicals
and keep
chemicals out of reach of children.
●
Wear protective clothing
during sun exposure and
use sunscreen.
●
Avoid using tanning beds.
●
Avoid smoking in bed and when under the influence of
alcohol or sedating medications.
●
Do not smoke or have open flames in a room where
oxygen is in use
.
●
Never
add flammable
substances (gasoline, lighter fluid,
NURSING CARE
Stop the burning process.
●
If providing care at the burn scene,
extinguish flames
or
remove
the source of fire.
●
Remove clothing or jewelry
that might conduct heat.
●
Apply
cool water soaks or run cool water over injury
;
do
not use ice
.
●
Flush
chemical burns
with a
large volume of water
.
●
Cover the burn with
a clean cloth to prevent
contamination and hypothermia.
●
Provide
warmth
.
●
Perform an ABCDE primary survey and
provide treatment.
Minor burns
●
Provide analgesics.
●
Cleanse with
mild soap and tepid water
. (Avoid
excess friction.)
●
Use antimicrobial ointment.
●
Apply a
dressing
(nonadherent, hydrocolloid) if clothing
is irritating the burn.
●
Educate the family to avoid using
greasy lotions or
butter
on the burn.
●
Teach the family to observe for evidence of
infection
.
●
Determine the need for a
tetanus immunization
.
Moderate and major burns
During the initial (resuscitation) phase (from the time of injury
to
12 to 48 hr later
) following a major burn, sympathetic
nervous system manifestations (tachycardia, increased
respiratory rate, decreased gastrointestinal motility, increased
blood glucose) are expected findings.
Comfort management
●
Monitor
pain
and the effectiveness of pain treatment.
Pain:
IV best route WHY? Subq: skin layer damaged, IM: muscles can
be damaged, GI (oral): remember the gut isn’t working like it should
right now…..always select the option with
IV route and PRE-
Respiratory system
●
Assess respiratory rate and depth. Monitor
chest
expansion
during respiration to ensure that eschar or
chest dressings on chest, neck, and back do not restrict
movement.
●
Upper airway edema becomes pronounced
8 to 12 hr
after the beginning of fluid resuscitation. Crowing,
stridor, or dyspnea requires nasal or oral intubation.
