●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 canbe 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.