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Burn Shock
- A condition that can occur with moderate to major burns that cover sufficient body surface area (BSA)
- Inhalation of superheated air may lead to the lining of the larynx to swell (laryngeal edema)
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Superficial Burn
- Burn that only involves the epidermis.
- First-degree burn.
- Red skin
- Pain at site
- Tenderness
- No blisters
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Partial-thickness Burn
- Burn that involves the epidermis and portions of the dermis
- Second-degree burn
- Blisters
- Intense pain
- white to red skin
- moist and mottled skin
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Full-thickness Burn
- Burn that involves all the layers of the skin and can extend beyond the subcutaneous layer into the muscle, bone, or organs.
- Third-degree burn
- Leathery appearance(eschar)
- Charring, dark brown or white
- skin hard to touch
- no pain
- pain at periphery of burn
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Eschar
The hard, tough, leathery,dead soft tissues formed as a result of a full-thickness burn
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Determining the Severity of Burn
- Depth of burn
- Location of burn
- Patient's age
- Pre-existing medical conditions
- Percentage of BSA involved
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Circumferential Burns
Burn that encircles a body area.
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Burn Severity Classification
- Critical burns: -Burn accompanying breathing
- -Full or partial burns involving the face, genitalia or major joints
- -full-thickness burns covering more than 10% BSA
- -partial-thickness burns covering 25% BSA in people less than 50 or 20% in people older than 50/younger than 5
- -burns complicated by a fracture to an extremity
- -any circumferential burns
- Moderate burns: -Full-thickness 2-10% BSA excluding the face, genitalia, or respiratory tract
- -partial-thickness burn 15-25% BSA
- Minor burns: -Full less than 2%
- -partial less than 15% BSA
- -superficial less than 50% BSA
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Rule of Nines
- Standardized format to identify the amount of BSA that has been burned.
- Head + neck 9%
- Posterior trunk 18%
- Anterior trunk 18%
- Each upper extremity 9%
- External genitalia 1%
- Each lower extremity 18%
- For infants: -Posterior/anterior trunk 18%
- -Each upper extremity 9%
- -head + neck 18%
- -Each lower extremity 14%
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Rule of Ones
- The concept that the area of a patient's palm is equal to about 1% of his BSA.
- Rule of palms
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Types of Burns
- Inhalation burns: High temperature or steam being inhaled
- Chemical burns: Acids, alkalis, and heat generating chemicals
- Electrical burns: result from resistance to current flow in body
- Radiation burns: absorption of radiation into the body
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Causes of Burns
- Flame burn
- Contact burn
- Scald: contact with hot liquid
- Steam burn
- Gas burn
- Electrical burn
- Flash burn: type of flame burn that is the result of quick ignition
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Primary Assessment
- Cooling down the pt
- After cooling, continue the ABCs
- Determine priority transport
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Secondary Assessment
- Reassessment of MOI
- Rapid secondary
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Burn Sheet
Commercially prepared sterile, particle-free, disposable sheet used to cover the entire body in severe burn injuries
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Emergency Medical Care
- 1. Remove pt from source of burn
- -stop the burn process by water or saline
- -do not attempt to remove adhered clothing
- 2. Maintain airway and breathing
- 3. Classify severity and transport
- 4. Cover the burn area with dry sterile dressing-use a burn sheet
- 5. Keep the pt warm and treat other injuries as needed
- 6. Transport
- -Avoid using material that leaves particles
- -Never apply any type of lotion, ointments
- -Never break or drain a blister
- -remove jewelry around the wound
- -do not attempt to open eyelids
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