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What is the outer layer of skin?
What makes dermis different than epidermis?
- Dermis is thicker and is made of collagen, fibrous connective tissue and elastic fibers.
- Dermis also includes: Blood Vessels, Sensory Nerves, Hair Follicles, Lymph Vessels, Sebaceous and sweat glands
Functions of the Skin
- Protective barrier
- Fluid and electrolyte balance: break in skin =loss of fluid
- excretes sweat
- sensations: pain, pressure, temp, touch
the skin can tolerate temps up to ___
- temp of 158 and above cause rapid cell destruction
Main Concern for patient with burns
Superficial - thickness wounds
- 1st degree, least serious
- Involves outer layer of skin
- Causes: Redness, Swelling, Pain
- Usually treated as minor burn
- Small Blister OK, Big blister will need to see doctor. If large part of the body is covered see physician
Treatment for superficial/1st degree burns
- Do Not Bust the Blister, but when it busts on its own keep clean and covered
- Motrin, tylenol for pain
- May need tetnus shot
- Remove Constrictiong clothing, jewlerly
- Cool water, Not Cold for 10-15 mins until pain decreases
- May Apley Aloe Vera
Superficial Partial - Thickness Wounds
- 2nd degree (involves epidermis and some of the dermis)
- Red with white splotchy patches
- usually have blisters
- If large or covers hands, feet, face, buttock, groin or major joint seek medical attention
Deep Partial thickness wounds
- 2nd degree
- Red or white area
- Tend not to see blisters because the damage to the underlying tissue
- **closer to the nerve ending the pain changes
Full Thickness wounds
- 3rd degree
- involves all layers of the skin, destruction to the entire dermis and epidermis
- Hard, dry, leathery eschar that forms.
- eschar is dead tissue that must be removed before healing can occur.
- Charred Look
- Not uncommon to have white areas
- If injuries are this bad they will prob have inhalation injuries too regardless of burn location
- Consider breathing issues, Were there toxins/chemicals in the flames?
- Carbon Monoxide Knocks the O2 off the Hgb (crank up the O2 to 100%)
Deep Full Thickness
Goes into the