EMERGENCY HEALTH CARE
LECTURE 8
BURNS
DEFINITION
Burn is a type of injury that affect only the
Epidermal tissue and the Dermis, and rarely the
deeper tissues such as as muscles, bones, and
blood vessels due to exposure to physical form
of energy, certain chemicals or radiation.
CAUSES OF BURN INJURIES
1. Heat
2. Steam
3. Flame
4. Electricity
5. Chemicals
6. Light
7. Radiation
8. Friction
CLASSIFICATION OF BURNS
CLASSIFICATION BY DEPTH
Burns are described according to the depth of
injury to the dermis and are classified into first,
second, third and fourth degrees
This (degree of burn) is determined by:
1. The nature of the agent such as temperature
and concentration
2. The length of contact
3. The tissues resistance to injury such as the
skin vascularity and thickness
First Degree Burns
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Involves only a partial thickness of the skin (The
Epidermis)
Characterized by dryness and erythema
(redness) of the skin and slight edema
Pain which subsides in 48 hours
Epidermis peels off in small scales in five to ten
days
Has no complications or scarring
Second Degree Burns
A. Superficial Partial Thickness
 Extends into superficial (papillary) Dermis
 Characterized by redness with clear blisters,
and subcutaneous edema, paleness with
pressure
 Painful
 Lasts from 2-3 weeks
 Complications include local infection (Cellulitis)
B. Deep Partial Thickness
 Extends deep into (reticular) Dermis
 Characterised by red-and-white skin colour, less
paleness
 Moist and painful
 Lasts many weeks and may progress to thirddegree burn
 Complications include scarring, contractures
and may required excision and skin grafting
Third Degree Burn
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Extends through the entire Dermis
Characterized by stiff and white/brown skin, dry,
leathery
No pain
Complications include scarring, contractures,
amputation
Requires excision
Fourth Degree Burn
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Extends through skin, subcutaneous tissue and
into underlying muscles and bones
Characterised by black, charred skin with
eschar (slough and dead skin)
Dry painless (no pain)
Complications include amputation and
significant functional impairment
Requires excision
ASSESSMENT OF AREA OF BURN
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This is done using the "rule of nines".
The body is divided up into eleven areas, each
representing 9% of the total body surface.
Body Area
Percentage Of Burn
Head and Neck
9%
Anterior Trunk
18%
Posterior Trunk
18%
Rt. Lower Extremity
18%
Lt. Lower Extremity
18%
Rt. Upper Extremity
9%
Lt. Lower Extremity
9%
Ext. Genitalia and Perineum
1%
GUIDE TO MANAGEMENT
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Minor burns (less than 10%) can be treated in
the hospital on out-patient basis
Moderate and severe burns should be
hospitalized for treatment
Adult patients sustaining more than 20% burn
require intravenous therapy.
FIRST AID TREATMENT
1.
2.
3.
4.
Place the burning person in a horizontal
position and roll him over in a blanket
In case of respiratory arrest, do positive
breathing, using the mouth-to-mouth or mouthto-mask technique. CPR
Apply cold bath using Normal Saline that is
kept at 10 to 15C
Cover the wound to minimize contamination
and inhibit pain by preventing air to come in
contact with the injured surface ( Clean cloth)
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Medications or home remedies should not be
applied
Facilitate transport to a hospital of severely
burned patients
BURN THERAPY FOR SEVERE
BURNS
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Assure an adequate airway
Look for and treat immediate life-threatening
conditions
Perform venipuncture with large bore needle
Remove patients clothing
Obtain history (Cause, time, place of burn,
allergies, tetanus, diabetes, cardiac, renal and
liver disease)
Insert indwelling catheter
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Cleanse wound by removing any dirt, irrigate
with cooling water to prevent further damage
Estimate % and depth of burn in a chart
Provide adequate analgesic as needed
Calculate fluids intake and output
Apply dressing: either the Open Method, or the
Closed Occlusive Pressure Dressings
Face and perineum exposed
Hands polythene bags
Rest of the body closed method
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Do not open blisters.
Do not add ice to burn.