Burns
CH 1 & 3 in class assignment based upon choice of study
1.
Define basic terminology used in the study of disease?

Damage to the skin or other body parts caused by extreme heat, flame, contact
with heated objects, or chemicals.

There are different types of burns that range such as first-degree, second-degree,
third-degree, and fourth-degree burns.
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First-degree: Localized injury to or destruction of epidermis by direct or indirect contact. The
barrier function of the skin remains intact.
Second-degree/superficial partial-thickness burns: destruction of epidermis and some of the upper
area of the dermis.
Second-degree/deep partial-thickness: destruction of the epidermis and more of the dermis.
Third- and fourth-degree burns: Affects every body system and organ. A third-degree burn extends
through the epidermis and dermis and into the subcutaneous tissue layer, the fourth-degree burns
damages muscle bone and interstitial tissues. Within hours, fluids and protein shift from capillary to
interstitial spaces, causing edema.
Other terminology includes:
 Electrical burns - burns due to contact with an electrical current.
 Graft - uninjured skin, which is removed from its original site and placed
on the burn wound.
 Granulation tissue - a specialized tissue created by the body as a
response to injury. It is exceedingly rich in tiny blood vessels.
 Radiation burns - burns due to prolonged exposure to ultraviolet rays of
the sun, or to other sources of radiation such as x-ray.
 Skin graft - using a piece of skin from an uninjured part of the body to
repair a deep skin wound.
 Minor, Moderate, and Major Burns
2.
Identify the major causes of diseases, list them?
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Thermal: residential fires, automobile accidents, playing with matches,
improper handling of firecrackers, scalds caused by kitchen or bathroom
accidents.
Chemical: contact, ingestion, inhalation, or injection of acids, alkalis, or
vesicants.
Electrical: contact with faulty electrical wiring, electrical cords, or highvoltage power lines.
Friction or abrasion
Ultraviolet radiation: sunburn
3.
Identify risk factors related to disease?
There are many risk factors which include gender, age, regional factors, socioeconomic
factors, and other risk factors.
 Gender: Females have a slightly higher rate of death from burns compared to
males. The higher rate is associated with open fire cooking, inherently unsafe
cookstoves (igniting clothing), and open flames used for heating and lighting.
 Age: Children age considered to be more vulnerable to burns. A risk associated
with this is unsupervised children and burn injuries on children resulting from
child maltreatment.
 Regional: Different regional areas such as African Regions, low- and middleincome countries, burn injuries requiring medical care is higher in Western
Pacific Regions than in the Americas.
 Socioeconomic: people living in low- and middle-income countries are at higher
risk for burns than people living in high income countries
 Other Risk Factors: occupations that increase exposure to fire, poverty and
overcrowding with lack of proper safety measures, alcohol abuse and smoking.
Inadequate safety measures for liquefied gas and electricity.
4.
Describe how health promotion and disease prevention reduce the burden of
disease?
 Burns are preventable. Prevention strategies should address the hazards for
specific burn injuries, education for vulnerable populations and training of
communities on first aid, an effective burn plan should include improving
awareness, develop and enforce effective policies, provide burn prevention
programs, strengthen burn care. Other recommendations include enclosing
fires and limit the height of open flames in domestic environments,
promote safer cook stoves and less hazardous fuels and educate regarding
loose clothing, lower the temperature in hot water taps, promote fire safety
education and the use of smoke detectors, fire sprinklers, and fire escape
systems and homes. For children specifically, reduce water temperatures,
avoid hot spills, establish “no” zones (i.e. fireplace, stove, space heaters,
radiators.), keep hot dishes out of reach, address outlets and electrical
cords.
Chapter 2 Immunity and Disease
1.
Describe the function of the immune system?
 Burns are thermal, chemical, or electrical injuries of the skin. The severity
a range from extremely mild to life threatening; Burns can cause local or
systemic injury dependent upon the intensity of the energy experienced,
the duration of exposure, and the type of tissue. It also protects internal
structures from invasion by infection or harmful agents in mechanical
damage. The skin serves as an important barrier between the body in the
external environment. The skin prevents dehydration, regulates body
temperature, and produces vitamin D. The skin is the bodies first line of
defense mechanism and if that defense mechanism is not working that can
cause weakness to the immune system causing the body to be less able to
fight off threats. The inflammatory response, which is the second line of
defense for the body, is also impaired with burns. Burns cause serious
body wide problems. The normal inflammatory response protects the body
from bacteria, viruses, toxins, and foreign material. It helps in response to
infection, injury, and other threats. With burns there is fluid loss which
impairs blood circulation, edema, and dehydration. The lungs, heart, brain,
and kidneys are susceptible too. With the bodies defense mechanisms not
working properly it poses the threat to infection. Complications can also
include sepsis, anemia, respiratory complications, hypovolemic shock, and
multisystem organ failure.
2.
Explain the nonspecific immune response to infection?
Nonspecific/innate immune response involves the skin, mucous membranes,
inflammation, and phagocytes (macrophages and neutrophils). We are born with
this. White blood cells protect against infection. Neutrophils and monocytes
remove foreign particles from the body. It is the first responder to insult. This
immune response is rapid and can be initiated by many different pathogens,
without requiring prior exposure. This response system prevents microbe
colonization, entry, and spread.
3.
Explain the humoral immune response the role of antibodies in immunity?
Humoral immune response involves B lympohcytes in which they interact
indirectly by producing antibodies that destroy the antigens or antigen-bearing
agents. The plasma cells create antigen specific antibodies. The cells mature in the
red bone marrow. Antibodies work by opsonization, agglutination, and activate
complement to form the membrane attack complex. Occurs over a lifetime,
promoting the body’s ability to adapt to the threat of reinfection.
4.
Describe the cell-mediated immune response and the role of T cells in
immunity?
In the cell-mediated immune response activated T cells interact directly with the
antigen presenting cell. The role of T cells in cell-mediated and humoral immune
responses to representative pathogens. Cell-mediated immune responses involve
the destruction of infected cells by cytotoxic T cells, or the destruction of
intracellular pathogens by macrophages. Occurs over a lifetime, promoting the
body’s ability to adapt to the threat of reinfection.
5.
Describe the incidence, risk factors, signs and symptoms, etiology, diagnosis,
treatment, and prevention________?
Incidence:
• Each year in the United States, 1.1 million burn injuries require medical attention.
Approximately 50,000 of these require hospitalization; 20,000 have major burns
involving at least 25 percent of their total body surface, and approximately 4,500 of these
people die.
Risk Factors:
 Gender: Females have a slightly higher rate of death from burns compared to
males. The higher rate is associated with open fire cooking, inherently unsafe
cookstoves (igniting clothing), and open flames used for heating and lighting.
 Age: Children age considered to be more vulnerable to burns. A risk associated
with this is unsupervised children and burn injuries on children resulting from
child maltreatment.
 Regional: Different regional areas such as African Regions, low- and middleincome countries, burn injuries requiring medical care is higher in Western
Pacific Regions than in the Americas.
 Socioeconomic: people living in low- and middle-income countries are at higher
risk for burns than people living in high income countries
 Other Risk Factors: occupations that increase exposure to fire, poverty and
overcrowding with lack of proper safety measures, alcohol abuse and smoking.
Inadequate safety measures for liquefied gas and electricity.
Signs and Symptoms:
First degree burn: localized pain and erythema, usually without blister in the first
24 hours. More severe first-degree burns: chills, headache, localized edema, nausea,
vomiting. Second degree burns: thin-walled, fluid filled blisters that appear within
minutes of injury, white waxy appearance of damaged area, edema, pain. Third- and
fourth-degree burns: white, brown, or black leathery tissue, visible thrombosed vessels,
no blisters.
Etiology: Damage to the skin or deeper tissues caused by sun, hot liquids, fire,
electricity, or chemicals
Diagnosis:
 Arterial blood gas levels show evidence of smoke inhalation, CBC reveals
decreased hemoglobin level and hematocrit if blood loss occurs, urinalysis
shows myoglobinuria and hemoglobinuria, electrocardiogram shows ischemia,
injury, or arrythmias. Estimation of the rule of nines, along with a
determination of the thickness of the burn, allows the health professional to
determine the severity of the injury and direct treatment.
Treatment: Sunburn and small scalds can often be treated at home. Deep or widespread
burns and chemical or electrical burns need immediate medical care, often at specialized
burn units. Pain or anti-inflammatory medication, systemic antimicrobial therapy,
debridement followed by application of antimicrobial dressings.
Prevention:
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6.
Burns are preventable. Prevention strategies should address the hazards
for specific burn injuries, education for vulnerable populations and
training of communities on first aid, an effective burn plan should include
improving awareness, develop and enforce effective policies, provide burn
prevention programs, strengthen burn care. Other recommendations
include enclosing fires and limit the height of open flames in domestic
environments, promote safer cook stoves and less hazardous fuels and
educate regarding loose clothing, lower the temperature in hot water taps,
promote fire safety education and the use of smoke detectors, fire
sprinklers, and fire escape systems and homes. For children specifically,
reduce water temperatures, avoid hot spills, establish “no” zones (i.e.
fireplace, stove, space heaters, radiators.), keep hot dishes out of reach,
address outlets and electrical cords.
Describe allergy and hypersensitivity?
Allergy occurs when a person reacts to substances in the environment that are harmless to
most people such as dust, pets, pollen, foods. A hypersensitivity is the result from
excessive immune responses to allergens.