September 29-30, 2014
Burns can be caused by:
 heat,
 electricity,
 UV radiation, or
 chemicals
First degree burn:
only epidermis is
damaged.
Second degree burn:
Damage extends
partway into dermis.
Third degree burn:
Damage extends all
the way through
dermis.
First degree burn:
only epidermis is
damaged.
Second degree burn:
Damage extends
partway into dermis.
Third degree burn:
Damage extends all
the way through
dermis.
Signs: red, swollen skin
Example: most sun burns
Will heal on own
First degree burn:
only epidermis is
damaged.
Signs: red, swollen skin
Example: most sun burns
Will heal on own
Second degree burn: Signs: blistering
Damage extends
Skin will heal care
partway into dermis.
Third degree burn:
Damage extends all
the way through
dermis.
First degree burn:
only epidermis is
damaged.
Signs: red, swollen skin
Example: most sun burns
Will heal on own
Second degree burn: Signs: blistering
Damage extends
Skin will heal with care
partway into dermis.
Third degree burn:
Damage extends all
the way through
dermis.
Signs: blackened or
blanched (gray-white) skin,
lack of pain due to damaged
nerves
Skin will not heal; grafts
must be done
Burned skin can no longer carry out its functions
Turn & Talk
Quick review: What are the functions of the skin?
Analyze: Which functions are most critical?
1) Protection from abrasion / chemical damage / UV
damage / pathogens / against dessication
2) Excretion of wastes
3) Thermoregulation
4) Synthesis of Vitamin D
Burned skin can no longer carry out its functions
Most critically, skin can no longer
 Prevent loss of fluids and electrolytes
 Fluid loss and electrolyte imbalance can cause kidneys to
shut down and patients to go into shock due to low blood
volume.
 Happens almost immediately, unless fluids are replaced.
 Protect the body from pathogens
 Infection becomes a major concern within 2-3 days
following severe burns.
 Burned skin cannot thermoregulate. Hypothermia
becomes a problem.
 Burned skin cannot regenerate. Scar tissue forms. If
the scar tissue is extensive, mobility may be affected.
The severity of burns is determined by both the degree
(depth) of the burn and the % of the body covered.
Burns are critical if
 More than 25% of the body has second degree burns
 More than 10% of the body has third degree burns
How to estimate body %?
“Rule of nines”
If the whole
anterior right arm is
burned …
“Rule of nines”
If the whole
anterior right arm is
burned …
4.5%
“Rule of nines”
If the whole
anterior right arm is
burned …
4.5%
If 1/3 of the
abdomen is burned
…
“Rule of nines”
If the whole
anterior right arm is
burned …
4.5%
If 1/3 of the
abdomen is burned
…
3%
“Rule of nines”
If the whole
anterior right arm is
burned …
4.5%
If 1/3 of the
abdomen is burned
…
3%
If a whole leg (all
sides) is burned …
“Rule of nines”
If the whole
anterior right arm is
burned …
4.5%
If 1/3 of the
abdomen is burned
…
3%
If a whole leg (all
sides) is burned …
18%
“Rule of nines”
You do:
Half of upper back
All of right arm
All of head
“Rule of nines”
You do:
Half of upper back
4.5%
All of right arm
9%
All of head
9%
What are the two most important complications of
severe burns and why does each occur?
What are the two most important complications of
severe burns and why does each occur?
 Loss of fluids & electrolytes (causing kidney
malfunction & shock)
 Infection
There a three main types of skin cancers, defined by the type of
cell from which they arise.
Basal cell carcinoma – arise
from the basal edge of the
epithelial tissue.
Squamous cell carcinoma –
arise from the keratinproducing cells in the middle
of the epithelial tissue.
Melanoma – arise from the
melanin-producing cells at
the basal edge of the
epithelial tissue
 Most common form
of skin cancer
 Affects ~2.8 million
people in the US each
year
 Slow-growing and
rarely fatal
 Second most
common form of
skin cancer
 Affects ~700,000
people in the US
each year
 Grow and invade
surrounding
tissue quickly
 <5% are fatal
 Third most common skin
cancer
Melanoma may be the least common
 Affects ~76,000
in but it is by far the
type ofpeople
skin cancer,
most
the US each
yeardeadly.
 Quickly metastasizes
Moreover, while rates of most other
cancers
declining in the US (due to
(spreads) to
bloodare
vessels
reduction
of smoking) melanoma
and lymphanodes
– which
are to
increasing.
allows it torates
spread
other
locations in the body
 Fatal in more than 10% of
cases
 What were our objectives today?
How did we meet them?
 What was our learner profile trait and how did we use
it?
 How does what we did today address our unit
objective?
Homework:
Study for Quiz!