Summer Skin
Burns, Bites & Abrasions
Alexa Colgrove Curtis PhD, FNP-BC
Associate Professor SONHP
Director, Nurse Practitioner Programs
Summer Skin
• Burns
– Sunburns & Skin Cancer
– Burn First Aid
– Poison Oak
• Bites
– Mosquitos
– Ticks
• Abrasions
– Cuts & Scrapes
Burns
Burns
Burns
Burns Severity
Minor
Moderate
Major
Adult <10% TBSA
Adult 10-20% TBSA
Adult >20% TBSA
Young or old < 5% TBSA
Young or old 5-10% TBSA
Young or old >10% TBSA
<2% full thickness burn
2-5% full thickness burn
>5% full thickness burn
High voltage injury
High voltage burn
Possible inhalation injury
Known inhalation injury
Circumferential burn
Significant burn to face,
joints, hands or feet
Other health problems
Associated injuries
Sunburn Prevention
• Avoid sun exposure between 10 am & 4 pm
– Seek shade
– UV index 0-11+
• Risk of sunburn
• http://www.epa.gov/sunwise/uvindex.html
• Sunscreen
–
–
–
–
SPF 30 or greater
UVA/UVB
Apply generously 15-30 minutes before exposure
Reapply every two hours
Sunburn Treatment
• Take a cool shower/bath or use cool
compresses
• Liberal use of moisturizer
• Hydrate
• Anti-inflammatory
– Ibuprofen
– 1% Hydrocortisone
Burn First Aid for Minor Burns
• Cool the burn
– Don’t use ice
• Apply a sterile bandage
– Observe for infection
• Hydrate
• Take an anti-inflammatory
– Ibuprofen
Poison Oak
Poison Oak Prevention
• Learn to spot poison oak in all seasons
• Wear protective clothing when exposed to brush
• If exposed scrub with soap and water, or rubbing
alcohol, within 10 minutes.
• Scrub under your nails, plant oil can be spread by
oil on your fingers
• If your pet has been exposed wash in shampoo
and water, wear rubber gloves
• Wash exposed equipment with soap and water,
the oil can stay potent for as long as five years.
Poison Oak Identification
Poison Oak Treatment
•
•
•
•
Cool compresses
Calamine lotion
Hydrocortisone cream
Steroids
– Cream
– Pills
– Injectable
Skin Cancer
• http://www.webmd.com/melanoma-skincancer/ss/slideshow-skin-lesions-and-cancer
• ABCDE
– Asymmetry
– Border
– Color
– Diameter
– Evolving
Bites
• Mosquitos
West Nile Virus
• Spread by infected mosquitos
• Can cause encephalitis (inflammation of the
brain) or meningitis (inflammation around the
brain and spinal column)
• People over 60 and the chronically ill are most
at risk
• Incubation period is generally 2-6 days
• Most people are infected June – September
West Nile Virus Symptoms
• 70-80% of people exposed to West Nile Virus
do not develop symptoms
• About 1 in 5 people who are infected will
develop a fever with other symptoms such as
headache, body aches, joint pains, vomiting,
diarrhea, or rash. Most people with this type
of West Nile virus disease recover completely,
but fatigue and weakness can last for weeks or
months.
West Nile Virus Symptoms
• Less than 1% of people who are infected will
develop a serious neurologic illness such as
encephalitis or meningitis. The symptoms of
neurologic illness can include headache, high
fever, neck stiffness, disorientation, coma,
tremors, seizures, or paralysis.
• Recovery from severe disease may take several
weeks or months. Some of the neurologic effects
may be permanent. About 10 percent of people
who develop neurologic infection due to West
Nile virus will die.
West Nile VIrus Activity
West Nile Virus Prevention
•
•
•
•
Avoid mosquito infected areas
Reduce mosquito breeding grounds
Wear protective clothing
Use mosquito repellant
– Of the products registered with the EPA, those
containing DEET, picaridin, IR3535, and some oil of
lemon eucalyptus and para-menthane-diol products
provide longer-lasting protection.
• Report dead birds to the local health department
Bites
• Ticks
Lyme Disease
• Caused by the bacterium Borrelia burgdorferi
• transmitted to humans through the bite of
infected blacklegged ticks
Early Lyme Disease Symptoms
• “Bull’s-eye” rash:
Erythema Migrans (EM)
• Fatigue, chills, fever, headache, muscle and joint
aches, and swollen lymph nodes
• 3-30 days post-tick bite
Lyme Disease
Early Disseminated Stage
• Additional EM lesions in other areas of the
body
• Facial or Bell's palsy
• Severe headaches and neck stiffness due to
meningitis
Lyme Disease
Early Disseminated Stage
• Pain and swelling in the large joints (such as
knees)
• Shooting pains that may interfere with sleep
• Heart palpitations and dizziness due to
changes in heartbeat
Lyme Disease
Late Disseminated Stage
• Approximately 60% of patients with untreated
infection may begin to have intermittent bouts
of arthritis, with severe joint pain and
swelling.
• Large joints are most often affected,
particularly the knees.
Lyme Disease
Late Disseminated Stage
• Up to 5% of untreated patients may develop
chronic neurological complaints months to
years after infection
– shooting pains
– numbness or tingling in the hands or feet
– problems with short-term memory.
Lyme Disease
Reported Cases in the U.S.
Lyme Disease Prevention
• Be extra vigilant in warmer months (AprilSeptember) when ticks are most active.
• Avoid wooded and bushy areas with high grass
and leaf litter.
• Wear protective clothing.
• Use repellents that contain 20% or more DEET
on the exposed skin.
• Use products that contain permethrin on
clothing.
Lyme Disease Prevention
• Find and remove ticks from your body.
• Pull upward with steady, even pressure. Don't twist or jerk the
tick
• After removing the tick, thoroughly clean the bite area
and your hands with rubbing alcohol, an iodine scrub, or
soap and water.
Lyme Disease
Testing & Treatment
• Testing blood for evidence of antibodies
against the Lyme disease bacteria
• Antibiotics for 2-3 weeks
• Symptom management
Abrasions
• Use soap and water to clean
the wound.
– Irrigate as needed
• Apply pressure to stop the
bleeding
• Apply topical antibiotic cream
– Bacitracin not Neosporin due to skin allergies
• Apply a sterile dressing
• Observe for infection
Abrasions
When to Seek Medical Attention
• If you are unable to control the bleeding.
• Wound edges of the cut are jagged or gape open
• The cut is deep (1/4 inch or more), or you can see fat or
muscle.
• You can't get all of the dirt or debris out of the wound, or
the wound was caused by something very dirty or rusty.
• You have a puncture wound or a deep cut and haven't had
a tetanus shot in the past 5 years.
• The wound is from an animal or human bite.
• You have numbness, loss of sensation, or loss of movement.
Minor Lacerations
Glue Me
•
•
•
•
•
•
•
Dermabond
Clean and irrigate wound
Approximate wound edges
Gently apply adhesive to the external skin surface
Wipe off excess adhesive immediately
Hold wound edges together for 30 seconds
Adhesive acts as its own water-resistant bandage, and
no added coverings are needed.
• No ointment, it will cause adhesive to fail.
• Adhesive will spontaneously peel off in five to 10 days.
Have a Wonderful Summer