The greater the heat energy, the the wound. Exposure time is an important factor. People reflexively limit heat energy and exposure time.

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1 1 2 Chapter 26 Burns Burns Burns account for about 3,400 deaths/year. Burns are the most serious and painfu injuries. A burn occurs when the body receives more radiant energy than it can. Sources of this energy incude heat, toxic chemicas, and eectricity. 3 4 Burns Remember to perform a compete assessment on burn patients for other injuries. Chidren, oder patients, and patients with chronic inesses are more ikey to experience from burn injuries. Pathophysioogy of Burns Pathophysioogy Burns are soft-tissue injuries created by the transfer of radiation, therma, or eectrica energy. Therma burns occur when the skin is exposed to temperatures higher than. 5 6 Pathophysioogy of Burns Pathophysioogy (cont d) Severity of a therma injury correates directy with: Concentration Amount of heat energy possessed by the object or substance Duration of exposure Pathophysioogy of Burns Pathophysioogy (cont d) The greater the heat energy, the the wound. Exposure time is an important factor. Peope refexivey imit heat energy and exposure time. 1

2 Exposure time is an important factor. Peope refexivey imit heat energy and exposure time. Compications of Burns When a person is burned, the skin that acts as a barrier is destroyed. Burns to the are of significant importance. Circumferentia burns of the chest can compromise breathing. Circumferentia burns of the extremity can ead to compromise and irreversibe damage. The Burn Victim is at Risk For: Infection: most deaths from burns are caused by i, days or weeks ater Hypothermia: the body is unabe to maintain body temp; even in hot weather Hypovoemia: due fuid oss from bisters and sweing Shock: may be respiratory, hypovoemic, or Determining Burn Severity What is the of the burn? What is the extent of the burn? Are any critica areas invoved? Face, upper airway,, feet, genitaia Are there any preexisting medica conditions or other injuries? Is the patient younger than years or oder than 55 years of age? Cassifications of Burns Superficia (1 st Degree) Thickness (2 nd Degree) Fu Thickness (3 rd Degree) Superficia Burns 1 st degree burns Invove ony skin ayer Characterized by reddening of the skin Partia Thickness Burns 2 nd degree burns Invove the epidermis and some portion of the Characterized by the formation of bisters 2

3 Characterized by the formation of bisters Fu Thickness Burns 3 rd degree burns Extend through of the skin Characterized by charring Back or dark brown and eathery Extent of Burns Can be estimated using the rue of or the rue of pam Incude ony partia-thickness and fu-thickness in estimation of the extent of burn injury Proportions differ for infants, chidren, and aduts Extent of Burns (Rue of 9 s) Used to determine percent of body surface that is burned (TBS) Area Adut Chid Infant Head 9% 12% 18% Arms 9% 9% 9% Torso (front) 18% 18% 18% Torso (back) 18% 18% 18% Genitaia 1% 1% 1% Legs 18% % Extent of Burns (Rue of 9 s) Rue of Pam (Pamer Method) The size of the patient s pam is roughy equa to of Tota Body Surface (TBS) Used when burns are scattered about the body Critica Burns (1 of 2) Fu-thickness burns invoving, feet, face, upper airway, genitaia, or circumferentia burns of other areas Fu-thickness burns covering more than of tota body surface area Partia-thickness burns covering more than 30% of tota body surface area Burns associated with respiratory injury 3

4 area Burns associated with respiratory injury Critica Burns (2 of 2) Burns compicated by Burns on patients younger than 5 years od or oder than 55 years od that woud be cassified as moderate on young aduts Burns invoving compications, diabetes, or other injuries or inesses. Moderate Burns 3rd degree burns of 2 to TBS excuding face, hands, feet, or genitaia. 2nd degree burns of 15 to 30 % TBS. 1st degree burns of 50 to TBS. Minor Burns Fu-thickness burns invoving ess than 2% of the tota body surface area Partia-thickness burns covering ess than 15% of the tota body surface area Superficia burns covering ess than of the tota body surface area Therma Burns Caused by heat Most commony, caused by scads or an open Coming in contact with hot objects produces a contact burn. A steam burn can produce a topica (scad) burn. A fash burn is produced by an exposion. 23 Chemica Burns Occur whenever a substance contacts the body Eyes are particuary vunerabe. Fumes can cause burns. The severity of the burn is directy reated to the: Type of chemica Concentration of the chemica of the exposure 4

5 Concentration of the chemica of the exposure To prevent exposure, wear appropriate goves and eye protection. Care for Chemica Burns the chemica from the patient. If it is a powder chemica, brush off first. Remove a contaminated. Fush burned area with arge amounts of water for about 15 to 20 minutes. Transport quicky. Eectrica Burns (1 of 2) The human body is a good conductor. The type of eectric current, magnitude of current, and votage have effects on the seriousness of the burn. Make sure the power is before touching the patient. There wi be wounds (an entrance and an exit wound) to bandage. Transport the patient and be prepared to administer CPR. Eectrica Burns (2 of 2) Eectrica Burns Taser Injuries In recent years, aw enforcement has increased its use of Tasers. Potentia compications for patients with disorders. Use of a Taser has been associated with dysrhythmias and sudden cardiac arrest. Make sure you have access to an AED when responding to patients who have been exposed to Taser shots. Inhaation Burns (1 of 2) Can occur when burning takes pace in encosed spaces without ventiation Upper airway damage is often associated with the inhaation of gases. Lower airway damage is more often associated with the inhaation of chemicas and particuate matter. 5

6 Lower airway damage is more often associated with the inhaation of chemicas and particuate matter. Inhaation Burns (2 of 2) You may encounter severe upper airway, requiring intervention immediatey. Consider requesting ALS backup. The combustion process produces a variety of toxic gases. Carbon monoxide intoxication shoud be considered whenever a group of peope in the same pace a report a headache or nausea. Radiation Burns Potentia threats incude: Incidents reated to the use and transportation of radioactive Intentionay reeased radioactivity in terrorist attacks You must determine if there has been a radiation exposure and then whether ongoing exposure continues to exist. 3 Types of Ionizing Radiation : Litte penetrating energy, easiy stopped by the skin or a singe piece of paper Beta: Greater penetrating power, but bocked by simpe protective cothing Gamma: Very penetrating, easiy passes through the body and soid materias Most ionizing radiation accidents invove gamma radiation, or x- rays Management of Radiation Burns (1 of 2) Protect yoursef Patients with a radioactive source on their body must be initiay cared for by a responder. Irrigate open wounds. Notify the emergency department. 6

7 Irrigate open wounds. Notify the emergency department. Management of Radiation Burns (2 of 2) Identify the radioactive source and the ength of the patient s exposure to it. Limit your of exposure. Increase your distance from the source. Attempt to pace shieding between yoursef and the sources of gamma radiation Emergency Care for Burns (1 of 2) Foow proper BSI precautions. Move the patient away from the burning area. the burning process Dry, sterie, oose dressing and bandaging Give oxygen if the patient has a critica burn. Protect from ; regardess of the ambient temperature Emergency Care for Burns (2 of 2) Aways ook in mouth for soot or bisters Prevent body heat oss. Rapidy estimate the burn s severity. Check for traumatic injuries. Treat the patient for. Provide prompt transport. Transport to a burn center if critica Treatment Tips for Burns Use no types of ges or other ointments uness authorized by medica contro or protocos Do not use bandages due to sweing Sterie sheets (burn sheets) work we for arge burn areas ALWAYS examine the mouth and throat Functions of Dressing and Bandaging for Burns Contro beeding Protect the wound 7

8 39 Contro beeding Protect the wound Prevent contamination Pediatric Needs Burns to chidren are considered more than burns to aduts. Chidren have more surface area reative to body mass than aduts. Many burns resut from abuse. Report a suspect cases of abuse to the authorities. 8

Don t learn safety by accident

Don t learn safety by accident WORKPLACE HEALTH AND SAFETY Legisation Don t earn safety by accident Work Heath and Safety Act 2011 (Cth) (WHS Act) and the Work Heath and Safety Reguations 2011 (Cth) (WHS Reguations) outine the requirements