Burn Care Basics

Burn Care Basics

• Burn care involves a multi-faceted approach, addressing the initial assessment and management, principles of acute burn life support (ABLS).

• The presentation outlines various burn degrees (superficial, superficial partial thickness, deep partial thickness, full thickness, sub dermal) and their associated characteristics.

• The categories for depth classification have changed; an old depth classification system exists.

• A presentation on burn depth classification highlights different burn degrees based on affected tissue layers. This includes diagrams indicating epidermal, dermal, and deeper tissue layers.

• Inhalation injury is a major concern during burn incidents, often causing higher mortality compared to visible burn injuries.

• Factors like the location, age, causative agent (e.g., chemical, thermal), duration of contact, and patient's general health condition help determine burn severity.

• Burn depth assessment requires expertise, and factors like patient evolution, factors beyond initial assessment influence final burn outcomes.

• Initial management includes primary and secondary surveys, TBSA calculations, fluid resuscitation, and monitoring requirements tailored to age.

• The presentation covers topics like carbon monoxide (CO) poisoning (symptoms and CO level percentages, treatment) and cyanide poisoning (mechanism and antidote), highlighting the need for comprehensive care.

• The key takeaway is the significance of early assessment and management to improve patient outcomes.

• Initial management includes airway assessment, breathing, circulation, disability, exposure management, and further secondary survey measures to determine and address possible injuries.

• The information presented highlights various methods for assessing burn severity and determining the appropriate management strategies based on the patient's condition.

• There are various methods used to estimate the extent of burns for appropriate care and treatment. One method discussed is the Lund and Browder chart.

• The discussion includes local vs. systemic inflammatory response to emphasize the importance of comprehensive care.

• A presentation on nutrition support emphasizes the critical role of early nutrition support after burn injuries. Different aspects such as referral to registered dietitians, gut-preferred nutrition, micronutrients, and adjuncts of care are discussed.

• Prophylactic antibiotics and adult / pediatric fluid resuscitation protocols are detailed for the appropriate burn treatment response.

Objectives of Wound Management

• Wound management aims to prevent wound conversion, remove necrotic tissue, minimize infection, prepare the tissue for grafting, promote new tissue granulation, and decrease scar incidence.

Mechanical Debridement

• Mechanical debridement involves the removal of non-viable tissue, eschar, blisters, and debris using instruments (scissors, forceps), minimizing trauma to healthy tissue.

Wound Cleansing

• Wound cleansing, a crucial element of burn treatment, focuses on debridement to remove damaged tissue & contaminants using chlorhexidine sponge and warm nasal saline solutions to create a clean treatment area.

Blister Management

• Blister management in burn victims focuses on handling blisters during treatment & repair.

Surgical Management

• Surgical management, discussed within the context of burn care, details the use of skin grafts, considering their characteristics based on thickness and source (autograft, allograft, or xenograft).

Skin Graft Healing Stages

• Skin graft healing stages include the period where there is no disruption to the graft and recipient bed for graft optimization.

Scars

• A quick description of hypertrophic and keloid scars, emphasizing hypertrophic scars remaining within the original injury borders and keloid scars extending beyond the original injury area.

Case Studies

• The presentation includes two case study examples, detailing patient scenarios and prompting relevant questions to aid in understanding proper burn care protocols and management. The questions are designed to test knowledge/application in real-world, complex scenarios.