CH11.pdf

Chapter 11 Burns Copyright © 2021 by Public Safety Group, A Division of Jones & Bartlett Learning. www.psglearning.com. Burns  Skin death and injury occur as heat exceeds the body’s ability to disperse it.  Damage depends on:  Intensity of heat  Duration of contact  Thickness of skin Copy...

Chapter 11 Burns Copyright © 2021 by Public Safety Group, A Division of Jones & Bartlett Learning. www.psglearning.com. Burns  Skin death and injury occur as heat exceeds the body’s ability to disperse it.  Damage depends on:  Intensity of heat  Duration of contact  Thickness of skin Copyright © 2021 by Public Safety Group, A Division of Jones & Bartlett Learning. www.psglearning.com.  Burns occur in every age group and in a variety of settings. Burn Classifications  Caused by:  Flames  Hot objects  Flammable vapor  Steam  Hot liquids Copyright © 2021 by Public Safety Group, A Division of Jones & Bartlett Learning. www.psglearning.com.  Thermal burns Burn Classifications (cont.)  Caused by wide range of chemicals  Acids  Alkalis  Organic compounds Copyright © 2021 by Public Safety Group, A Division of Jones & Bartlett Learning. www.psglearning.com.  Chemical burns Burn Classifications (cont.)  Caused by contact with electric current  Injury depends on:  Type of current  Voltage  Area exposed  Duration of contact Copyright © 2021 by Public Safety Group, A Division of Jones & Bartlett Learning. www.psglearning.com.  Electrical burns Evaluating a Thermal Burn  First-degree (superficial)  Second-degree (partial-thickness)  Third-degree (full thickness) FIGURE 11-1 First-degree burn © Suzanne Tucker/Shutterstock. FIGURE 11-2 Second-degree burn blisters © American Academy of Orthopaedic Surgeons. FIGURE 11-3 Third-degree burn © American Academy of Orthopaedic Surgeons. Copyright © 2021 by Public Safety Group, A Division of Jones & Bartlett Learning. www.psglearning.com.  Determine depth of burn. Evaluating a Thermal Burn (cont.)  Estimate how much total body surface area (TBSA) the burn covers.  The rule of nines FIGURE 11-4 The rule of nines in infants and children (A) and adults (B) © Jones & Bartlett Learning. Copyright © 2021 by Public Safety Group, A Division of Jones & Bartlett Learning. www.psglearning.com.  Determine the extent of the burn. Evaluating a Thermal Burn (cont.)  The rule of the hand  A hand represents about 1% of a person’s total body surface (TBSA) FIGURE 11-5 Rule of the hand © Jones & Bartlett Learning. Copyright © 2021 by Public Safety Group, A Division of Jones & Bartlett Learning. www.psglearning.com.  Determine the extent of the burn (cont.). Evaluating a Thermal Burn (cont.)  Burns on the face, hands, feet, and genitals are the most severe.  Circumferential burns are more severe than noncircumferential burns. Copyright © 2021 by Public Safety Group, A Division of Jones & Bartlett Learning. www.psglearning.com.  Determine which parts of the body are burned. Evaluating a Thermal Burn (cont.)  Superheated air can be absorbed by the upper respiratory tract.  Swelling occurs in 2 to 24 hours.  Restricts or shuts off airway Copyright © 2021 by Public Safety Group, A Division of Jones & Bartlett Learning. www.psglearning.com.  Determine respiratory involvement. Evaluating a Thermal Burn (cont.)  Whether other injuries exist  Preexisting medical problems  If the person is older than 55 years  If person is younger than 5 years Copyright © 2021 by Public Safety Group, A Division of Jones & Bartlett Learning. www.psglearning.com.  Determine: Evaluating a Thermal Burn (cont.) Flowchart 11-1 Thermal Burns © Jones & Bartlett Learning. Copyright © 2021 by Public Safety Group, A Division of Jones & Bartlett Learning. www.psglearning.com.  Determine the burn’s severity. First Degree (Superficial) Burns Copyright © 2021 by Public Safety Group, A Division of Jones & Bartlett Learning. www.psglearning.com.  What to look for:  Redness  Mild swelling  Tenderness  Pain First Degree (Superficial) Burns (cont.)  Apply cold water or compress.  Give ibuprofen.  Elevate arm or leg.  Have the person drink water.  Apply aloe vera or other lotion. FIGURE 11-7 Immerse the burn. Cool the burn with cold water until pain is relieved © Jones & Bartlett Learning. Copyright © 2021 by Public Safety Group, A Division of Jones & Bartlett Learning. www.psglearning.com.  What to do: Small Second-Degree (Partial Thickness) Burns  Blisters  Swelling  Weeping of fluids  Severe pain  What to do:  Follow the first three steps for first degree burns.  Apply antibacterial ointment.  Cover with a loose, dry, nonstick, sterile dressing. Copyright © 2021 by Public Safety Group, A Division of Jones & Bartlett Learning. www.psglearning.com.  What to look for: Large Second-Degree (Partial Thickness) Burns  Follow the first three steps for first-degree burns.  Apply cold.  Monitor for hypothermia.  Call 9-1-1. Copyright © 2021 by Public Safety Group, A Division of Jones & Bartlett Learning. www.psglearning.com.  What to do: Third-Degree (Full Thickness) Burns  Dry, leathery, gray-colored, or charred skin.  What to do:  Cover burn with a dry, nonstick sterile dressing.  Call 9-1-1. Copyright © 2021 by Public Safety Group, A Division of Jones & Bartlett Learning. www.psglearning.com.  What to look for: Later Care for Thermal Burns  Suggestions:  Wash hands before changing dressing.  Leave unbroken blisters intact.  Change dressings daily.  Watch for signs of infection.  Elevate burn for first 24 hours.  Give OTC pain medication, if necessary. Copyright © 2021 by Public Safety Group, A Division of Jones & Bartlett Learning. www.psglearning.com.  Follow physician’s recommendations. Chemical Burns  Chemicals burn as long as they are in contact with skin.  Check the safety data sheet, if available. Copyright © 2021 by Public Safety Group, A Division of Jones & Bartlett Learning. www.psglearning.com.  Result of an acid or an alkali substance touching the skin Chemical Burns (cont.)  Pain  Burning  Breathing difficulty  Eye pain or vision change FIGURE 11-8 Chemical burn from sulfuric acid © American Academy of Orthopaedic Surgeons. Copyright © 2021 by Public Safety Group, A Division of Jones & Bartlett Learning. www.psglearning.com.  What to look for: Chemical Burns (cont.)  Brush dry chemical off skin.  Flush burn with large amounts of water for at least 20 minutes or until EMS arrives.  Call 9-1-1. FIGURE 11-10 Flushing a chemical burn © Jones & Bartlett Learning. Copyright © 2021 by Public Safety Group, A Division of Jones & Bartlett Learning. www.psglearning.com.  What to do: Chemical Burns (cont.)  For a chemical in an eye:  Tip head so affected eye is below nose.  Wash eye with warm water from nose out to side of face for at least 20 minutes. Copyright © 2021 by Public Safety Group, A Division of Jones & Bartlett Learning. www.psglearning.com.  What to do (cont’d): Electrical Burns  Arc burn (flash)  True electrical injury (contact) FIGURE 11-11 Electrical burns. A. Exit wound on a foot. B. Electrical burn caused by chewing through an electrical cord. A: © Charles Stewart, MD, EMDM MPH; B: © American Academy of Orthopaedic Surgeons. Copyright © 2021 by Public Safety Group, A Division of Jones & Bartlett Learning. www.psglearning.com.  Thermal burn (flame) Contact With Outdoor Power Line  Check breathing; begin (CPR) if necessary.  Cover all burn wounds with sterile dressings.  Person(s) should receive professional medical care. Copyright © 2021 by Public Safety Group, A Division of Jones & Bartlett Learning. www.psglearning.com.  When the area becomes safe and the electrocuted person has been rescued: Contact Inside Buildings  Unplug appliance.  Do not touch appliance or person until current is off.  Damage occurs under skin. FIGURE 11-12 The external signs of an electrical burn may be deceiving. The entrance wound may be a small burn, while the damage to deeper tissue may be massive © Jones & Bartlett Learning. Copyright © 2021 by Public Safety Group, A Division of Jones & Bartlett Learning. www.psglearning.com.  Turn off electricity. Electrical Burns  Burn wound, which might appear small  Entrance and exit wounds  Multiple burns  Absent breathing/pulse Copyright © 2021 by Public Safety Group, A Division of Jones & Bartlett Learning. www.psglearning.com.  What to look for: Electrical Burns (cont.)  Check breathing.  Call 9-1-1.  Check for broken bones.  Treat the person for shock.  Cover wounds with sterile dressings. Copyright © 2021 by Public Safety Group, A Division of Jones & Bartlett Learning. www.psglearning.com.  What to do: