L3 Burns v1 October 2020.pdf

Support the emergency care of wounds, bleeding and Burns Component 7 Burns  Burns - Component 7 Objective Understand the management and treatment of minor and major burn injuries. © Department of Clinical Education...

Support the emergency care of wounds, bleeding and Burns Component 7 Burns  Burns - Component 7 Objective Understand the management and treatment of minor and major burn injuries. © Department of Clinical Education & Standards  Burns - Component 7 Overview  Explain what is meant by the term burn.  Describe the types of burn and their causes.  Explain safety considerations when dealing with burns.  State the rules associated with estimating burns.  Explain time critical factors that affect the management of burns.  Explain the complications associated with burns  Treatment of burns © Department of Clinical Education & Standards  Burns - Component 7 “A burn is an injury caused by energy transfer to the body’s tissues, causing necrosis and associated inflammatory reaction.” [Greaves 2008] In the UK 250,000 burns injuries of which 175,000 resulted in trips to A&E. © Department of Clinical Education & Standards  Burns - Component 7 Most burns happen within the home, usually in the kitchen. Common sources are: Children – Hot beverages Adults - Petrol ignition Elderly - Bathing, kettles and central heating radiators © Department of Clinical Education & Standards  Burns - Component 7 Types of burns Chemical – Acids and Alkaline substances Cold – Frost bite Electrical – Power source, Lightning Friction – Contact with a surface Radiation – Sun or radiation Thermal – Flame, scalds or contact Scene safety 1st © Department of Clinical Education & Standards  Burns - Component 7 Assessment Its important to take a history of what has happened and note: What caused the burn When the injury occurred How long patient was exposed to the source and Duration of any cooling Consider if this could be a non accidental injury. © Department of Clinical Education & Standards  Burns - Component 7 Rule of 9’s © Department of Clinical Education & Standards  Burns - Component 7 © Department of Clinical Education & Standards  Burns - Component 7 © Department of Clinical Education & Standards  Burns - Component 7 Burn Classification Epidermal Burns can also be referred to as superficial or 1st degree Causes: Mainly ultraviolet light Appearance: Dry and red Blanches with pressure No blistering May be painful © Department of Clinical Education & Standards  Burns - Component 7 Burn Classification Superficial Dermal can also be referred to as superficial, partial thickness and 2nd degree Causes: Mainly scalds (spill or splash) Appearance: Pale pink Fine blisters Blanches with pressure Very painful © Department of Clinical Education & Standards  Burns - Component 7 Burn Classification Mid-dermal can also be referred to as Superficial, partial thickness and 2nd degree Causes: Mainly scalds (spill) or flame Appearance: Dark pink Large blisters Delayed capillary refill May be painful © Department of Clinical Education & Standards  Burns - Component 7 Burn Classification Deep Dermal can also be referred to as deep partial thickness and 2nd degree Causes: Mainly scalds (spill) or flame Appearance: Blotchy Red May blister No capillary refill No sensation © Department of Clinical Education & Standards  Burns - Component 7 Burn Classification Full thickness can also be referred to as 3rd degree Causes: Immersion scald, steam or high voltage electricity Appearance: White, waxy or charred skin No blistering No capillary refill No sensation © Department of Clinical Education & Standards  Burns - Component 7 Normal Epidermal Mid-dermal Full Thickness © Department of Clinical Education & Standards  Burns - Component 7 Complications Inhalation of hot gases Hypotension End-organ hypo-perfusion Bronchoconstriction Acute Respiratory Distress Syndrome – even in non inhalation injury Infections – leading to sepsis © Department of Clinical Education & Standards  Burns - Component 7 Treatment Safety First! Follow the AcBC approach for burns as you would any traumatic injury Correct any major AcBC problems Airway burns History of hot air or gas inhalation Respiratory distress Evidence of circumferential If in doubt check JRCALC out! © Department of Clinical Education & Standards  Burns - Component 7 Treatment The first line of treatment is cool (not cold) running water Remove necessary clothing, unless it is stuck to the burn Do not submerge a limb in to a bowl of water, use a tap or shower if possible Hold under running water for 20 minutes, ensure that any chemical or heat source is removed from the skin REMEMBER: remove any jewellery including rings, watches and bracelets If no water source is available then a CoolThermTM dressing can be used © Department of Clinical Education & Standards  Burns - Component 7 Treatment Dress the wound using cling film but remember: Do not wrap the cling film around the burn, use small squares to avoid restricting blood flow (burns may cause swelling). Consider contacting the trauma desk for serious burns Cling film provides pain relief, protection from infection/bacteria and does not adhere to the burn causing further injury. Convey to A&E if appropriate and place a pre-alert call for serious burns (Refer to major trauma tree) Consider Pain Relief (AAP = Entonox only) © Department of Clinical Education & Standards  Burns - Component 7 Advanced clinical interventions Early Endotracheal intubation Intermittent Positive Pressure Ventilation (IPPV) Early Opiate analgesia Early Fluid Resuscitation Early recognition of time critical patients! © Department of Clinical Education & Standards  Burns - Component 7 Major Trauma Centre Burn / scald greater 20% in a child Burn / scald greater 30% in a adult Facial burns with complete skin loss to lower half of face Circumferential burns from a flame injury © Department of Clinical Education & Standards  Burns - Component 7 Summary Think Safety first Cool the burn Dress the wound Keep patient warm Consider advanced clinical support Definitive care © Department of Clinical Education & Standards