Types of Burns Overview/Cx Thermal Burns Most common type (85% of all burns) Causes: Flash fire, scald flame, hot pan Direct contact with heated object
ss Burn Redness Vary in severity
Prevention First Aid/Interventions Caution with hot beverages Remove pt from heat source if its safe Mishandling fireworks Use fire safety Supervise bathing/water temp Remove metal objects Don't use gas when starting a fire Loosen garments and remove garments, cover with sterile or clean sheath Assess airway (Priority) especially burns on chest/neck face Maintain thermoregulation Cool with water- keep from going deeper Do not SUBMERGE someone don't. Don't put ice on it Use pressure, water in very large burns DO NOT COOL for longer than 10 mins b/c can cx hypothermia Initiate IV- fluid resuscitation Store chemical safely Remove all clothing- chemicals are on it Educate on dangerous substances Flush Liquids with water for 20 mins make sure kids don't have access UNLESS it's a powder- NO WATER FOR Powder b/c it to comet cleaner activates it- just brush it of Protective gear Remove and dispose contacts Call poison control Don't apply high pressure b/c it will drive it in harder May need endoscopy if battery ingested Complication: Compartment syndrome Assess for: Increased Pressure r/t edema Cervical Spine edema= less blood flow EKG- V Fib, arrythmias can be seen up to 24 hrs aft- Watch for 6 P's ABG 1. Pain- out of proportion with Chemistries, output- kidneys will be displeased with injury, not managed with opioid break down of muscle 2. Increased Pressure 3. Paresthesia- numb/tingle 4. Pallor- coolness, loss of color 5. Paralysis 6. Pulselessness Install smoke and carbon Assess cough, black sputum, hoarseness, monoxide detectors Signed nose hair AIways Suspect INHALTION with Upper airway- Stridor BURNS to HEAD,NECK,chest Lower airway- Wheezing
Chemical Burns Tissue injury from acid, Alkalis, and organic compounds (OFTEN FOUND AT HOME) AIkali burn is WORSE than acid- b/c we don't neutralize those it cx melting
Blistering at site of contact Redness, irritation Pain or numbness Vision issue (if eye exposed)
Electrical Burns Intense heat from electrical current Causes Tissue anoxia and tissue death Direct damage to nerves and vessels- ANOXIA May have electrical injury and fall from roof Entrance and exit wound Don't see as much damage on outside b/c damage is BENEATH THE SURFACE (below the skin)
Flash injury- ignite clothes Fractures- b/c cx muscle contraction cx fractures to bone and vertebrae (CERVICAL SPINE) Loss of consciousness, Paralysis Loss of peripheral pulse Myoglobinuria (+) positive Elevated CK (norm 50-150)- breakdown of cell membrane seen in trauma, crush injury Cardiac arrest See RHABDO -- brown urine Types Upper airway injury Lower airway injury Metabolic asphyxiation- Co
Smoke and Inhalation Injury
From inhalation of hot air HIGH MORTALITY d/t airway compromised and EDEMA If not corrected can see ARDS in 12-24 hrs. .Not necessarily synonymous with large burns Injury to mouth, oropharynx, larynx Very rapid onset of edema , change in cap perm. Eschar tightens chest, make difficult to expand Trachea, bronchioles and a