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Burn Shock
- A condition that can occur with moderate to major burns that cover sufficient body surface area (BSA)Inhalation of superheated air may lead to the lining of the larynx to swell (laryngeal edema)
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Superficial Burn
- Burn that only involves the epidermis.
- First-degree burn.
- Red skin
- Pain at site
- Tenderness
- No blisters
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Partial-thickness Burn
- Burn that involves the epidermis and portions of the dermis
- Second-degree burn
- Blisters
- Intense pain
- white to red skin
- moist and mottled skin
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Full-thickness Burn
- Burn that involves all the layers of the skin and can extend beyond the subcutaneous layer into the muscle, bone, or organs.
- Third-degree burn
- Leathery appearance(eschar)
- Charring, dark brown or white
- skin hard to touch
- no pain
- pain at periphery of burn
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Eschar
The hard, tough, leathery,dead soft tissues formed as a result of a full-thickness burn
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Determining the Severity of Burn
- Depth of burn
- Location of burn
- Patient's age
- Pre-existing medical conditions
- Percentage of BSA involved
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Circumferential Burns
Burn that encircles a body area.
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Burn Severity Classification
- Critical burns: -Burn accompanying breathing
- -Full or partial burns involving the face, genitalia or major joints
- -full-thickness burns covering more than 10% BSA
- -partial-thickness burns covering 25% BSA in people less than 50 or 20% in people older than 50/younger than 5
- -burns complicated by a fracture to an extremity
- -any circumferential burns
- Moderate burns: -Full-thickness 2-10% BSA excluding the face, genitalia, or respiratory tract
- -partial-thickness burn 15-25% BSA
- Minor burns: -Full less than 2%
- -partial less than 15% BSA
- -superficial less than 50% BSA
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Rule of Nines
- Standardized format to identify the amount of BSA that has been burned.
- Head + neck 9%
- Posterior trunk 18%
- Anterior trunk 18%
- Each upper extremity 9%
- External genitalia 1%
- Each lower extremity 18%
- For infants: -Posterior/anterior trunk 18%
- -Each upper extremity 9%
- -head + neck 18%
- -Each lower extremity 14%
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Rule of Ones
- The concept that the area of a patient's palm is equal to about 1% of his BSA.
- Rule of palms
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Types of Burns
- Inhalation burns: High temperature or steam being inhaled
- Chemical burns: Acids, alkalis, and heat generating chemicals
- Electrical burns: result from resistance to current flow in body
- Radiation burns: absorption of radiation into the body
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Causes of Burns
- Flame burn
- Contact burn
- Scald: contact with hot liquid
- Steam burn
- Gas burn
- Electrical burn
- Flash burn: type of flame burn that is the result of quick ignition
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Primary Assessment
- Cooling down the pt
- After cooling, continue the ABCs
- Determine priority transport
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Secondary Assessment
- Reassessment of MOI
- Rapid secondary
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Burn Sheet
Commercially prepared sterile, particle-free, disposable sheet used to cover the entire body in severe burn injuries
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Emergency Medical Care
- 1. Remove pt from source of burn
- -stop the burn process by water or saline
- -do not attempt to remove adhered clothing
- 2. Maintain airway and breathing
- 3. Classify severity and transport
- 4. Cover the burn area with dry sterile dressing-use a burn sheet
- 5. Keep the pt warm and treat other injuries as needed
- 6. Transport
- -Avoid using material that leaves particles
- -Never apply any type of lotion, ointments
- -Never break or drain a blister
- -remove jewelry around the wound
- -do not attempt to open eyelids
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