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Types of Burns
- Thermal
- Electrical
- Chemical
- Radiation
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Jackson's Theory of Thermal Wounds
- Explanation of the physical effects of thermal burns
- Zone of Coagulation
- Zone of Stasis
- Zone of Hyperemia
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Zone of Coagulation
Area in a burn nearest the heat source that suffers the most damage and is characterized by clotted blood and thronbosed blood vessels
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Zone of Stasis
Area in a burn surrounding the zone of coagulation that is characterized by decreased blood flow
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Zone of Hyperemia
Area peripheral to a burn that is characterized by increased blood flow
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Body's response to burns:
4 stages
- Emergent Phase
- Fluid shift phase
- Hypermetabolic phase
- Resolution Phase
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Emergent Phase
First stage of the burn process that is characterized by a chtecholamine release and pain mediated reaction
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Fluid shift phase
stage of the burn process in which there is a massive shift of fluid from the intravascular to the extravascular space
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Hypermetabolic phase
Stage of the burn process in which there is increased body metabolism in an attempt by the body to heal the burn
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Resolution Phase
Final stage of the burn process in which scar tissue is laid down and the healing process is completed
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Electical burn can be particularly damagin because:
the current burns from the inside out
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Acid Chemical Burns:
usually a form of a thick insoluble mass where they contact tissue through coagulation necrosis, limiting burn damage
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Alkalis Chemical Burn:
usually continue to destroy cell membranes through liquefaction necrosis, allowing them to penetrate underlying tissue and causing deeper burns
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Coagulation Necrosis:
The process in which an acid, while destroying tissue, forms an insoluble layer that limits further damage
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Liquefaction necrosis:
The process in which an alkali dissolves and liquefies tissue
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Factors Affecting Exposure to Radiation:
- Duration of exposure
- Distance from the source
- Shielding from the source
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Inhalation injury may be associated with burns especially if the injury occurred in:
An enclosed space
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Types of inhalation injury
- Toxic inhalation
- Carbon Monoxide Poisoning
- Airway thermal burn
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Depth of Burns:
- Superficial burns
- Partial thickness burns
- Full thickness burns
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Superficial burns
a burn that involves only the epidermis; reddening skin
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Partial thickness burns
Burn in which the epidermis is burned through and the dermis is damaged; reddness and blistering
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Full thickness burn:
Burn that damages all layers of the skin; areas are white and dry
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In sever burns to airway consider early:
Intubation
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Local and minor burn management:
Cool water immersion of minor localized burns may be effective if accomplished in the first few minutes after a burn
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Extensive partial and full thickness burn management:
Cover with dry sterile dressing or a clean sheet, keep the patient warm, initiate fluid resuscitation
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What to use between areas of full thickness burns:
Use soft, nonadherent dressing, as between the fingers and toes to prevent adhesion
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Fluid resuscitation dosage:
4 mL x patient wheight in kg x BSA burned= fluids for 24 hours
Half administered in first 8 hours, other half over next 16 hours
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