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Burns

181 st INF BDE Combat Lifesaver Plus. Burns. Overview. Basic anatomy and functions of skin Epidermal, dermal layers and structures Severity of burns Appearance, depth, extent Extent of burn using Rule of Nines Complications and management: Thermal, chemical, and electrical burns

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Burns

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  1. 181st INF BDE Combat Lifesaver Plus Burns

  2. Overview • Basic anatomy and functions of skin • Epidermal, dermal layers and structures • Severity of burns • Appearance, depth, extent • Extent of burn using Rule of Nines • Complications and management: • Thermal, chemical, and electrical burns • Carbon monoxide poisoning and inhalation injury Burns - 2

  3. Burns • Safety is extremely important. • Scene Size-up, rescue or removal • Multiple agents cause burn injuries. Burns - 3

  4. Functions of Skin • Largest organ • Functions: • Protective barrier • Sensory organ • Temperature regulation Burns - 4

  5. Burn Classification Depth of burn Extent of burn • Superficial (first degree)‏ • Partial-thickness (second degree)‏ • Full-thickness (third degree)‏ • Rule of Nines • Palmar surface Burns - 5

  6. Burn Depth • Superficial • Minor tissue damage to outer epidermal layer • Intense and painful inflammatory response • “Sunburn” • Management • Symptomatic treatment Burns - 6

  7. Burn Depth • Partial-thickness • Entire epidermis into variable depth of dermis • Usually no scarring • Management • Cool burn and cover with clean dry dressing Burns - 7

  8. Burn Depth • Full-thickness • Epidermis and dermis • Scars contract, limit motion • Deeper full-thickness • “Leather-like” eschar • Management • Moist sterile dressing Burns - 8

  9. Burn Depth Courtesy of Roy Alson, MD Burns - 9

  10. Burn Depth Burns - 10

  11. Burn Types • Flash burn • Source is explosion, not sustained fire • Superficial or partial-thickness to exposed skin • Full-thickness (rare)‏ • Associated symptoms • Explosion trauma • Fractures • Internal injuries • Blast chest injuries Burns - 11

  12. Chemical Burns Courtesy of Roy Alson, MD Burns - 12

  13. Chemical Burns Burns - 13

  14. Burn Types • Electrical burns • Heat generated by passage of current • Extremities greater risk of injury • Mechanism • Path of current through body • Duration of contact with current source Burns - 14

  15. Electrical Burns • Management • Rapid transport • IV access • Fluid administration needs often higher than thermal Burns - 15

  16. Electrical Burns Burns - 16

  17. Electrical Burns Courtesy of Bonnie Meneely, EMT- P Courtesy of David Effron, MD Burns - 17

  18. Electrical Burns Courtesy of Roy Alson, MD Burns - 18

  19. Burn Types • Lightning injury • Extreme voltage • Short duration • Mechanism • Direct contact • Indirect contact • Associated symptoms • Superficial and partial-thickness burns • Cardiopulmonary arrest Burns - 19

  20. Lightning Injury Burns - 20

  21. Burn Types • Pediatric burns • Greater severity • Thinner skin, larger surface area to body mass ratio • Mechanism • Accidental • Child neglect or abuse • Match object shapes • Clear lines without splatter or splash • History does not match developmental age Burns - 21

  22. Summary • Safety is essential • Early deaths are due to airway compromise • Limit progression of depth and extent • Careful, systematic approach: • Identify and manage critical life-threatening problems to improve patient outcome Burns - 22

  23. Questions? Burns - 23

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