A SLIDE FOR UNDERSTANDING BURN

1. EMMANUEL MASIH
B.SC NURSING 3RD YEAR

2. introduction
burns are most devastating condition encountered in
medical field. The injury represent an assault on all the
aspect of the patient from physiological to psychological.
It affects all the age groups from babies to elderly people
and is problem to both the developed and developing
world. All of us have experienced the severe pain that
even a burn can cause.

3. DEFINITION
Acc. to jay Ivan – burns are wounds
caused by excessive exposure of body to
heat, flame, scalding water etc.
Acc. to nurse’s dictionary – an injury to
tissues caused by physical agent,
chemical agent, electrical current or
many other things that damages the
skin.

5. PHYSIOLOGY
Protection
Excretion
Maintenance
Formation
Detection
Storage

6. ETIOLOGY

7. DRY HEAT

8. Scalds

9. friction

10. Chemical

11. Electrical

12. Radiation

13. Risk factors

14. age
Drinking
Gender
smoking

15. TYPES

16. Heat burns

17. Cold burn

18. Electric burn

19. Radiation burn

20. Chemical burn

21. Friction burn

22. DEGREES

23. DEGREES
FIRST SECOND THIRD FOURTH

24. 1st DEGREE

25. SKIN RED AND PAINFUL

26. Dry in appearance

27. HEALING IN 3-5
DAYS
HOSPITALIZATION
FOR PAIN AND
FLUID
MANAGEMENT

28. 2nd degree
Partial
thickness
Full
thickness

29. Partial thickness
Blister can be present

30. Red / pink in appearance and painful in
nature

31. Heal within 10
– 21 days Blanch when
pressure is applied

32. Full thickness
Red / white in appearance

33. Destruction of complete epidermis

34. Sensation present but diminished
Full thickness likely to have excision and
needs grafting

35. 3rd degree

36. All layers are destroyed

37. Appear black / white and dry in nature

38. No pain

39. Can appear leathery in texture
Extend into subcutaneous tissue
Skin wouldn’t blanch if pressure is applied

40. 4th degree

41. Muscles and bone can be seen

42. Clinical features

43. 1st degree

44. Reddened skin

45. Possible blisters

46. Hyperesthesia

47. Tingling
Pain
soothe by
cooling
dry
Minimal /
no edema

48. 2nd degree

49. Wound moist/wet

50. Red/white or splotchy skin

51. Weeping surface

52. pain
Edema
Broken epidermis
hyperesthesia
Cold air sensitive

53. 3rd degree

54. shock

55. Fat exposure

58. 3rd degree
Pale white
skin
Leathery
Dry
edema

59. 4th degree

60. Bones exposed

61. Bleeding

62. severe Pain
Muscle
destruction
shock

63. Diagnostic criteria

64. History taking

65. Physical examination

69. Other measures
X – ray CBC
Ser.
Creat.
ECG

70. Risk factor

71. Infection to delicate organs

72. Bleeding

73. Trauma

74. Management

75. classification
On the
scene
medical
Pharmacologica
l
Surgical
Nursing
dietary

76. On the scene management
 Call for help
 Extinguishing the flames
 Cool the burn
 Cover the wound
 Irrigate chemical burn
 Cover the wound to prevent infection
 Asses for breathing pattern and circulatory status
 Establish airway
 O2 supply
 Assess pulse and BP
 Insert at least a large bore vein flan [18 gauge or according to vein size]
 Cervical spinal immobilization In case of electric burn
 Assess for tachycardia and slight hypotension after burn.
 In patient with extensive burns neurological status is examined

77. Medical management
∫ Bring the patient to emergency department
∫ 100% humidified o2
∫ Initially start treating for ABC
∫ Patient is encouraged to cough so that suction can be done
∫ Administration of bronchodilators and mucolytic agents
∫ Continuous positive airway pressure and mechanical ventilation may be
required.
∫ Validate incidental scenarios
∫ Gain data about burn injury, source of burn, place where burn occurred,
how burn was treated at site.
∫ Nasogastric insertion
∫ ECG monitoring
∫ Arranging referral to burn centers if extent of burn is higher.

78. PHARMACOLOGICAL MANAGEMNET
ANTI – BIOTIC
PPI
HISTAMIN H2 ANTAGONIST
ANALGESICS
I/V FLUID REPLACEMENT
TOPICAL APPLICATION
ANTI –AMOEBICS

79. Surgical mgt
Skin grafting
Reconstructive
surgery
Cosmetic
surgery
Tissue
Expansion
Micro surgery debridement

80. Skin grafting
Skin transfer is done in this common type
of surgery.
1.Auto – graft
2.Allograft
3. Xenograft

81. Reconstructive surgery
Done only to enhance visual appearance

82. Cosmetic surgery
Optional procedure performed on normal body part
to improve only appearance.
 Abdominoplasty
 Blepharoplasty
 Phalloplasty
 Liposuction
 Orthognatic surgery
 Cheek alignment
 Rhinoplasty
 Genioplasty
 Browplasty
 Labiaplasty
 Lip enhancement
And many other surgeries are performed according to location in body

83. Tissue expansion
Micro - surgery
Debridement

84. Nursing management
 Proper positioning
 Vital sign monitoring
 Airway, breathing and circulation monitoring
 Pain assessment and management
 Intravenous fluid administration
 Burn dressing
 Wound cleaning
 Administration of medication
 Management of itching
 Physiotherapy to prevent contractures

85. Dietary management
Carbohydrate – 250-300 gm.
Protein – 1.4 gm / kg / day
Fat – 30 – 40 gm.

86. Nursing care plan

87. complication

88. contractures

89. Infection

90. Low blood volume

91. Low body temp
scarring
Bone and joint problem
Unconsciousness
Coma
Kidney failure
amnesia