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BURNS

Prepared by: Erma Novea R. Amante, RN

BURNS

Is an injury involving the skin, including


muscles, bones, nerves, and blood vessels.
Burns are characterized by severe skin
damage in which many of the affected cells
die. Depending on the cause and degree of
injury, most people can recover from burns
without serious health consequences. More
serious burns require immediate emergency
medical care to prevent complications and
death.

BURN LEVELS

There are three primary types of burns:


first-, second-, and third-degree. Each
degree is based on the severity of damage to
the skin, with first degree being the most
minor and third degree being the most
severe. Damage includes:

first-degree burns: red, non-blistered skin


second-degree burns: blisters and some
thickening of the skin
third-degree burns: widespread thickness
with a white, leathery appearance
There is also technically a fourth-degree
burn. In this type, the damage of thirddegree burns extends beyond the skin into
tendons and bones.

CAUSES

scalding from hot, boiling liquids


chemical burns
electrical burns
fires, including flames from matches,
candles, and lighters
excessive sun exposure

FIRST-DEGREE BURN
First-degree burns cause minimal skin damage.
They are also called superficial burns because
they affect the outermost layer of skin. Signs of a
first-degree burn include:
redness
minor inflammation (swelling)
pain
dry, peeling skin (occurs as the burn heals)
Since this burn affects the top layer of skin, the
signs and symptoms disappear once the skin cells
shed. First-degree burns usually heal within three
to six days. Still, you should see your doctor if the
burn affects a large area of skin (more than three
inches), and if its on your face or a major joint.

MANAGEMENT

First-degree burns are mostly treated with home


care. Healing time may be quicker if you treat the
burn sooner. To treat this type, you can:
soak the wound in cool water for five minutes or
longer
take acetaminophen or ibuprofen for pain relief
apply aloe vera gel or cream to soothe the skin
use an antibiotic ointment and loose gauze to protect
the affected area
Make sure you dont use ice, as this may make the
damage worse. Never apply cotton balls to a burn
because the small fibers can stick to the injury and
increase the risk of infection.

SECOND-DEGREE BURN

Second-degree burns are more serious because the


damage extends beyond the top layer of skin. This type
of extensive damage causes the skin to blister and
become extremely red and sore. Some blisters pop
open, giving the burn a wet appearance.
Due to the delicate nature of such wounds, frequent
bandaging is required to prevent infection. This also
helps the burn heal quicker. Some second-degree burns
take longer than three weeks to heal, but most heal
within two to three weeks. The worse the blisters are,
the longer the burn will take to heal. In some severe
cases, skin grafting is required to fix the subsequent
damage. Skin grafting borrows healthy skin from
another area of the body and replaces it at the site of
the burned skin.

As with first-degree burns, avoid cotton ball wraps


and questionable home remedies. You can generally
treat a mild second-degree burn by:
running the skin under cool water for 15 minutes or
longer
taking over-the-counter pain medication
(acetaminophen or ibuprofen)
applying antibiotic cream to blisters
However, seek emergency medical treatment if
burns affect a widespread area of the:
face
hands
buttocks
groin
feet

THIRD-DEGREE BURN

Third-degree burns are the worst burns. They


cause the most damage, extending through
every layer of skin. The damage can even
reach the bloodstream, major organs, and
bones, which can lead to death.

There is a misconception that third-degree


means most painful. With this type of burn,
the damage is so extensive that you may not
feel pain because your nerves are damaged.
Depending on the cause, third-degree burns
cause the skin to look:
waxy and white
charred
dark brown
raised and leathery

COMPLICATIONS

Third-degree burns carry the most risk for


complications, such as infections, blood loss, and
shock. All burns carry the risk of infections because
bacteria can enter broken skin. Sepsis, or a
bloodstream infection, can occur in the most
severe cases. This can lead to shock or even death.
Tetanus is another possible complication with burns
of all levels. Like sepsis, tetanus is a bacterial
infection. It affects the nervous system, eventually
leading to problems with muscle contractions. As a
rule of thumb, every member of your household
should receive updated tetanus shots every five
years to prevent this type of infection.

COLLABORATIVE MNAGEMENT

Promote Respiratory Function


Promote Fluid-electrolyte, acid-base balance
Promote Comfort
Prevent Infection
Wound Care
Maintain Adequate Nutrition
Hydrotherapy
Debridement
Skin Grafting
Promote GI Support
Rehabilitation

RULE OF NINE

Therule of ninesassesses the percentage of


burn and is used to help guide treatment
decisions including fluid resuscitation and
becomes part of the guidelines to determine
transfer to a burn unit. You can estimate the
body surface area on an adult that has been
burned by using multiples of9.

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