Burns

Burns

Length: 864 words (2.5 double-spaced pages)

Rating: Excellent

Open Document

Essay Preview

More ↓
Burns

Epidemiology:
US – 2M seek serious burns  70k require hospitalizations, 5k die
Usually caused by careless and ignorance, nearly half are smoking or alcohol -related.

Goal: well healed durable skin with normal function and near-normal appearance.

Pathology

Cutaneous burns – caused primarily by the application of heat to the skin resulting in coagulative necrosis of some or all of the epidermis and dermis.

Depth of burn – depends on heat of the burn source, thickness of the skin, duration of contact, and the blood flow.

Classifications:

Shallow burns
•     First Degree – involve only the epidermis; no blisters; painful and erythematous due to dermal vasodilation; erythema and pain subsides in 2-3 days; desquamation occurs in day 4
•     Superficial Dermal Burns (Second Degree) - include the upper layer of the dermis; form blisters at the interface of the epidermis and dermis; when blisters are removed, wound is pink and wet, and currents of air passing over it cause pain; wound is hypersensitive and blanches with pressure; if without infection, spontaneous healing in 5% TBSA in any age group
5.     Electrical burns including lightning injury
6.     Chemical injury
7.     Inhalation injury
8.     Burns of any size in patients with pre-existing medical disorders that could complicate management, prolong recovery, or affect mortality
9.     Burns with concomitant mechanical trauma (e.g. fractures) where the burn injury poses the greatest risk of morbidity and mortality
10.     Burns in children if there are no qualified personnel or equipment for pediatric care at the initial hospital
11.     Burns in patients requiring special social, emotional, and/or long-term rehabilitative support, including cases of suspected child abuse, substance abuse, etc

Emergency Care

Airway – initial attention must be directed to this; if patient is rescued from a burning building or exposed to a smoky fire, place on 100% oxygen by tight-fitting mask; if patient unconscious, place ET tube attached to a source of 100% oxygen

Once airway is secured, assess patient for other injuries and transport to the nearest hospital. Begin fluid administration of crystalloid solution at a rate of approximately 1L/h. Wrap patient in clean sheet, remove constricting clothing and jewelries.

Cold application is used in smaller burns, particularly scalds. Ice should not be used.

Assessment of Inhalational Injury - suspect for patients with a flame burn, esp in enclosed space. Hoarseness and expiratory wheezes are signs of potentially serious airway edema or smoke poisoning; inspect mouth for swelling, blisters, soot; copious mucus production and carbonaceous sputum are signs of smoke inhalation and other products of combustion; get ABGs and carboxyhemoglobin levels (if >1, smoke inhalation)

How to Cite this Page

MLA Citation:
"Burns." 123HelpMe.com. 29 Mar 2020
    <https://www.123helpme.com/view.asp?id=56682>.

Need Writing Help?

Get feedback on grammar, clarity, concision and logic instantly.

Check your paper »

Cold Sassy Tree by Olive Ann Burns Essay

- Cold Sassy Tree by Olive Ann Burns Chapter 30 starts with Will and Miss. Love talking in the kitchen about why Queenie drinks out of a jar instead of a normal cup. Will thinks that she does because she told him that the first cup is always the best so a big jar makes a big first glass. Miss Love points out to Will that Quennie is just saying that because black people are not supposed to eat or drink off of the people they work fours stuff. They go on talking about the horse that Wills grandpa got for her and how much she likes it....   [tags: Cold Sassy Tree Burns]

Free Essays
1594 words (4.6 pages)

Cold Sassy Tree by Olive Ann Burns Essay

- Cold Sassy Tree is a moving novel written by Olive Ann Burns. It is filled with interesting life-like characters that are foils or opposites of each other. Two of the characters are Mary Willis Tweedy and Loma Campbell. Mary Willis and Loma sisters and they are both alike and different in many ways. The same is true for me and my sister Amna. Loma and Mary Willis are very different people but they can be alike and agree on many things. When their father, Rucker Blakeslee, gets married to a woman young enough to be his daughter, just three weeks after his wife dies....   [tags: Cold Sassy Tree Olive Burns]

Free Essays
983 words (2.8 pages)

Religion and Coming of Age in Olive Ann Burns’ Novel, Cold Sassy Tree Essay

- Religion and Coming of Age in Olive Ann Burns’ Novel, Cold Sassy Tree In the small southern town of Cold Sassy, Georgia, at the turn of the twentieth century, teenage boys had to grow up fast. They were not in any way sheltered from the daily activities of the town. This was especially true for fourteen year old Will Tweedy. Olive Ann Burns’ first, and only completed novel, Cold Sassy Tree, tells of young Will’s coming-of-age. His experiences with religion, progress, and death in Cold Sassy escorted him along the path to manhood....   [tags: Olive Ann Burns’ Cold Sassy Tree]

Research Papers
518 words (1.5 pages)

Essay on Psychology and Burns

- For the purpose of this essay I will be reflecting upon the experience of the presentation, which was based on a clinical problem. The focus of the presentation was to identify the complex psychological factors that affect the patient and the fact that we have a part time clinical psychologist who works at the burns centre and in her absence expert advice is not readily available. Britain is at the forefront of healthcare for people with disfigurement yet many disfigured people report that the health care system has failed to cater their psychosocial problems....   [tags: Health Care]

Research Papers
1904 words (5.4 pages)

The Popularity of The Burns and Allen Show Essays

- ... Unlike Burns, Allen was born in California into a performing family. Allen was born with an abnormality called heterochromia, one eye was blue and the other eye was green. Allen’s first on stage debut was at age 3 and at age 14, Allen dropped out of a Catholic girl’s school to join the family business; entertaining on stage. A few years before dropping out of school, while still a child, a pot of boiling hot tea had fallen on Allen, burning the left arm and shoulder and leaving behind a permanent scar....   [tags: radio, comedy, family]

Research Papers
761 words (2.2 pages)

Burns Essay

- Burns Epidemiology: US – 2M seek serious burns &#61664; 70k require hospitalizations, 5k die Usually caused by careless and ignorance, nearly half are smoking or alcohol -related. Goal: well healed durable skin with normal function and near-normal appearance. Pathology Cutaneous burns – caused primarily by the application of heat to the skin resulting in coagulative necrosis of some or all of the epidermis and dermis. Depth of burn – depends on heat of the burn source, thickness of the skin, duration of contact, and the blood flow....   [tags: essays research papers]

Free Essays
864 words (2.5 pages)

Robert Burns Essay

- Robert Burns A Biography of Robert Burns Robert Burns was a Scottish poet and writer of traditional Scottish folk songs. He was born on January 25, 1759 in Alloway, Ayrshire. Burns was the oldest of seven children born to William Burness and his wife Agnes Broun. His father was the descendant of a line of tenant farmers. His wife was also eldest daughter of a tenant farmer. Burns’ parents were both not very well educated, but were deeply religious. When Burns was born, his father worked as a gardener....   [tags: Essays Papers]

Free Essays
632 words (1.8 pages)

Robert Burns Essay

- People have made entire careers off the belief in and practices of astrology. The idea of the stars determining our fate has withheld people’s interest for centuries. Robert Burns, an Aquarius, was very anti-superstition. He had almost no belief in astrological predictions or zodiac signs. There is some humor in this though, because through Burns’ poems and songs this pseudoscience shows just how accurate it can be. The most parallel example of Burns’ personality and his Aquarius sign can be seen in the work The Fornicator....   [tags: essays research papers]

Free Essays
741 words (2.1 pages)

Robert Burns Essay

- Robert Burns is a man of the most impassioned temper; with passions not strong only, but noble, and of the sort in which great virtues and great poems take their rise. It is his love towards his country, people, and nature that inspires him. That opens his eyes to its beauty, leading his heart and voice to praise them with his passion. Robert Burns was born January 25, 1759, in a straw-thatched cottage, to William and Agnes Burns. His mother had a great store of folklore songs and ballads, and his father tried at all costs to surround his children with good reading and conversation....   [tags: essays research papers]

Free Essays
1464 words (4.2 pages)

Robert Burns Essay

- Robert Burns Robert Burns is a poet that offers timeless, literary creations that merge his Scottish dialect and country lifestyle. He was born on the outskirts of Scotland, in a small town called Alloway. Although some people beg to differ when it comes to the extent of Burns’ education, he was well taught through his parent’s dedication to his education. In addition to his father teaching him, he was fully exposed to many literary characters, such as William Shakespeare and Joseph Addison while attending a one-room school house for a total of 3 consecutive years....   [tags: Biography]

Free Essays
1340 words (3.8 pages)

Related Searches


Fluid Resuscitation – patients with burns >20% typically develop shock due to hypovolemia 2 to extravasation of fluid and protein; institute fluid resuscitation ASAP with LRS 1L/h in adults and 20ml/kg in children; insert foley catheter and monitor urine output q1

Tetanus – previous immunization within 5 years requires no treatment, immunization within 10 years requires a tetanus toxoid booster, and unknown immunization status require hyperimmune serum (hyper tet)

Gastric Decompression – many begin tube feeding by admission to protect the stomach from stress ulceration and prevent paralytic ileus, as well as provide nutrition

Pain control – during shock phase, give meds by IV. Best managed by small IV doses of morphine, 2-5mg.

Esharotomy and Fasciotomy – rarely required within the first 6 hours

Eschar – necrotic and coagulated skin; rigid and unyielding; as fluid and protein extravasate into the underlying tissues the eschar does not expand, and may result in increased tissue pressure sufficient to interfere with breathing or limb perfusion

Chest escharotomy – performed in the anterior axillary line bilaterally; if with significant extension of the burn onto the adjacent abdominal wall, extend incisions to this area and should be connected by a transverse incision along the costal margin

Escharotomy of extremities – edema formation of the tissues may produce significant vascular compromise that may lead to permanent neurologic and vascular deficits. Skin color, sensation, capillary refill, and peripheral pulses must be assessed q1. Poor perfusion: cyanosis, deep tissue pain, progressive paresthesia, progressive decrease in or absence of pulse, or sensation of cold extremities
-     may be done as bedside procedure; place incision along the midmedial or midlateral aspect of the extremity and should extend through the echar down to the subcutaneous fat

Burn Severity

Rule of Nines
Each upper extremity – 9
Each lower extremity – 18
Anterior trunk – 18
Posterior trunk – 18
Head and neck – 9
Perineum – 1

Fluid Management

Primary goal : replace fluid sequestered as a result of thermal injury because massive fluid shifts can occur even though total body water remains unchanged. What changes is the volume of each fluid compartment, with intracellular and interstitial volumes increasing at the expense of plasma and blood volume.

Crystalloid resuscitation – in particular, LRS, is the most popular fluid
Parkland formula – 4ml/kg/%burn in the first 24 hours, ½ of the amount administered in the first 8 hours.
Modified Brooke formula – 2ml/kg/%burn in the first 24 hours

Pediatric Resuscitation
Cincinnati Unit – 4ml/kg/%burn + 1500 ml/m2 BSA
     1st 8 hours: LRS + 5-mg NaHCO3
     2nd 8 hours: LRS
     3rd 8 hours: LRS + 12.5g albumin

Wound Management
Burn wound is usually treated with once or twice daily washing, removal of loose, dead tissue, and topical application of antimicrobial agent (mafenide acetate, silver sulfadiazine, silver nitrate)

Excision and Grafting – for deep dermal and full thickness burns
-     small (
Return to 123HelpMe.com