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College of Nursing
By
Hatem Alsrour
(nursing college)
Burns
Burns are caused by a transfer of energy
from a heat source to the body.
Major burns have a significant risk of
morbidity & death.
The pre-hospital care is a major
contributor to patients final out come.
Burns
The skin is the largest organ in the body
It provides Thermal regulation &
prevention of fluid loss by evaporation.
Hermetic barrier to infection.
Contains sensory receptors that provide
information about the environment.
Skin Anatomy
The skin is divided into 3 layers
Epidermis- outer layer of cornified
epithelial cells.
Dermis- the middle layer, mostly
connective tissue. Contains capillaries,
nerve endings, & hair follicles.
Hypodermis- a layer of fat & connective
tissue between skin & underlying tissue
Anatomy
Approach to Burn Patient
Age
History
Duration of exposure
Type of fire
Consider Abuse in pediatrics
Determine depth, type & extent of injury
Consider Abuse
RULE OF NINES
RULE OF NINESA estimation of the TBSA
involved in a burn is simplified by using
the rule of nines.
The rule of nines is a quick way to
calculate the extent of burns.
The system assigns percentages
in multiples of nine to major body surfaces.
Types of burns
With a first-degree burn, the epidermis (top layer of
skin) is destroyed. A second-degree burn causes
injury to the epidermis, the upper layers of the
dermis (deeper portion of skin), and some injury to
the deeper portions of the dermis. The dermis is
totally destroyed in a third-degree burn, and in some
cases, so is a lot of the underlying tissue, including
portions of bone.
In the case of an extensive burn, cover the area with
a clean, dry sheet or towel. Do not let the burn victim
eat or drink anything on the way to the hospital.
Burn Patients
Burn patients need lots of medical skill
You must identify the amount of burn
You must define degree of burn
You must identify associated injuries
You must establish events preceding the
injury
Establish basic care first
Treatment
Airway- establish early
Fluids- Two (2) big bore IV’s
Consider Foley for fluid management
Protect from further injury
No food or fluid is given by mouth, and the
patient is placed in a position that will prevent aspiration of
vomitus because nausea and vomiting typically occur
due to paralytic ileus resulting from the stress of injury.
Arrange appropriate referral &/or treatment
Burn Patients
Care of the Patient During the