burns
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Burns. Aaron J. Katz, AEMT-P, CIC www.es26medic.net. Burn categories. Thermal Chemical Electrical Each with its distinct issues. Thermal burns. Also known as heat burns Caused by flames or heat. Burn classifications. Superficial or First Degree Partial Thickness or Second Degree - PowerPoint PPT PresentationTRANSCRIPT
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Burns
Aaron J. Katz, AEMT-P, CICwww.es26medic.net
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Burn categories Thermal Chemical Electrical Each with its distinct issues
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Thermal burns Also known as heat burns
Caused by flames or heat
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Burn classifications Superficial or First
Degree Partial Thickness
or Second Degree Full Thickness or
Third Degree
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Burn classifications
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Superficial burns Only epidermal layer is involved Redness Pain
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Superficial burns
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Partial Thickness burns Involves dermal layer as well Redness and blistering Extremely painful
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Partial Thickness burns
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Full Thickness burns Involves all skin layers and can
include bone Sometimes call “painless burns”
Why? Charring “Eschar” Associated with poor outcomes
and permanent disfiguration
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Full Thickness burns
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Quantifying burns – Rule of Nines Divide the body into 11 segments
of 9% and 1% for the genital area Does nothing to treat the
patient But allows receiving hospital to
get some idea of the severity to expect
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Rule of Nines -- Adult Each of the following body parts get 9%
Head Chest Abdomen Upper back Lower back/buttocks Each arm Front of each leg Back of each leg
Genital area gets 1%
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Rule of Nines -- Child Body divided as follows:
Head………………………….18% Chest…………………………..9% Abdomen……………………..9% Upper back…………………..9% Lower back/buttocks……..9% Each arm………………………9% Front of each leg……………7% Back of each leg…………….7%
Genital area gets 1%
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Rule of Nines
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Question 1 Your 55 year old patient has been
burned on most of his chest, entire right arm and the entire front of his right leg.
Using the Rule of Nines, what percentage of his body has been burned?
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Question 2 Your 5 year old patient has been
burned on his entire head, entire right arm and the entire front of his right leg.
Using the Rule of Nines, what percentage of his body has been burned?
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Quantifying burns – Palm Rule The patients palm will cover
approximately 1% of their body surface Use the number of the patient’s palms
required to cover the burns as an approximation
Very good for burns covering a small area
Rule of Nines is a better approximation for large areas burned
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Burns -- Treatment As per regional burn centers No oils or ointments Stop the burning process
Use saline/water to stop burning PRN Cover with sterile dressings (burn sheet)
Maintains sterility Minimizes exposure to air
Minimizes pain! Keep patient warm ABCs Do not break blisters
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Critical burns Second degree > 20% BSA Burns to critical areas
Having social or functional effects Face, hands, genitalia…
Check textbook for others
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Chemical burns – key items Scene safety Gloves, eye protection Remove substance from patient with
copious irrigation with water Exceptions:
Sodium, lye, sulfuric acid Water will increase the burning
Treat chemical inhalation with careful attention to airway control
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Chemical burns -- Liquids Flush with copious amounts of H2O Except as noted above
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Chemical burns -- Dry No Water Brush off carefully
Sweat on hands may react with chemicals
Be extra careful with lime and sodium
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Chemical burns to the eye Gently flush eye
Affected eye downward Even during transport At least 20 minutes
Use whatever works to flush eye E.g. IV bag, nasal cannula…
Consider calling for ALS
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Irrigation
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Irrigation
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Electrical burns Scene safety! From current or lightning (static) Can cause damage to remote areas as
electricity travels through body Can cause damage anywhere on the route Always check for an exit wound Main concern is not the burn itself,
rather from the cardiovascular effects
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Complications Smoke inhalation Airway burns
May quickly swell and occlude airway Look for
Singed mustache hairs Swollen lips/tongue Dire emergency – Rapid transport
Infection Social effects