1. BURN INJURYBURN INJURY
Burns are wounds produced by variousBurns are wounds produced by various
kinds of agents that cause cutaneous injurykinds of agents that cause cutaneous injury
and destruction of underlying tissue.and destruction of underlying tissue.
2. ETIOLOGY OF BURNSETIOLOGY OF BURNS
THERMALTHERMAL
CHEMICALCHEMICAL
ELECTRICALELECTRICAL
RADIATIONRADIATION
3. BURN CLASSIFICATION BY DEPTHBURN CLASSIFICATION BY DEPTH
SuperficialSuperficial
Partial-ThicknessPartial-Thickness
– Partial-thickness superficialPartial-thickness superficial
– Partial-thickness deepPartial-thickness deep
Full-ThicknessFull-Thickness
Deep Full-ThicknessDeep Full-Thickness
4. BURN CLASSIFICATION BY EXTENTBURN CLASSIFICATION BY EXTENT
Rule of NinesRule of Nines
Re-evaluate 2-3 daysRe-evaluate 2-3 days
post burnpost burn
Burns of face, handsBurns of face, hands
or feetor feet
Burns complicated byBurns complicated by
fractures, respiratoryfractures, respiratory
tract injury or majortract injury or major
soft tissue injurysoft tissue injury
5. PATHOPHYSIOLOGY OF BURNS
Emergent Phase - First 48 hrs. Post Burn
Plasma-to-Interstitial Fluid ShiftPlasma-to-Interstitial Fluid Shift
Generalized DehydrationGeneralized Dehydration
OliguriaOliguria
HyperkalemiaHyperkalemia
HyponatremiaHyponatremia
Metabolic AcidosisMetabolic Acidosis
HemoconcentrationHemoconcentration
Water LossWater Loss
6. PATHOPHYSIOLOGY OF BURNS
Fluid Remobilization Phase
Starts 48 hrs. Post Burn - Lasts 2-3 days
Interstitial Fluid-to-Plasma ShiftInterstitial Fluid-to-Plasma Shift
HemodilutionHemodilution
Increased Urinary OutputIncreased Urinary Output
HyponatremiaHyponatremia
Risk for Pulmonary EdemaRisk for Pulmonary Edema
7. PATHOPHYSIOLOGY OF BURNSPATHOPHYSIOLOGY OF BURNS
Rehabilitative PhaseRehabilitative Phase
Starts 4-5 days Post BurnStarts 4-5 days Post Burn
HypokalemiaHypokalemia
Negative Nitrogen BalanceNegative Nitrogen Balance
AnemiaAnemia
HypocalcemiaHypocalcemia
8. INITIAL PATIENT ASSESSMENTINITIAL PATIENT ASSESSMENT
When did burn occur?When did burn occur?
Nature of burningNature of burning
agent?agent?
Length of exposure?Length of exposure?
Prior Medications?Prior Medications?
Was burn sustained inWas burn sustained in
an enclosed area?an enclosed area?
9. INITIAL PATIENT ASSESSMENT
(Continued)
Any pre-existing
illnesses?
What is normal pre-
burn height and
weight?
Is pain present?
Any drug/food
allergies?
Any other injuries?
10. INITIAL BURN MANAGEMENTINITIAL BURN MANAGEMENT
Establish an Open AirwayEstablish an Open Airway
Support CirculationSupport Circulation
Maintain Urinary OutputMaintain Urinary Output
Prevent GI DistressPrevent GI Distress
Administer MedicationsAdminister Medications
Determine Burn Depth & ExtentDetermine Burn Depth & Extent
11. ESTABLISH AN OPEN AIRWAYESTABLISH AN OPEN AIRWAY
Etiology ofEtiology of
Respiratory BurnsRespiratory Burns
S&S of Resp BurnsS&S of Resp Burns
ET Tube/TrachET Tube/Trach
Monitor for ARDSMonitor for ARDS
Ventilator/ABG’sVentilator/ABG’s
13. MAINTAIN URINARY OUTPUTMAINTAIN URINARY OUTPUT
Foley Catheter & Hourly OutputsFoley Catheter & Hourly Outputs
Increased Urinary Specific GravityIncreased Urinary Specific Gravity
Urinary Output - Most Reliable Index ofUrinary Output - Most Reliable Index of
Adequacy of Fluid ReplacementAdequacy of Fluid Replacement
14. PREVENT GI DISTRESSPREVENT GI DISTRESS
NG Tube to SuctionNG Tube to Suction
IleusIleus
Keep NPO InitiallyKeep NPO Initially
Curling’s UlcerCurling’s Ulcer
16. CONTINUING CARECONTINUING CARE
WOUND CARE MANAGEMENTWOUND CARE MANAGEMENT
InfectionInfection
DebridementDebridement
EscharotomyEscharotomy
HydrotherapyHydrotherapy
Open MethodOpen Method
Closed MethodClosed Method
Topical Drug TherapyTopical Drug Therapy
