Week 11: Burns

Erythema of the skin, with no blistering (most sunburns and some water scalds fall into this group) rarely requiring treatment

A thermal insult which damages the skin and/or underlying structures

Results from deeper damage but variable number of the skins structures of the dermis, (capillaries, nerve endings, sweat glands, hair follicles) are still present

Blistering of the epidermis, and presence of pain, they look red and have a blotchy red and white appearance

Results from death of all layers of the skin and sometimes underlaying structures

Not painful (dead nerve endings), doesn’t blanch on pressure, appears white or even charred or leathery

• flame/hot gas • fluids • contact with a solid object • chemical burns • electrical burns • radiations burns

• associated with FTB • airway burns • blunt trauma (explosions, jumping from buildings, carbon monoxide poisoning)

• usually FTB and shows the pattern of the object with which the skin has come into contact with

• often called scalds when hot water involved • burns from water are usually PTB and fat FTB

• identification of exact chemical • transport of labels/containers to A&E to assist with management

• associated with cardiac arrhythmia • factures (tectanic contraction of muscles)

• sunburn rarely requires treatment • skin burns from radioactive material indicate overwhelming radiation exposure • rescuer safety and decontamination is essential

More of an abrasion than a burn

Centre area of wound, where all tissues are damages

Surrounds the coagulation area, some tissues are damages

Unburned area surrounds the stasis but it is red due to inflammation

• capillary permeability increases • leads to loss of intravascular proteins and fluid into interstitial space peripheral and splanchnic vasoconstriction occur and myocardial contractibility decreases • combined with fluid loss from the burn may result in hypotension and end-organ hyoperfusion

• airway/inhalation • fluid loss/ hypovolaemic shock • pain • Caron monoxide/ cyanide poisoning • hidden injury • hypothermia • circumferential

Almost always occur in the supraglottic region of the larynx, interventions such as tracheal tubes or cricothryiodotomy may be required

Significant fluid loss (IV fluids requires), if they burn is >25% on an adult and 12.5% surface area

Burns are painful (unless FTB), entonox is an affective analgesic, however adapt a stepwise approach and IV drugs such as paracetamol/morphine can be considered

If the patient has been in a fire, initial presentation may be confusion or a reduced GCS, SPO2 reading will be normal. High flow 02 to be considered, cyanide is a result from burning plastics- variable respiratory distress, rapidly loses consciousness and often leads to cardiac arrest

• blunt trauma (spinal, abdominal) • happens during falls, explosions, falls and occasionally electrics