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Presentation On Burns and Scalds

The presentation on burns and scalds covers definitions, causes, pathophysiology, types, classification, management, and complications of burn injuries. It highlights the significant global burden of burn injuries, particularly in low and middle-income countries, and outlines the clinical manifestations and medical management strategies. Additionally, it discusses fluid resuscitation calculations and safety measures to prevent burns.

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5 views26 pages

Presentation On Burns and Scalds

The presentation on burns and scalds covers definitions, causes, pathophysiology, types, classification, management, and complications of burn injuries. It highlights the significant global burden of burn injuries, particularly in low and middle-income countries, and outlines the clinical manifestations and medical management strategies. Additionally, it discusses fluid resuscitation calculations and safety measures to prevent burns.

Uploaded by

habaccrachie11
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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GHANA COLLEGE OF NURSING AND

MIDWIVERY.
FACULTY OF NEONATAL NURSING,
TAMALE TRAINING SITE.
PRESENTATION ON BURNS AND SCALDS
BY;YAKUBU HABIB ACCRACHIE
PRESENTATION OUTLINES.
• definition of terms
• causes of burns and scalds.
• Pathophysiology of burns.
• Types of burns
• classification of burns and scalds.
• Management of burns.
• Calculating of volume of fluid for fluid replacement therapy in burns.
• complications of burns.
• References .
INTRODUCTION

• Burn injuries contribute significantly to the global burden of disease and


remain a leading cause of worldwide morbidity.
• From global perspective, more than 8million new cases of burns occur
annually
• More than 95% burn deaths occurring in low and middle-income countries.
• Consequences of burn injuries depends on the severity of tissue damage.
DEFINITIONS

BURNS SCALDS
• Burns are injuries caused by dry heat, • Scalds are burns caused by hot liquids
for example ( like boiling water, steam or oil
fire,electricity,chemicals,and friction.
TYPES OF BURNS AND SCALDS

1. THERMAL BURNS
2. RADIATION BURNS
3. CHEMICAL BURNS
4. ELECTRICAL BURNS.
PATHOPHYSIOLOGY OF BURNS

• Heat from burns causes protein denaturation and thus coagulative necrosis.

Around the coagulated tissue, platelets aggregate, vessels constrict, and

marginally perfused tissue (known as the zone of stasis) can extend around the

injury. In the zone of stasis, tissue is hyperemic and inflamed.


PATHOPHYSIOLOGY CONT…..
• Damage to the normal epidermal barrier allows

• Bacterial invasion

• external fluid loss impaired thermoregulation

• Damaged tissues often become edematous, further enhancing intravascular volume loss.

Heat loss can be significant because thermoregulation of the damaged dermis is absent,
particularly in wounds that are exposed.
The loss of fluid may lead to;
Burn shock (low blood pressure),electrolyte imbalance and potential organ damage
CLASSIFICATION OF BURNS ACCRODING TO
THE DEPTH OF THE BURNS.
1ST DEGREE BURNS
First degree burns affect only the epidermis, or the outer
layer of the skin.

the burns site is red and painful with no blisters

There’s no scarring and heals in a few days.

long term damage to tissues is very real

an example is mild sunburn


2ND DEGREE BURNS
this involves the epidermis and part of the dermis
layer of the skin.

the burn site appears red and blistered

and may be swollen and painful.

It usually heals between 2-6weeks.


3RD DEGREE BURNS
3rd degree burns destroy the epidermis and the dermis
third degree burns may also burn underlining muscles
and tendons.
May sometimes look black, yellow, red and wet.
There may be no pain or the pain may be
limited(nerves fibers are destroyed )
Skin will usually not heal completely (and skin
grafting needs to be done.
4TH DEGREE BURNS
In forth degree burns ,the epidermis, dermis,
muscles, tendons and bones are destroyed.

There is usually no pain felt since the nerve


endings are completely destroyed.
CLINICAL MANIFESTATION OF BURNS AND
SCALDS
• 1. INTEGUMENTARY SYSTEM

• Redness at the site, swelling(edema), blister formation, charring or


white/blackened skin, peeling skin.

• 2. CARDIOVASCULAR SYSTEM.

• Hypovolemia, tachycardia, hypotension, shock .

• 3. Respiratory system.

• Coughing, wheezing or stridor, respiratory distress.


CLINICAL MANIFESTATION CONTN……

• 4. NERVOUS SYSTEM.
• Pain, numbness(full thickness) and altered mental status.
• 5. RENAL SYSTEM.
• Decreased urine output, dark or tea-colored urine.
• 6. GASTROINTESTINAL SYSTEM.
• Nausea and vomiting due to systemic inflammatory response, paralytic ileus(reduced bowel
movement).
• 6. IMMUNE SYSTEM AND SYSTEMIC EFFECTS.
• Fever ( due to infection or inflammatory response, increased risk of infection(sepsis)
INVESTIGATIONS
• PHYSICAL EXAMINATION AND HISTORY TAKING

• Complete blood count.(CBC)

• Blood urea nitrogen (bun).

• RBS.

• Electrolyte panel to check for sodium(na+) and potassium(k+) imbalances.

• Wound cultures to identify bacterial or fungal infections.

• Liver function test.

• C-reactive protein (C-RP) to monitor inflammation and response to treatment.


MEDICAL MANAGEMENT OF BURNS AND SCALDS.
• Remove clothes , assess the extent of the burns in terms of total body
surface affected using the wallace rule of nine.
• Start fluid resuscitation immediately with crystalloid solution such as
ringers lactate.20mg/kg for the first hour
• Administer morphine 0.2mg/kg and analgesics for pain relief.
• Give antibiotics , in severe full thickness burns.
• Administer tetanus vaccines and thromboprophylaxis(enoxaparin).
• Administer oxygen in severe burns that affects the trunk and other
respiratory muscles and in inhalation burns.
• Pass nasogastric tube for feeding.
RULE OF NINES
Used for quick estimate of the % of
the total body surface area(TBSA)
affected by a partial or full-thickness
burn in adult.
OTHER METHODS
USED TO ESTIMATE
THE TBSA% OF BURN.
1. Palmar method
2. Lund-browder chart
The chart on the right is the lund-
browder’s chart.
CALCULATING FLUID REQUIRED FOR
RESUSCITATION IN BURNS.

• Parkland formula is used to measure the total volume of fluid the patients may
need.
4mlxTBSA%xbody weight (kg)=total
ml of fluid needed for 24hours.

Give half of the fluid for the first


8hours

Give the other half for 16hours.


PRACTICE QUESTION

Q1. A 1 years old male patient who weighs 12.5kg sustained burns to the back of
the right arm, posterior trunk, front of the left leg and the anterior head and neck.
Using the Lund-browder’s chart, calculate; the total body surface area percentage
that is burned.
Q2. Using the parkland formula, calculate the total amount of ringer's lactate that
will be given over the next 24hours.
SURGICAL MANAGEMENT OF BURN.

• Perform escharotomy for circumferential burns to prevent ischemia


• Surgical excision-grafting for deep burns
• Monitor for signs of infection and manage promptly.
• Debridement and excision.
NURSING MANAGEMENT
• Check vital signs routinely and when necessary.
• Perform dressing changes regularly using aseptic technique
• Apply silver sulfadiazine cream to prevent infection and promote healing .
• Assess patient’s level of pain using the pain assessment scale of 0-10
• Educate patient on wound care at home to prevent infection after discharge.
• Coordinate with other team members such as the physiotherapist, plastic surgeons,
speech therapist.
• Position patient in a comfortable position to reduce pain.
• Administer prescribed medications.
• Monitor input and output.
• Monitor patient for signs of respiratory difficulties
COMPLICATIONS
• Hypovolemic shock.
• Scarring and contractures.
• Septic shock.
• Renal failure.
• Electrolyte imbalance.
• Keloids.
• Malnutrition.
• Curling’s ulcer.
• Eschar. (Stiff dead tissue caused by deep burns can compromise the limb).
SAFETY MEASURES OR PRECAUTIONS
• B.U.R.N S.A.F.E mnemonic for ensuring baby safety at home.
• B- Bottles: test temp on wrist (lukewarm only)
• U- Unplug irons and other electrical appliances after use.
• R- Radiators/heaters: block access by closing gates.
• N- No holding bay near hot food or whiles cooking.

• S- Sun shade (less than 6months) : sleeves and hat for protection.
• A- Always check bath water with elbow (37-38 degrees Celsius)
• F- First aid ( cool with water, cover with clean cloth and seek medical help if severe.
• E- Edges matters –keep pots/hot drinks away from the edge of the table.
REFERENCE

1. Phillip l Rice, Jr, Md, Dennis P Orgill, Md, Phd, emergency care of moderate
and severe thermal burns in adults(2023)
2. American burn Association’s guidelines.
3. Up-to-date.
4. Hettiaratchy S, Dziewulski P. ABC of burns; pathophysiology and
types of burn. Bmj2004.
O U
Y
N K
H A
T

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