Etiology
- Thermal
- Electrical
- Chemical
- Radiation
Assessment
- History
- Causative agent
- Temperature of burning agent
- Duration of contact
- Thickness of skin
Types
- Superficial burns (1st Degree)
- Involves epidermis only
- Local pain and erythema; may or may not have blisters
- Rapid healing without scarring
- Discomforts last about 48hours
- Pain eased by cooling
- Partial-thickness burns (2nd Degree)
- Involves the epidermis and part of the dermis
- Painful, red to pale ivory moist skin with blisters
- Intact tactile and pain sensors
- Healing: 21-28 days with variable scarring
- Full-thickness Burn (3rd Degree)
- Involves epidermis, dermis and underlying subcutaneous tissue
- Skin: white, cherry red, black
- Blisters: dry hard leathery appearance
- Painless
Nursing Management
- Provide emergency care
- Eliminate source of burn
- Flame
- Scald
- Chemicals
- Electric current
- Cool the burn for several minutes. Do not use ice.
- Remove restrictive objects
- Cover wound
- Apply abc of trauma
- Assess for and treat smoke inhalation injury
- Assess for and treat carbon monoxide poisoning
- Prevent shock
- Monitor acid-base balance and electrolyte
- Nothing per orem
- Hemodynamiz stabilization
- Prevent burn shock
- IV fluid therapy
- Metabolic support
- Wound care
- Wound cleansing and hydrotherapy
- Immersion
- Spraying
- Showering
- Debridement
- Mechanical
- Enzymatic
- Surgical
- Topical antimicrobials
- Silver sulfadiazine
- Mafenide acetate 10% cream
- Silver nitrate
- Surgical management
- Tangential excision
- Primary excision
- Burn wound coverings
- Biologic dressings
- Amnion
- Allograft
- Xenograft
- Biosynthetic dressing
- Biobrane
- Autograft
- Permanent
- Care of graft site
- Elevate and immobilize graft site
- Keep site free from pressure
- Remove exudates
- Monitor foul-smelling drainage
- Lubricate skin and protect from sulight
- Use support garments and splints
- Prevention and treatment of complications
- Potential complications
- Acute respiratory failure
- Distributive shock
- Acute renal failure
- Compartment syndrome
- Paralytic ileus
- Curling’s ulcer
- Estimate burn size
- Rule of nine
- Lund and browder
- Measure urine output
- Promote optimum recovery
- Wound management
- Physical therapy
- Pain management
- Morphine sulphate
- Meperidine (Demerol)
- Nutrition
- Nothing per orem
- High protein, carbohydrates, fats and vitamins
- Monitor calorie intake
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