BURNS

and
INJURIES
 BURNS
A burn is an injury to the skin or other organic tissue primarily caused by
heat or due to radiation, radioactivity, electricity, friction or contact with
chemicals.

Thermal (heat) burns occur when some or all of the cells in the skin or
other tissues are destroyed by:
● hot liquids (scalds)
● hot solids (contact burns), or
● flames (flame burns).
 FACTS
● An estimated 180 000 deaths every year are caused by burns – the vast
majority occur in low- and middle income countries.

● Non-fatal burn injuries are a leading cause of morbidity.

● Burns occur mainly in the home and workplace.

● Burns are preventable

 Who is at risk?
01 Gender 02 Age

03 Regional factors 04 Socioeconomic factors

05 Other risk factors

 COMMON
CAUSE OF
BURNS
Open flames are one of the most
common reasons that people
get burned, but there are
many other causes
 Cold burns
Friction burns Thermal burns
Radiation burns
Thermal burns Chemical burns

Electrical burns
• Friction burns. When a hard object rubs off some of your skin, you have
what’s called a friction burn. It’s both an abrasion (scrape) and a heat
burn.

• Cold burns. Also called “frostbite,” cold burns cause damage to your
skin by freezing it. You can get frostbite by being outside in freezing
temperatures.

• Thermal burns. Touching a very hot object raises the temperature of

your skin to the point that your skin cells start dying.
• Radiation burns. Sunburn is a type of radiation burn. Other sources of
radiation, like X-rays or radiation therapy to treat cancer, can also cause
these.

• Chemical burns. Strong acids, solvents or detergents that touch your skin
can cause it to burn.

• Electrical burns. If you come into contact with an electrical current, you
can get this type of burn.
 Symptoms
Burn symptoms vary
depending on how deep the skin
damage is. It can take a day or two
for the signs and symptoms of a
severe burn to develop.
This minor burn affects only
the outer layer of the skin
(epidermis). It may cause
redness and pain.
1st-degree burn
swelling and red, white or splotchy
This type of burn affects both the
epidermis and the second layer of
skin (dermis). It may cause
skin. Blisters may develop, and
pain can be severe. Deep second-
degree burns can cause scarring.
2nd-degree burn
 This burn reaches to the fat layer
beneath the skin. Burned areas may be
black, brown or white. The skin may
look leathery. Third-degree burns can
destroy nerves, causing numbness.

3rd-degree burn.
 TREATMENT

Most minor burns can be treated at home. They usually heal within a couple of weeks.

For serious burns, after appropriate first aid and wound assessment, your treatment
may involve medications, wound dressings, therapy and surgery.

People with severe burns may require treatment at specialized burn centers. They may
need skin grafts to cover large wounds. And they may need emotional support and
months of follow-up care, such as physical therapy.
● First-degree burns can usually be treated with skin care products like aloe
Vera cream or an antibiotic ointment and pain medication such as
acetaminophen (Tylenol).

● Second-degree burns may be treated with an antibiotic cream or other

creams or ointments prescribed by a doctor.

● Third-degree and fourth-degree burns may need more intensive

treatments such as intravenous (IV) antibiotics to prevent infection or IV
fluids to replace fluids lost when skin was burned. They may also need skin
grafting or the use of synthetic skin.
 Medical Treatment
After you have received first aid for a major burn, your medical care may include
medications and products that are intended to encourage healing.

● Water-based treatments. Your care team may use techniques such as ultrasound
mist therapy to clean and stimulate the wound tissue.

● Fluids to prevent dehydration. You may need intravenous (IV) fluids to prevent
dehydration and organ failure.

● Pain and anxiety medications. Healing burns can be incredibly painful. You
may need morphine and anti-anxiety medications — particularly for dressing
changes.
● Burn creams and ointments. If you are not being transferred to a burn center,
your care team may select from a variety of topical products for wound
healing, such as bacitracin and silver sulfadiazine (Silvadene). These help
prevent infection and prepare the wound to close.

● Dressings. Your care team may also use various specialty wound dressings to
prepare the wound to heal. If you are being transferred to a burn center, your
wound will likely be covered in dry gauze only.

● Drugs that fight infection. If you develop an infection, you may need IV
antibiotics.

● Tetanus shot. Your doctor might recommend a tetanus shot after a burn injury.
 SURGICAL AND OTHER
PROCEDURES
1 Breathing assistance Skin grafts 4

2
2 Feeding tube Plastic surgery. 5

3 Easing blood flow

around the wound
● Breathing assistance. If you've been burned on the face or neck, your
throat may swell shut. If that appears likely, your doctor may insert a tube
down your windpipe (trachea) to keep oxygen supplied to your lungs.

● Feeding tube. People with extensive burns or who are undernourished

may need nutritional support. Your doctor may thread a feeding tube
through your nose to your stomach.

● Easing blood flow around the wound. If a burn scab (eschar) goes
completely around a limb, it can tighten and cut off the blood circulation.
 ● Skin grafts. A skin graft is a surgical procedure in which sections of your
own healthy skin are used to replace the scar tissue caused by deep burns.
Donor skin from deceased donors or pigs can be used as a temporary
solution.

● Plastic surgery. Plastic surgery (reconstruction) can improve the appearance

of burn scars and increase the flexibility of joints affected by scarring.
LIFESTYLE AND
HOME
REMEDIES
To treat minor burns, follow these steps:
● Cool the burn. Hold the burned area under cool (not cold) running water or
apply a cool, wet compress until the pain eases. Don't use ice. Putting ice
directly on a burn can cause further damage to the tissue.

● Remove rings or other tight items. Try to do this quickly and gently, before
the burned area swells.

● Don't break blisters. Fluid-filled blisters protect against infection. If a blister

breaks, clean the area with water (mild soap is optional). Apply an antibiotic
ointment. But if a rash appears, stop using the ointment.
● Apply lotion. Once a burn is completely cooled, apply a lotion, such as one that
contains aloe vera or a moisturizer. This helps prevent drying and provides relief.

● Bandage the burn. Cover the burn with a sterile gauze bandage (not fluffy cotton).
Wrap it loosely to avoid putting pressure on burned skin. Bandaging keeps air off
the area, reduces pain and protects blistered skin.

● Take a pain reliever. Over-the-counter medications, such as ibuprofen (Advil,

Motrin IB, others), naproxen sodium (Aleve) or acetaminophen (Tylenol, others),
can help relieve pain.

● Consider a tetanus shot. Make sure that your tetanus booster is up to date. Doctors
recommend that people get a tetanus shot at least every 10 years.
NURSING ASSESSMENTS &
INTERVENTIONS
The nursing assessment focuses on the major priorities for any
trauma patient; the burn wound is a secondary consideration.
● Focus on the major priorities of any trauma patient. The burn wound is a
secondary consideration, although aseptic management of the burn wounds
and invasive lines continues.

● Assess circumstances surrounding the injury. Time of injury, mechanism of

burn, whether the burn occurred in a closed space, the possibility of
inhalation of noxious chemicals, and any related trauma.

● Monitor vital signs frequently. Monitor respiratory status closely; and

evaluate apical, carotid, and femoral pulses particularly in areas of
circumferential burn injury to an extremity.
● Start cardiac monitoring if indicated. If a patient has a history of cardiac
or respiratory problems, electrical injury.

● Check peripheral pulses on burned extremities hourly; use Doppler as

needed.

● Monitor fluid intake (IV fluids) and output (urinary catheter) and
measure hourly. Note amount of urine obtained when catheter is
inserted (indicates preburn renal function and fluid status).

● Obtain history. Assess body temperature, body weight, history of

preburn weight, allergies, tetanus immunization, past medical surgical
problems, current illnesses, and use of medications.
● Arrange for patients with facial burns to be assessed for corneal injury.

● Continue to assess the extent of the burn; assess depth of wound, and
identify areas of full and partial thickness injury.

● Assess neurologic status: consciousness, psychological status, pain and

anxiety levels, and behavior.

● Assess patient’s and family’s understanding of injury and treatment. Assess

the patient's support system and coping skills.
 REFERENCES
Non-print
● Burns - Symptoms and causes. (2020, July 28). Mayo Clinic.
https://www.mayoclinic.org/diseases-conditions/burns/symptoms-causes/syc
20370539
● view, L. in or sign up to. (n.d.). First aid & emergencies. WebMD. Retrieved November 10,
2021, from https://www.webmd.com/first
aid/types-degrees-burns
● WHO, W. H. O. (2018, March 6). Burns. World Health Organization: WHO.
https://www.who.int/news-room/fact-sheets/detail/burns
● MARIANNE BELLEZA, R. (2021, February 20 ). Burn Injury. Retrieved from Nurseslabs:
https://nurseslabs.com/burn
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● Burns. (n.d.). Retrieved from Mayo Clinic: https://www.mayoclinic.org/diseases-
conditions/burns/diagnosis-treatment/drc
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