INTRODUCTION

Burn are most common household

injuries, especially among the children.
The term burn mean from than the
burning sensation associated with this
injury.
 DEFINITION

Burn can be defined as injury that result

from the direct contact or exposure of any
thermal radiation source.
INCIDENCE
India record 70lacs burn injury annually
which 1.4 lacs people die and 2.4 suffer
from disability.
80% cases with women are related are
kitchen accidents.
70% are cases are in 15-35 year age
group.
Death /injury of children age1-9 year.
 CLASSIFICATION OF BURN
1-FIRST DEGREE (SUPERFICIAL BURN)-
First degree burn affect only outer layer of skin in epidermis .The
burn such redness, pain.
2-SECOND DEGREE BURN(PARTIAL THICKNESS)-
The involves epidermis and part of lower layer of skin the dermis .
such as blister.
3-THIRD DEGREE BURN- The destroyed epidermis and dermis
.they may go into the inner most layer of skin the subcutenous
tissue. Such as(white black skin).
4- FOURTH DEGREE BURN- through both layer of skin and
underlying the deeper tissue involving muscle and bone
destroyed.
 CAUSES OF BURN
 THERMAL BURN
 Heat
 Boiling
 Water steam
 CHEMICAL BURN
 Paint
 Thinner
 Acid

 RADIATION BURN
 X- ray
 Ultraviolet ray
 ELECTRICAL BURN
Electricity contact with your body.
PATHOPHYSIOLOGY
Due to etiology factor
Release of vasoactive peptide
Due to loss of fluid
Decrease cardiac output
Decreased renal failure
Altered pulmonary resistance
Infection
Multi organ dysfunction syndrome
 CLINICAL FEATURES
FIRST DEGREE-
 pain at burn site
 Redness skin
 Involves only epidermis

SECOND DEGREE
 Very painful /sensation
 White or red skin
 Blister

Third Degree
 Dry
 Loss Of Sensation(little Pain)

Fourth Degree
 involves structure beneath the skin , muscle, bone
DIAGNOSTIC EVALUATION
History collection
Physical examination
Complete blood count
Serum urea electrolyte
X-ray
Arterial blood gas
Laserdoppler imaging
PHASES OF BURN MANAGEMENT

Emergent phase/ resuscitative phase

Acute phase/ wound healing phase
Rehabilitative phase/ restorative phase
PRE HOSPITAL MANAGEMENT

Rescuer to avoid injuring himself.

Remove patient from source of injury
Stop burn process.
Burning clothing; jewelry ,watches, belts to be
removed.
HISTORY-
Mechanism of injury
Time of injury
Surrounding ( closed space/ chemical)
PHYSICAL EXAMINATION
Head to toe assessment
Careful neurological examination
EMERGENT /RESUSCITATIVE
PHASE
Life threatening airway problems.
Hypovolemia
Assess airway breathing circulation
ET intubation+ assisted ventilation with 100%
oxygen if:
Acute respiratory distress
Quick assessment to extent
Foleys catheter and NG tube placement
Check weight
Tetanus prophylaxis ( the only IM administered
injection).
 2- FLUID RESUCITATION
Parkland formula
PARKLAND FORMULA
Total fluid replacement in 24 hours= 4ml per%
of burn/kg body weight.
Half of the volume is given in first 8 hours rest
is given in next 16 hours.
ACUTE MANAGEMENT
Proper prevent infection.
Medical management-patient controlled
analgesics device.
ASSESSMENT OF ADEQUACY OF
FLUID RESUSCITATION
Monitor urinary output
Proper daily weight
Proper check vital signs
Check heart rate and blood pressure
Level of consciousness
Laboratory value
RULE OF NINE
 RULE OF NINE
The approximate the percentage of burned
surfaces area the body has been divided into
eleven section each section takes about nine
percent of the body skin to cover .these section
account for 99% . The genital make up the last
1% .to apply the rules of nine add up of the
body that are burned deep enough to cause
blister or worse.2ND and 3Rd degree burns.
REHABILITATION PHASE
Minimize function loss
Proper exercise and proper positioning.
Proper psychological support
Good communication and encourage
independence.
Proper improving mobility.
Proper improving body image.
SURGICAL MANAGEMENT
WOUNG GRAFTING
AUTOGRAFT- from one part of the body
to another ex. trunk to arm.
ISOGRAFT- between genetically identical
individual .ex. monozygotic twins.
ALLOGRAFT-between different members
of the same species.ex.mr.smith and Jones.
XENOGRAFT-between members of
different species ex.pig to human
SURGICAL MANAGEMENT
FASCIOTOMY- A surgery is a
procedure to cut open the fascia ( tissue
beneath the skin ) to relieve tension or
pressure. fasciotomy is a limb saving
procedure when used to treat acute and
chronic compartment syndrome.
ESCHAROTOMY
Isa procedure used to treat full thickness third
degree burn. In full thickness burn, both the
epidermis and dermis are destroyed along with
sensory nerve in the dermis.
 NURSING MANAGEMENT
Maintain proper oxygenation and tissues
perfusion.
Maintain fluid and electrolyte balance.
Proper relieving pain.
Proper prevent hypothermia.
Proper provide wound care.
Proper preventing infection.
Proper nutrition and promoting comfort.
Proper prevent the graft care.
COMPLICATION
Burn shock
Pulmonary complication due to inhalation
Acute renal failure
Infection and sepsis.
Multiple organ failure
Cardiac disease.
 CONCLUSION

Prevention of burn injuries based on the the

epidemiology of the burn in developing
countries remains a major way of reducing the
current spots of morbidity and mortality in our
patient.
 BIBLIOGRAPHY
Lewis “medical surgical nursing” volume
-1 1ST edition elsevier publisher page no
1062-1069
Brunner and suddharth “ medical surgical
nursing” suzzine with smatlzer brenda
bare 13Th edition.
www. Slide share burns .com