Burns

WELCOME
BURNS
INTRODUCTION
Burns are the injuries occurring due to direct

contact or exposure to any thermal, chemical,
electrical or radiation source. As a result, the
energy from the heat source is transferred to the
tissues of the body. The depth and severity of
injury is related to temperature and the duration
of exposure or contact.
DEFINITION
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.
Burn Is defined as a wound which is caused
by an exogenous agent leading to coagulative
necrosis of the tissue
ETIOLOG
Thermal
Burns Y Non Thermal Burns
Cold Injury Electrical Radiation

Chemical Burn Burn
Injury
CLASSIFICATION
First Degree
Burn
Superficial
(Superficial) Partial
burn
Second
Fourth According Degree Burn
Degree Burn to the depth (Partial)
Deep
Partial
Third Degree burn
Burn(Full)
2.Depending on the Percentage of Burns:
(a) Mild:
Partial thickness burn less than 15% in adult or less than 10% in children or
full thickness less than 2%.
(b) Moderate: Second degree 15-25% burns in adult or 10-20% in children

or third degree 2-10% burns.
(c) Major:
Second degree >25% burns in adult or >20% burns in children or third degree
>10% burns or burns involving eyes, ears, feet, hand, perineum. All
inhalational and electrical burns.
Theory of Thermal Wounds
According to Jackson
Three Zones in Burns:
1.ZONE OF COAGULATION
2.ZONE OF STASIS
3.ZONE OF HYPEREMIA
ASSESSMENT OF BURNS
Various method is applied to estimate the total body
surface area affected by burns.
Burn Assessment:
History of burn
1.Time of injury
3. Mechanism of injury
• Scald
• Contact
• Friction
• Flame/Exposure
• Electrical
• Chemical
• Cold
• Radiant
4. First Aid
ASSESSMENT BASED ON TBSA
•Wallace Rule of Nine
•Lund-Browder Method
•The Palm Method
•Surface Area Graphic
Evaluation (SAGE) Method
WALLACE LUND-BROWDER
RULE OF NINE METHOD
THE PALM Surface Area Graphic
METHOD Evaluation (SAGE)
Method
• It quickly diagrams the
burn injuries,estimates the
burn area and calculates
fluid resuscitation for burns
over 20% total body surface
area (TBSA) using Parkland
formula
MANAGEMENT OF
1. Management in burn casualty
BURNS
Assess ABC
Rule of nine or Lund and Browder chart
Weigh the patient
Infuse Ringer lactate
Remove constricting objects
Escharotomy should be done in circumferential burn
Oxygen inhalation to be started incase of inhalation injury
Dress the wound
Give tetanus prophylaxis
Major burns
Minor burns
Maintain records in detail
• Legal procedures
IV fluid calculation and infusion
2. Management in ICU
Vitals monitoring
Assess airway for inhalation injury and intubate if required
Catheterize the patient for monitoring urine output
Assess extremeties ,neck and chest
ABG should be recorded in inhalation injury
Nil per oral until patient is out of shock
ECG monitoring
Put Central line
Chest physiotherapy should be started.
Hb,Hematocrit, electrolytes,RFT and blood sugar should be checked daily.
IV fluids to be continued as per daily losses and requirements
Monitor Intake output chart
Dressing should be done with1% SSD
No antibiotics during initial period
• Oral or parental analgesics and sedation for pain management.
FLUID RESUSCITATION
• Greater 15% burns two IV cannula
large bore placed
• Greater 30% burns put Central line
• Fluids replacement achieved with
crystalloid solution ,colloids or
combination of two
1.Parklandor Baxter formula
Fluid 2.American Burn Association
Resuscitation formula
Formula s 3.Brooke formula
4.Consensus formula
5.Evans formula
6.Dextran formula
Clinical parameters used for assessing
adequacy of fluid resuscitation
1.Urine Output
2.Cardiac Parameters
CONCLUSION
As discussed throughout the presentation, learning about
burns and its management will help nurses to care for a
burn injury patient.
• Nurses can do burn wound assessment,classify the
degree of burn, observe the sign and symptoms, provide
the necessary nursing care and support the patient
psychologically.
• Nurses can also counsel the patients and their family
for various options available in burn treatment and
rehabilitation.
BIBLIOGRAPHY
Usha Ukande, Textbook of Adult Health
Nursing,CBS publishers and distributors
pvt.ltd,1st edition, pg no:1052
• MJ Kumari,Textbook of Adult Health
Nursing,Jaypee brothers medical publishers,
2nd edition,pg no:157
THANK YOU

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WELCOME

Burns are the injuries occurring due to direct

Cold Injury Electrical Radiation

(b) Moderate: Second degree 15-25% burns in adult or 10-20% in children

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