nursing care management of burns in er

BY: NESTOR A. SALAZAR JR., RN

Speaker

NURSING CARE MANAGEMENT OF BURNS IN ER

A. THERMAL BURN

EXPOSURE/CONTACT :

II. TYPES OF BURNS

Flames

Hot Liquids

Steam or Hot Object

B. CHEMICAL BURN

A. LUND-BROWDER CHART

III. METHODS TO ESTIMATE THE EXTENT OF INJURY

* Most accurate*Pediatric

Patient

B. RULE OF NINE

ADULT SKIN AREAS

Head & Neck 9%Torso36%Arms18%Legs36%Perineum

1%

____________

100%

Disadvantage: Overestimation

A. SUPERFICIAL-THICKNESS BURN

Injury to Epidermis

Blood supply-Intact

Painful – ease by cooling

Heals: 3-6 days

No scarring

Skin Graft not Required

IV. BURN DEPTH

B. SUPERFICIAL PARTIAL-THICKNESS BURN

Deeper into Dermis

Blood supply reduce

Large Blisters

Edema

Painful-sensitive to air

Heals: 10-21 days without scarring

Graft maybe use

C. DEEP PARTIAL-THICKNESS BURN

Extend to deeper Dermis

No blisters

Wound surface: Red & Dry

white areas in deep

Edema is Moderate

Can convert to Full-thickness burn

Heals: 3-6 wks

Scar form & skin grafting required

D. FULL THICKNESS BURN

Destruction of Epidermis & Dermis

Dry Hard & Leathery Eschar

Sensation: Reduce / Absent

Heals: Weeks or Month

Grafting required

E. DEEP FULL-THICKNESS BURN

Fascia, tissues, muscle, bone & tendon

Sensation: completely absent

Eschar: Hard/inelastic

Heals: Month

Skin Grafting required

III. BURN LOCATION

PulmonaryComplication

A.Head Neck

ChestB. Face

Corneal Abrasion

C. Ear

Auricular Chondritis

D. Perineal Area

Autocontamination

A.LOCAL RESPONSE

V. PATHOPHYSIOLOGY OF BURNS

JACKSON’S BURN ZONE

B. SYSTEMIC RESPONSE

Systemic changes that occur after a burn injury