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BURNS Definition: Tissue injury when there is contact between tissue and…

- - - - should be covered w/ clean, cool, tap water-dampened towel for comfort & protection until medical care available
    - - BREATHING- Check adequacy of ventilation
      - CIRCULATION- Check presence & regularity of pulses, & elevate burned limb above hart to < pain & swelling
      - AIRWAY- check for patency, soot around nares & on tongue, singed nasal hair, darkened oral or nasal membranes
- - - - Scarring 2 components
        
        1.) Discoloration
        
        Discoloration of scar fades with time
        
        2.) Contour
        
        Scar tissue develops different contours that appears enlarged above burned area
        
        Pressure can keep scar flat
        
        Custom fitted pressure garments
        Clear Thermoplastic face masks
        
        Only worn HEALED wounds Only removed for bathing
        *Worn up to 24 hrs a day for as long as 12-18 mnths
        
        May feel discomfort/ itching where healing occurs:
        
        Water based moisturizers
        Oral antihistamines (hydroxyzine,Atarax)
        Massage oil
        Silicone Gel sheeting (Biodermis)
        Gabapentin
        Injectable steroids
      - 4-6 weeks area becomes raised and hyperemic
        Mature healing @ 12 months
        Skin doesn't regain original color
      - Spontaneous re-epithelialization Keratinocytes rebuild tissue structure
        *Collagen strengthens weak areas
      - Old skin may flake off
        Newly formed skin is very sensitive to trauma
        New healed areas are hyper/hypo sensitive to cold, heat, or touch
        MUST protect healed burn areas from sunlight for 3 mnths to prevent hyperpigmentation/ sunburn injury
    - - Skin/ joint contractures
        
        -Position
        -Splint
        -Exercise
    - - Teach patient and caregiver how to care for wounds
        
        Dressing changes
        
        wound care
        
        Water based creams to keep skin moisturized and reduce itching/ flaking
        
        Vaseline
        
        Oral antihistamine if itching persists
      - Encourage patient to talk about fears
        Patient may feel disturbed body image
        Encourage patient to return to activities from before the incident
        Encourage counseling to help deal with patient concerns
- - - - -Flame, flash, scald, contact burns, chemical, tar, electric current
    - - -Fluid-filled vesicles that are red, shiny, wet (if ruptured), severe pain caused by nerve injury, mild to moderate edema
    - - Epidermis & dermis involved to varying depths. Tactile & pain sensation intact
  - - - Flame, flash, scald, contact burns, chemical, tar, electric current
    - - -Dry, waxy white, leathery, or hard skin; visible -thrombosed vessels.
        -Insensitivity to pain due to nerve destruction
        -Possible involvement of muscles, tendons, & bones
    - - All skin elements & local nerve endings destroyed. Coagulation necrosis present. Surgical intervention required for healing
  - - - -Superficial sunburn
        -Quick heat flash
    - - Erythema, blanching on pressure, pain & mild swelling, no vesicles or blisters
    - - Superficial epidermal damage w/ hyperemia
        Tactile & pain sensation intact