Burn

This PowerPoint presentation provides an overview of burn injuries, covering types of burns (first-degree, second-degree, and third-degree), their distinguishing characteristics, and treatment approaches. It explains how burns are classified by depth and extent, highlighting the appearance, symptoms, and severity of each type. The presentation also discusses key concepts such as the Rule of Nines for assessing burn area, common complications like infection and shock, and the importance of timely medical intervention for severe burns.

1. RacheenS. Haji
ParwarI. Tahir
University of zakho
Faculty of medical sciences
School of medicine
Surgical department

2. The effects of the burn are influenced by:
Intensity of the energy
Duration of exposure
Type of tissue injured

3. Types

4. Thermal

5. ●These are caused by exposure to or contact with flame, hot
liquids, semi liquids (steam), semi-solid (tar) or hot objects.
●Pre hospital care:
○Lavage with water
○Assist patient to drop and roll
○Cover body to prevent hypothermia
Thermal

6. Chemical

7. ●It is caused by contact of tissue to any strong acids, alkalis
or organic compounds.
●Pre hospital care:
○Remove cloths
○Use shower to lavage the involved area
●Treatment:
○Late neutralization with antidote done by 0.2% acetic
acid in alkali burns, sodium bicarbonate or calcium
gluconate for acid burns.
Chemical

8. Electrical

9. ●These are the injuries caused by heat that is generated by the electrical
energy as it passes through the body.
●It can result from contact with exposed or faulty electrical wiring or high
voltage power lines.
●People struck by lightening also sustain electrical injury.
●Pre hospital care:
○Disconnect the source of electric current
○Monitor cardio pulmonary arrest
○Begin CPR if patient is unresponsive
○Place patient on spinal board and apply cervical collar and
transport
●Treatment:
○Assess Entrance & Exit wounds.
○Remove clothing, jewelry, and leather items.
○Treat any visible injuries.
Electrical

10. Radiation

11. ●These are caused by exposure to radioactive source.
●Eg.
-Nuclear –radiation accidents
-Use of ionizing radiation in industries
-Therapeutic radiations
-Sunburns from prolonged exposure to ultraviolet rays
Radiation

12. Inhalation

13. ●It may results from exposure to asphyxiants and smoke, if
the victim was trapped in closed, smoke –filled area.
●It results in pulmonary pathophysiologic changes.
Inhalation

14. Rule of 9

15. Rule of 9

16. Rule of 9

17. Rule of 9

18. 1
st
Degree
2
nd
Degree
4
th
Degree
3
rd
Degree
Depth of burn

20. ●Layers involved: Epidermis
●Appearance: Redness (erythema)
●Texture: Dry
●Sensation: Painful
●Time of healing: 1wk or less
●Complication: Increase risk to develop skin cancer later in
life
1
st
degree

21. partial thickness)

22. ●Layers involved:Extends into superficial dermis
●Appearance: Red with clear blister. Bleaches with pressure
●Texture: Moist
●Sensation: Painful
●Time of healing: 2-3wk
●Complication: Local infection / Cellulitis
2
nd
degree (superficial
partial thickness)

23. thickness)

24. ●Layers involved: Extends into deep dermis
●Appearance: Red and white with blood blisters
●Texture: Moist
●Sensation: Painful
●Time of healing: Weeks -may progress to third degree
●Complication: Scarring, contractures (may require excision
and skin grafting)
2
nd
degree (deep partial
thickness)

25. thickness)

26. ●Layers involved: Extends through entire dermis
●Appearance: Stiff and white/brown
●Texture: Dry, leathery
●Sensation: Painless
●Time of healing: Requires excision
●Complication: Scarring, contractures, amputation
3rd degree (full
thickness)

28. ●Layers involved: Extends through skin, subcutaneous tissue
and into underlying muscle and bone
●Appearance: Black; charred with eschar
●Texture: Dry
●Sensation: Painless
●Time of healing: Requires excision
●Complication: Amputation, significant functional
impairment, possible gangrene, and in some cases death
4
th
degree

29. Clinical manifistation
Fluid and electrolyte
imbalance
Cardiac
alteraetion
pain
Alteration in
respiration
Loss of
consciousness
Thermoregulatory
alteration

30. that occurs immediately after burn like:
-hyperkaliemia
Hyponatraemia
Generalized body edema is seen in patients with greater than 25% burns.
•Increased hematocrit level
•After 18-36 hrcapillary membrane integrity begins to be restored.
•The body beings to reabsorbed edema, fluid and excess fluid is excreted
Clinical manifistation
Fluid and electrolyte
imbalance

31. Clinical manifistation
Fluid and electrolyte
imbalance
Cardiac
alteraetion
pain
Alteration in
respiration
Loss of
consciousness
Thermoregulatory
alteration

32. •It depends upon types of burn
•Manifested by dyspnea, rapid breathing, cyanosis, stridor.
•Thermal burn to the upper airway (mouthe, nasopharynx, and
larynx) leads to mucosal edema, blisters, ulceration leading to
upper airway obstraction.
Clinical manifistation
Alteration in
respiration

33. Clinical manifistation
Fluid and electrolyte
imbalance
Cardiac
alteraetion
pain
Alteration in
respiration
Loss of
consciousness
Thermoregulatory
alteration

34. •Hypovlemiaoccurs immediately after the burn
•Cardiac output decreased
•Decreased in blood pressure
•Anemia may occur as a result of damage to RBCs
Clinical manifistation
Cardiac
alteraetion

35. Clinical manifistation
Fluid and electrolyte
imbalance
Cardiac
alteraetion
pain
Alteration in
respiration
Loss of
consciousness
Thermoregulatory
alteration

36. •Burn patients experiences two types of pain.
1.Background pain: is experienced when patient is at rest.
2.procedural pain: is experienced during the performance of
theraouticprocedures like dressing, cleaning, Etc.
Clinical manifistation
pain

37. Clinical manifistation
Fluid and electrolyte
imbalance
Cardiac
alteraetion
pain
Alteration in
respiration
Loss of
consciousness
Thermoregulatory
alteration

38. •Loss of skin results in an inability to regulate body temperature.
•Patients may exhibit low body temperatures in the early hours
after injury.
Clinical manifistation
Thermoregulatory
alteration

39. Clinical manifistation
Fluid and electrolyte
imbalance
Cardiac
alteraetion
pain
Alteration in
respiration
Loss of
consciousness
Thermoregulatory
alteration

40. •That occurs due to neurological trauma
Clinical manifistation
Loss of
consciousness

41. Indication of admition
Moderate and severe burns.
Airway burns of any type.
Burns in extremes of age.
All electrical or deep chemical burns.

42. Medical management
Emergent / resuscitative phase: this phase lasts for
36-48 hrfrom onset of injury, it ends when fluid
resuscitation is complete.
Acute phase: this phase begins with diuresis and
end with closures of the burn wound.
Rehabilitation phase: this phase begins with
wound closure and ends when client returns
to the highest level of health.

43. Emergent phase
The management of burn patient begins at the scene of accident
Remove the patient from the area of danger
Stop the burning process
Implement basic life support

44. Medical management of
emergent phase
Assess the burn severity
Assess the burn depth
Assess burn extent using rules of nine
Assess location of burn
Identify the mechanism of injury

45. • One of the prime importance
• Inspect oropharynx for
erythema, blisters, ulcerations
and need for endotracheal
intubation.
• In inhalation injury administer
100% O2 via tight fitting mask.
Medical management of
emergent phase
Monitor airway
and breathing
Preventing tissue ischemia
Preventing burn
shock
Wound care Minimizing pain
Preventing
tetanus
Prevention od
aspiration 1 2
5 6
7
4
3

46. • In adults with > 15% burn fluid resuscitation is
required 2 largbore needles are inserted
intravenously.
• Fluid resuscitation is used to minimize the harmful
effect of fluid shift.
• The main goal is to maintain vital organ perfusion
Medical management of
emergent phase
Preventing tissue ischemia
Preventing burn
shock
Wound care Minimizing pain
Preventing
tetanus
Prevention od
aspiration 2
5 6
7
4
3
•One of the prime importance
•Inspect oropharynx for erythema, blisters, ulcerations
and need for endotracheal intubation.
•In inhalation injury administer 100% O2 via tight fitting
mask.
Monitor airway
and breathing

47. • Nasogastric tube is placed
to prevent vomiting and
reduce the risk of
aspiration which occur due
to GI dysfunction resulting
from the intestinal ileus or
paralytic ileus.
• One of the prime importance
• Inspect oropharynx for
erythema, blisters, ulcerations
and need for endotracheal
intubation.
• In inhalation injury administer
100% O2 via tight fitting mask.
Medical management of
emergent phase
Monitor airway
and breathing
Preventing tissue ischemia
Wound care Minimizing pain
Preventing
tetanus
Prevention od
aspiration 1
5 6
7
4
3
•In adults with > 15% burn fluid resuscitation is required
2 largbore needles are inserted intravenously.
•Fluid resuscitation is used to minimize the harmful
effect of fluid shift.
•The main goal is to maintain vital organ perfusion
Preventing burn
shock

48. Parkland
formula

49. RL 2-4 ml/kg/% TBSA
▪In 1
st
8hr:
first half of the amount
▪In next 8 hr:
¼ of total amount
▪In next 8 hr:
¼ of the total amount
Parkland formula
Example:
➢70 kg patient with 50% TBSA burn
RL to be administered is
2*70*50= 7000 ml in 24 hrs
In 1
st
8 hr3500ml
Next 8hr 1750ml
Next 8hr 1750ml

50. • Pain m anagement in m oderate or
m ajor burns is achieved through IV
adm inistration of opiodslike m orphine
sulphate.
• One of the prime importance
• Inspect oropharynx for
erythema, blisters, ulcerations
and need for endotracheal
intubation.
• In inhalation injury administer
100% O2 via tight fitting mask.
Medical management of
emergent phase
Monitor airway
and breathing
Preventing tissue ischemia
Wound care Minimizing pain
Preventing
tetanus
1
5 6
7
4
• In adults with > 15% burn fluid resuscitation is required 2
largbore needles are inserted intravenously.
• Fluid resuscitation is used to m inimize the harm ful effect of
fluid shift.
• The m ain goal is to m aintain vital organ perfusion
Preventing burn
shock2
•Nasogastric tube is placed to prevent vomiting
and reduce the risk of aspiration which occur due
to GI dysfunction resulting from the intestinal
ileus or paralytic ileus.
Prevention of
aspiration

51. • Immediate care
• Cover the wound with
sterile towel and place
on clean dry sheet
• Debridement
• Application of topical
agents
• Dressing
• One of the prime importance
• Inspect oropharynx for
erythema, blisters, ulcerations
and need for endotracheal
intubation.
• In inhalation injury administer
100% O2 via tight fitting mask.
Medical management of
emergent phase
Monitor airway
and breathing
Preventing tissue ischemia
Wound care
Preventing
tetanus
1
5 6
7
• In adults with > 15% burn fluid resuscitation is required 2
largbore needles are inserted intravenously.
• Fluid resuscitation is used to m inimize the harm ful effect of
fluid shift.
• The m ain goal is to m aintain vital organ perfusion
Preventing burn
shock2
• Nasogastric tube is
placed to prevent
vomiting and reduce
the risk of aspiration
which occur due to GI
dysfunction resulting
from the intestinal ileus
or paralytic ileus.
Prevention of
aspiration 3
•Pain management in moderate or major burns is
achieved through IV administration of opiodslike
morphine sulphate.
Minimizing pain

52. • Immunization with tetanus toxoid
• One of the prime importance
• Inspect oropharynx for
erythema, blisters, ulcerations
and need for endotracheal
intubation.
• In inhalation injury administer
100% O2 via tight fitting mask.
Medical management of
emergent phase
Monitor airway
and breathing
Preventing tissue ischemia
Preventing
tetanus
1
6
7
• In adults with > 15% burn fluid resuscitation is required 2
largbore needles are inserted intravenously.
• Fluid resuscitation is used to m inimize the harm ful effect of
fluid shift.
• The m ain goal is to m aintain vital organ perfusion
Preventing burn
shock2
• Nasogastric tube is
placed to prevent
vomiting and reduce
the risk of aspiration
which occur due to GI
dysfunction resulting
from the intestinal ileus
or paralytic ileus.
Prevention of
aspiration 3
• Pain m anagement in
m oderate or m ajor burns is
achieved through IV
adm inistration of opiodslike
m orphine sulphate.Minimizing pain4
•Immediate care
•Cover the wound with sterile towel and place on
clean dry sheet
•Debridement
•Application of topical agents
•Dressing
Wound care

53. • Elevate the injury extremity above the level
of the heart and perform active exercises to
reduce department edema formation
• Immediately assess the distal extremity
perfusion
• One of the prime importance
• Inspect oropharynx for
erythema, blisters, ulcerations
and need for endotracheal
intubation.
• In inhalation injury administer
100% O2 via tight fitting mask.
Medical management of
emergent phase
Monitor airway
and breathing
Preventing tissue ischemia
1
7
• In adults with > 15% burn fluid resuscitation is required 2
largbore needles are inserted intravenously.
• Fluid resuscitation is used to m inimize the harm ful effect of
fluid shift.
• The m ain goal is to m aintain vital organ perfusion
Preventing burn
shock2
• Nasogastric tube is
placed to prevent
vomiting and reduce
the risk of aspiration
which occur due to GI
dysfunction resulting
from the intestinal ileus
or paralytic ileus.
Prevention of
aspiration 3
• Pain m anagement in
m oderate or m ajor burns is
achieved through IV
adm inistration of opiodslike
m orphine sulphate.Minimizing pain4
• Immediate care
• Cover the wound
with sterile towel
and place on
clean dry sheet
• Debridement
• Application of
topical agents
• Dressing
Wound care 5
•Immunization with tetanus toxoid
Preventing
tetanus

54. • One of the prime importance
• Inspect oropharynx for
erythema, blisters, ulcerations
and need for endotracheal
intubation.
• In inhalation injury administer
100% O2 via tight fitting mask.
Medical management of
emergent phase
Monitor airway
and breathing 1
• In adults with > 15% burn fluid resuscitation is required 2
largbore needles are inserted intravenously.
• Fluid resuscitation is used to m inimize the harm ful effect of
fluid shift.
• The m ain goal is to m aintain vital organ perfusion
Preventing burn
shock2
• Nasogastric tube is
placed to prevent
vomiting and reduce
the risk of aspiration
which occur due to GI
dysfunction resulting
from the intestinal ileus
or paralytic ileus.
Prevention of
aspiration 3
• Pain m anagement in
m oderate or m ajor burns is
achieved through IV
adm inistration of opiodslike
m orphine sulphate.Minimizing pain4
• Immediate care
• Cover the wound
with sterile towel
and place on
clean dry sheet
• Debridement
• Application of
topical agents
• Dressing
Wound care 5
• Im m unization with tetanus toxoid
Preventing
tetanus 6
•Elevate the injury extremity above the level of
the heart and perform active exercises to reduce
department edema formation
•Immediately assess the distal extremity
perfusion
Preventing tissue ischemia

55. • One of the prime importance
• Inspect oropharynx for
erythema, blisters, ulcerations
and need for endotracheal
intubation.
• In inhalation injury administer
100% O2 via tight fitting mask.
Medical management of
emergent phase
Monitor airway
and breathing 1
• In adults with > 15% burn fluid resuscitation is required 2
largbore needles are inserted intravenously.
• Fluid resuscitation is used to m inimize the harm ful effect of
fluid shift.
• The m ain goal is to m aintain vital organ perfusion
Preventing burn
shock2
• Nasogastric tube is
placed to prevent
vomiting and reduce
the risk of aspiration
which occur due to GI
dysfunction resulting
from the intestinal ileus
or paralytic ileus.
Prevention of
aspiration 3
• Pain m anagement in
m oderate or m ajor burns is
achieved through IV
adm inistration of opiodslike
m orphine sulphate.Minimizing pain4
• Immediate care
• Cover the wound
with sterile towel
and place on
clean dry sheet
• Debridement
• Application of
topical agents
• Dressing
Wound care 5
• Im m unization with tetanus toxoid
Preventing
tetanus 6
• Elevate the injury extremity above the
level of the heart and perform active
exercises to reduce department edema
formation
• Immediately assess the distal extremity
perfusion
Preventing tissue ischemia 7

56. • One of the prime importance
• Inspect oropharynx for
erythema, blisters, ulcerations
and need for endotracheal
intubation.
• In inhalation injury administer
100% O2 via tight fitting mask.
Medical management of
emergent phase
Monitor airway
and breathing
Preventing tissue ischemia
Preventing burn
shock
Wound care Minimizing pain
Preventing
tetanus
Prevention of
aspiration

57. Acute phase
Acute phase begins when the patient is hemodynamically stable, capillary
permeability is restored and diuresis begins.
This is generally considered to be at 48 –72 hours after the time of burn
injury.
This phase continues until the wound closure is achieved.

58. • It i s done w i th the hel p of hydr other apy
• H ydr other apy i s a for m of show er car ts
• Indi vi dual show er s and bed baths can be used to cl ean the w ounds.
• T he tem per atur e of the w ater i s m ai ntai ned at 37.8 C
• T he tem per atur e of the r oom shoul d be m ai ntai ned betw een 26.6C to 29.4 C
• H ydr other apy shoul d be l i m i ted 20-30 m i n per i od to pr event chi l l i ng of the pati ent
• Pati ent i s encour aged to per for m acti ve exer ci ses of extr em i ti es dur i ng hydr other apy.
• C r oss i nfecti on shoul d be pr evented by changi ng the pl asti c l i ni ng pl ace i nsi de the bathtub.
• Vi tal si gns ar e m oni tor ed befor e and after hydr other apy.Wound cleaning 1
Nutrition therapy 8Infection control7
Pain
management 6
Grafting burn
wound 5
Wound
debridement 4
Wound dressing3
Topical antimicrobial
therapy2
The management includes

59. • It reduces the num ber of bacteria on the
burn wound.
• It prom otes conversion of open, dirty
wound to a closed, clean wounds.
• E.g. r Silver Nitrate
• Mafenide acetate
• Silver sulfadiazine
Nutrition therapy 8Infection control7
Pain
management 6
Grafting burn
wound 5
Wound
debridement 4
Wound dressing3
Topical antimicrobial
therapy2
•It is done with the help of hydrotherapy
•Hydrotherapy is a form of shower carts
•Individual showers and bed baths can be used to clean the wounds.
•The temperature of the water is maintained at 37.8 C
•The temperature of the room should be maintained between 26.6C to 29.4 C
•Hydrotherapy should be limited 20-30 min period to prevent chilling of the patient
•Patient is encouraged to perform active exercises of extremities during hydrotherapy.
•Cross infection should be prevented by changing the plastic lining place inside the bathtub.
•Vital signs are monitored before and after hydrotherapy.
The management includes
Wound cleaning

60. • W hen the wound is c leaned the burned areas are
patted dry and the topic al agent is applied, the
wound is c overed with the several lay ers of
dressings.
• A light dressing is used over joint areas to allow for
motions.
• Dressing is c hanged 20 minutes after giving
analgesic s.
• All PPE are used while dressing.
• It i s done w i th the hel p of hydr other apy
• H ydr other apy i s a for m of show er car ts
• Indi vi dual show er s and bed baths can be used to cl ean the w ounds.
• T he tem per atur e of the w ater i s m ai ntai ned at 37.8 C
• T he tem per atur e of the r oom shoul d be m ai ntai ned betw een 26.6C to 29.4 C
• H ydr other apy shoul d be l i m i ted 20-30 m i n per i od to pr event chi l l i ng of the pati ent
• Pati ent i s encour aged to per for m acti ve exer ci ses of extr em i ti es dur i ng hydr other apy.
• C r oss i nfecti on shoul d be pr evented by changi ng the pl asti c l i ni ng pl ace i nsi de the bathtub.
• Vi tal si gns ar e m oni tor ed befor e and after hydr other apy.Wound cleaning 1
Nutrition therapy 8Infection control7
Pain
management 6
Grafting burn
wound 5
Wound
debridement 4
Wound dressing3
•It reduces the number of bacteria on the burn
wound.
•It promotes conversion of open, dirty wound to a
closed, clean wounds.
•E.g. r Silver Nitrate
•Mafenide acetate
•Silver sulfadiazine
The management includes
Topical antimicrobial
therapy

61. • Remove tissues contaminated by bacteria
and foreign bodies.
• To remove devitalized tissue or burn
eschar in preparation for grafting and
wound healing.
• It reduc es the number of bac teria on the
burn wound.
• It promotes c onversion of open, dirty
wound to a c losed, c lean wounds.
• E.g. r Silver Nitrate
• Mafenide ac etate
• Silver sulfadiazine
• It is done with the help of hydrotherapy
• Hydrotherapy is a form of shower carts
• Individual showers and bed baths can be used to clean the
wounds.
• The temperature of the water is maintained at 37.8 C
• The temperature of the room should be maintained
between 26.6C to 29.4 C
• Hydrotherapy should be limited 20-30 min period to prevent
chilling of the patient
Nutrition therapy 8Infection control7
Pain
management 6
Grafting burn
wound 5
Wound
debridement 4
Topical antimicrobial
therapy2Wound cleaning 1
•When the wound is cleaned the burned areas are patted
dry and the topical agent is applied, the wound is covered
with the several layers of dressings.
•A light dressing is used over joint areas to allow for
motions.
•Dressing is changed 20 minutes after giving analgesics.
•All PPE are used while dressing.
The management includes
Wound dressing

62. • Grafting is done when
wounds are deep or
extensive or re-
epithelialization is not
possible.
• Patient's own skin is
used for graft.
• W hen the wound is c leaned the burned areas are
patted dry and the topic al agent is applied, the wound
is c overed with the several lay ers of dressings.
• A light dressing is used over joint areas to allow for
motions.
• Dressing is c hanged 20 minutes after giving
analgesic s.
• All PPE are used while dressing.
• It is done with the help of hydrotherapy
• Hydrotherapy is a form of shower carts
• Individual showers and bed baths can be used to clean the
wounds.
• The temperature of the water is maintained at 37.8 C
• The temperature of the room should be maintained
between 26.6C to 29.4 C
• Hydrotherapy should be limited 20-30 min period to prevent
chilling of the patient
Nutrition therapy 8Infection control7
Pain
management 6
Grafting burn
wound 5
Wound dressing3
Topical antimicrobial
therapy2Wound cleaning 1
•Remove tissues contaminated by bacteria and foreign bodies.
•To remove devitalized tissue or burn eschar in preparation for
grafting and wound healing.
The management includes
Wound
debridement

63. • Burn patients experiences
severe pain.
• Morphine sulfate is
adm inistered IV.
• Fentanyl m ay be used in
procedural pain.
• Remove tissues contaminated by
bacteria and foreign bodies.
• To remove devitalized tissue or burn
eschar in preparation for grafting and
wound healing.
• It is done with the help of hydrotherapy
• Hydrotherapy is a form of shower carts
• Individual showers and bed baths can be used to clean the
wounds.
• The temperature of the water is maintained at 37.8 C
• The temperature of the room should be maintained
between 26.6C to 29.4 C
• Hydrotherapy should be limited 20-30 min period to prevent
chilling of the patient
Nutrition therapy 8Infection control7
Pain
management 6
Wound
debridement 4
Wound dressing3
Topical antimicrobial
therapy2Wound cleaning 1
•Grafting is done when wounds are deep or
extensive or re-epithelialization is not
possible.
•Patient's own skin is used for graft.
The management includes
Grafting burn
wound

64. • Strict sterile technique is used for
wound care procedures.
• Provide safe and clean environm ent
to the patient.
• Use of PPE.
• Invasive lines and tubing m ust be
routinely changed.
• Regular changing of linen.
• Grafting is done when wounds are deep or
extensive or re-epithelialization is not possible.
• Patient's own skin is used for graft.
• It is done with the help of hydrotherapy
• Hydrotherapy is a form of shower carts
• Individual showers and bed baths can be used to clean the
wounds.
• The temperature of the water is maintained at 37.8 C
• The temperature of the room should be maintained
between 26.6C to 29.4 C
• Hydrotherapy should be limited 20-30 min period to prevent
chilling of the patient
Nutrition therapy 8Infection control7
Grafting burn
wound 5
Wound
debridement 4
Wound dressing3
Topical antimicrobial
therapy2Wound cleaning 1
•Burn patients experiences severe pain.
•Morphine sulfate is administered IV.
•Fentanyl may be used in procedural pain.
The management includes
Pain
management

65. • Burn injuries produc e profound metabolic
abnormalities.
• Patient's metabolic demands vary with the
extent of burns.
• The goal of nutritional support is to promote a
state of positive nitrogen balanc e.
• High protein, lipid and c arbohy drate diet should
be given to the patient.
• Curreri formula c an be used to estimate energy
requirement.
• Energy requirement = (25 kc al * kg body
weight) + (40 kc al * %TBSA burn)
• Method for delivering nutritional support inc lude
oral intake, enteral tube feeding, TPN and
Parenteral nutrition.
• These may be used alone or in c ombination.
• Burn patients experiences
severe pain.
• Morphine sulfate is
adm inistered IV.
• Fentanyl m ay be used in
procedural pain.
• It is done with the help of hydrotherapy
• Hydrotherapy is a form of shower carts
• Individual showers and bed baths can be used to clean the
wounds.
• The temperature of the water is maintained at 37.8 C
• The temperature of the room should be maintained
between 26.6C to 29.4 C
• Hydrotherapy should be limited 20-30 min period to prevent
chilling of the patient
Nutrition therapy 8
Pain
management 6
Grafting burn
wound 5
Wound
debridement 4
Wound dressing3
Topical antimicrobial
therapy2Wound cleaning 1
The management includes
•Strict sterile technique is used for wound care procedures.
•Provide safe and clean environment to the patient.
•Use of PPE.
•Invasive lines and tubing must be routinely changed.
•Regular changing of linen.
Infection control

66. • Stric t sterile tec hnique is used for wound c are
proc edures.
• Provide safe and c lean environment to the
patient.
• Use of PPE.
• Invasive lines and tubing must be routinely
c hanged.
• Regular c hanging of linen.
• It is done with the help of hydrotherapy
• Hydrotherapy is a form of shower carts
• Individual showers and bed baths can be used to clean the
wounds.
• The temperature of the water is maintained at 37.8 C
• The temperature of the room should be maintained
between 26.6C to 29.4 C
• Hydrotherapy should be limited 20-30 min period to prevent
chilling of the patient
Infection control7
Pain
management 6
Grafting burn
wound 5
Wound
debridement 4
Wound dressing3
Topical antimicrobial
therapy2Wound cleaning 1
•Burn injuries produce profound metabolic abnormalities.
•Patient's metabolic demands vary with the extent of burns.
•The goal of nutritional support is to promote a state of positive nitrogen
balance.
•High protein, lipid and carbohydrate diet should be given to the patient.
•Curreri formula can be used to estimate energy requirement.
•Energy requirement = (25 kcal * kg body weight) + (40 kcal * %TBSA burn)
•Method for delivering nutritional support include oral intake, enteral tube
feeding, TPN and Parenteral nutrition.
•These may be used alone or in combination.
The management includes
Nutrition therapy

67. • Burn injuries produc e profound metabolic
abnormalities.
• Patient's metabolic demands vary with the extent of
burns.
• The goal of nutritional support is to promote a state of
positive nitrogen balanc e.
• High protein, lipid and c arbohy drate diet should be
given to the patient.
• Curreri formula c an be used to estimate energy
requirement.
• Energy requirement = (25 kc al * kg body weight) + (40
kc al * %TBSA burn)
• Method for delivering nutritional support inc lude oral
intake, enteral tube feeding, TPN and Parenteral
nutrition.
• These may be used alone or in c ombination.
Wound cleaning 1
Nutrition therapy 8Infection control7
Pain
management 6
Grafting burn
wound 5
Wound
debridement 4
Wound dressing3
Topical antimicrobial
therapy2
The management includes

68. Wound cleaning
Nutrition therapy Infection control
Pain
management
Grafting burn
wound
Wound
debridement
Wound dressing
Topical antimicrobial
therapy
2
The management includes

69. Rehabilitation phase
Rehabilitation should begin immediately after the burn has occurred.
Wound healing, psychosocial support and restoration of maximal functional
activity remain priorities so that the patient can have the best quality of life
both personally and socially.
Reconstructive surgery may be done to improve body appearance and function.
Psychological counseling may be done to promote recovery and quality of life

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