Burn basic

This is a topic of MSN 2 from the unit of burn which include basic and initial portion of burn which includes:
definition
etiology
prevention
classification of burn
as per depth 1st, 2nd, and 3rd degree burn
rule of nine
pathophysiology

1. BURN
DEPARTMENT
OF
MEDICAL SURGICAL NURSING

2. Learning Objectives
At the end of this lecturer, students should be
able to
•Define burn
•Enlist the causes
•Describe the classification
•Explain the pathophysiology

3. Definition :
Injuriesthatresultfromdirectcontact/Exposure
toanythermal,chemical,electricalorradiation
sourcecalledasBurn

4. Etiology
Burn injuries are categorized occurring to the
mechanism of injury. It may be
•Thermal Burns
•Chemical Burns
•Electrical Burns
•Radiation Burns

5. 1)ThermalBurns:
2)ChemicalBurns:
Smokeandinhalationofhotairornoxious
chemicalscancausedamagetothetissueof
therespiratorytracte.g.carbonmonoxide
poisoning.

6. 3) Electrical Burns :
4) Radiation Burn injury
E.g. Use of ionizing radiation in industry
Therapeutic radiation
A sunburn from prolonged exposure to
ultraviolet ray

7. Burn injury prevention
During infancy
•Use caution when warming formula in
microwave oven.
•Always check temperature of liquid before
feeding.
•Beware of cigarette ashes that may fall on
infant.

8. •Do not leave infant in the sun for more than a
few minutes.
•Keep electrical wires hidden or out of reach.
•Donotallowschildtoplaywithelectrical
appliance,wiresorlighters.
•Coverelectricaloutletswithprotectivedevices.
•Routineinspectionandclearingofheatingunits.

9. Classification of Burns injury
The treatment of burns is
R/T the severity of burn injury, severity of burns is
determined by
•Burn depth
•Burn size % of TBSA burned
•Burn location

10. Classification of Burns injury
•Age of burn victim
•General health of burn victim
•Mechanism of injury.

11. Burn Depth
1) Superficial partial thickness (First degrees)
2) A deep partial –thickness (Second degree)
3) A full thickness (Third degree)

13. Full Thickness (Third degree)
Cause of burn Skin
involvement
Symptoms Appearance Course
1) Superficial first
degree
Sun born
Low intensity flash
Epidermis -Tingling
-Hyperesthesia
-Painful
-Soothed by cooling
-Reddened
-No edema
-Complete
recovery within
a week
-Peeling
2) Partial thickness
(2
nd
degree)
-Scaled
-Flash flame
Epidermis and
part of dermis
-Painful
-Hyperesthesia
-Sensitive to cold air
-Blistered
-Mottled red
base
-Edema
-Broken
epidermis
-Recovery in 2
to 3 weeks
-Some scarring
& depigment
action
--Infection may
convert to 3
rd
degree

14. Full Thickness (Third degree)
3) Full thickness
3
rd
Degree
-Flame
-Prolonged
exposure to not
liquid
-Electrical current

Epidemics,
entivedermi
s&
sometime
subcutaneou
s tissue.
Painless
Symptom of
shock
Hemataria
-Dry, pale
white,
leathery,
Broken skin
with fat
exposed
--edema
-Eschar
sloughs
-Grafting
necessary
-Loss of
function
-Loss of
digits or
extremity.

15. Burnsizeextent
Thesizeofaburnisdeterminedbyoneofthe
twotechniques
a)Theruleofnine
b)Anage–specificburndiagramoflund–
Browderchart.

16. A) The rule of nine : The basis of this rule is that
the body divided into anatomic sections, each
of which represents 9% or a multiple of 9% of
the TBSA.

17. The Rule of nine
Head and neck 9%
Arms 9%
Anterior trunk 18%
Posterior trunk 18%
Legs 18%
Perinium 1%
--------
100%
--------

18. B)BerkowMethod:-itismorereliablemethod
•ItisbasedonLundandBrowder’srecognition.
•Bydividingthebodyintoverysmallareaand
providinganestimateoftheproportionof
bodysurfaceareaaccountedforbysuchbody
parts

19. 3)Burnlocation
•Burnofface,head,neckandchest
•Pulmonarycomplication,inhibittherespiratory
functionandcornealabrasions.

20. •Burnofears–
•Burnofhandsandjoints–
•BurninvolvingthePerinealarea-
•Burn of the buttocks or genitalia -
•Burn of the extremities –

21. 4)AgeoftheBurnvictim:-
Theclient’sageaffectstheseverityandoutcome
oftheburn
5)GeneralHealthandBurn:-

22. 6)MechanismofBurninjury:
Inelectricalinjuries,heatisgeneratedasthe
electricitytravelsthroughthebodyresulting
internaltissuedamage.
Inchemicalburnssystemictoalleffectsfrom
cutaneousabsorptionoftheoffendingagent
mayoccurs.

26. PATHOPHYSIOLOGY
ed Red cell
mass
Anemia
ed Metabolic rate
ed Gluconeogenesis
glycogenolysis
ed
Aldosterone
ed Adrenal
Secretion
Major Burn O
2need
ed Cateacholamine
Release
H
20 loss
ed Myocardial
depressant
factor
Na
+
Retention Vasoconstriction Hypovolemia
ed Myocardial
insufficiency
K
+
loss ed Renal Flow ed Splenic Flow ed Cardiac
output
ed Glomerular
Filtration rate
Hepatic hypoxia
Tissue
perfusion
Renal failure Liver failure
Acidosis

27. Flow diagram of fluid shifts resulting in hypovolumic shocks:
Thermal Injury
Inflammation
Histamine Release
Vasoconstriction
ed Capillary
Permeability ed Protein leakage
ed B.P.
Fluid leakage
from injury side,
edema
ed
Hypoproteinemia
ed Blood Flow to
Injury
ed Intravascular
fluid
ed Plasma
Osmotic Pressure
Hypovolemic Shock

28. Summary
Sofarwehavediscussedaboutdefinition,
causes,classificationandpathophysiologyof
burn.

29. Bibliography
•Lewis et al, Medical Surgical Nursing, Mosby
Elsevier,7
th
edition.
•Joyce.M.Black et al, Medical Surgical Nursing,
Saunders publication.
•Brunner and Siddhartha, Medical Surgical
Nursing, Lippincott Williams and Wilkins.

30. Thank You