Transcript BURNS - INHS Health Training

BURNS
Russ Armstrong, EMT-I, Fire Prevention Officer,
Stevens County Fire Protection District #1
BLS, ILS, ALS
OTEP
• While we do understand this presentation is an
instructional tool for all levels of certification,
taking this into consideration everyone taking
this class must remember that they can only
practice at their level of certification NOT by their
level of instruction.
• YOU CAN ONLY PRACTICE AT THE LEVEL
YOU HAVE BEEN CERTIFIED.
BURN INTRODUCTION
• A burn is an injury caused by extremes of
temperature, electric current, or certain
chemicals.
• In this session we will learn how to
determine percentage and severity of
burns, proper treatment, and delivery to
the appropriate medical facility.
TYPES OF BURNS
• Focus on the treatment of life-threatening
injuries even though burn may consume
attention.
• Three types of Burns
– Superficial (1ST degree)
– Partial thickness (2nd degree)
– Full thickness (3rd degree)
SUPERFICIAL (1ST DEGREE)
Superficial (1st degree) – involves only the
upper layers of the epidermis and dermis.
It is an irritation of the living cells in this
region and results in some pain, minor
edema, and erythema.
SUPERFICIAL AND PARTIAL
THICKNESS (1ST & 2ND DEGREE)
PARTIAL THICKNESS BURN
(2ND DEGREE)
•
•
•
•
Epidermis and Dermis
No other underlying tissue
Intense pain
Skin may appear white or red, moist or
mottled
• Blisters usually
PARTIAL THICKNESS BURN
FULL THICKNESS (3RD
DEGREE)
• Through all dermal layers
• SQ tissue, muscle, bone, and/or organs
involved.
• Nerves have been burnt away.
– Thus no pain
– However, there may be extreme pain where
full thickness and partial thickness interface.
Third Degree Burn
Text
Text
Tex
t
Text
Text
CLASSIFICATION OF BURNS
• Thermal Burns – caused by exposure to
excessive heat.
• Electrical Burns – caused by direct
contact with electricity.
• Chemical Burns – caused by contact with
chemicals.
THERMAL BURN INJURY
ELECTRICAL BURN INJURY
CHEMICAL BURN INJURY
RULE OF NINES
• System used to estimate the percentage
of body surface involved in a burn injury
• To estimate the severity of the burn
• To “paint” a picture in the mind of the M.D.
MINOR BURNS
• <15% of BSA
• No complications or involvement of hands,
face, feet, or perineum.
• No evidence of inhalation burns,
associated injury, or severe preexisting
medical problem.
MODERATE BURNS
• 15-25% of BSA
• No complications or involvement of the
face, hands, feet or perineum.
• No evidence of inhalation burns,
associated injury, or severe preexisting
medical problem.
MAJOR BURNS
• 25% or greater of BSA burns
• A functionally significant involvement of
hands, face, feet, or perineum.
PATIENT ASSESSMENT
• Rule out possible c-spine involvement.
• Determine level of consciousness.
• ABC’s
AIRWAY ASSESSMENT
• Airway – look for signs of inhalation injury.
Soot around mouth and nose. Black
mucus from mouth. Visible burns around
nose and mouth.
INHALATION INJURY
BREATHING ASSESSMENT
• Breathing – Make sure patient is
breathing adequately and give
supplemental oxygen via nonrebreather
mask.
• Auscultate lung sounds
CIRCULATION ASSESSMENT
• Circulation – Check carotid pulse, and
pulses below injury site.
• Perform head to toe assessment and treat
all burns appropriately.
BURN TREATMENT
•
•
•
•
•
Be concerned for the airway (tube early)
High flow O2
Monitor
IV’s (Burns need fluid replacement)
Medicate for pain control (if available)
BURN TREATMENT (CONT.)
• Keep the patient warm.
• Treat any other injuries.
• Transport to appropriate facility while
monitoring vital signs and airway.
PARKLAND BURN FORMULA
• Formula to calculate the volume of fluid
necessary for fluid replacement
• Adult
• 4ml x (% of BSA 2nd or 3rd burns) x kg
2
• = fluid replacement for first 8 hours after
insult.
Test Answers
1. The three classifications of burn severity include all of
the following, except:
a. Minor
b. Eschar
c. Severe
d. Moderate
2. During the __________phase of a burn injury there is a
release of vasoactive substances from the burned
tissues causing wound edema, fluid loss and
hypovolemia.
a. Fluid shift.
b. Release of catecholamines.
c. Compensation.
3. Which of the following signs or symptoms may
indicate that a patient has an inhalation injury:
–
–
–
–
Stridor.
Singed nasal hairs.
Inspiratory wheezing.
All of the above.
4. The cause of death from electricity can be
attributed to all the following, except.
– The electrical effect on the heart.
– Scar tissue formation.
– Massive muscle destruction from the current passing
through the body.
– Thermal burns from contact with the electrical source.
5. The “rule of nines” is a method of determining
a. Body surface burned.
b. Severity of the burn.
c. Classification of the burn.
d. Type and degree of the burn.
6. Which of the following is not a classification of a
burn injury?
a. Superfical.
b. Deep fascia
d. Partial-thickness.
e. Full-thickness.
7. The Parkland formula is used by many burn
centers to _____________ for the burn patient.
a.
b.
c.
d.
Measure scar formation.
Determine the time of healing.
Determine fluid replacement.
Measure circulatory compromise.
8. All of the following should be considered in the
treatment of a burn patient, except.
a.
b.
c.
d.
Cool the patient with cold water.
High flow O2.
Replace fluids with IV’s.
Transport to appropriate facility.
9. At what percent of BSA burned would be
considered a Major or Severe burn.
a.
b.
c.
d.
30%
25%
35%
All of the above.
10. Burns are the leading cause of trauma in the
___________age group.
a.
b.
c.
d.
Newborn.
Toddler and preschool.
Teenage.
Elderly.
Contact
• Renee Anderson
1-509-232-8155 Phone
1-509-232-8344 Fax
[email protected]
Russ Armstrong: [email protected]