Types of Burns

• Thermal• Chemical• Electrical• Energy (laser, welding,uv,

radiotherapy etc.

• The most important function of the skin is to act as a barrier against infection. The skin prevents loss of body fluids, thus preventing dehydration.

• When the skin is burned, these functions are impaired or lost completely.

• Because of the importance of the skin, it becomes clear that injury can be traumatic and life threatening.

The skin, the largest organ of the body, consists of two layers-the epidermis and dermis. The depth or degree of burn depends on which layers of skin are damaged or destroyed. The epidermis is the outer layer that forms the protective covering. The thicker or inner layer of the dermis contains blood vessels, hair follicles, nerve endings, sweat and sebaceous glands. When the dermis is destroyed, so are the nerve endings that allow a person to feel pain, temperature, and tactile sensation.

قانون: • 9وسعتو • پذیرش زمان دست ساعت 72کف

بعدبراودر • الندو• - - - اسیب: سطح سوختگی عمق سن شدت

ناحیه- استنشاقی

• - نسبی: ضخامت سطحی نسبی ضخامت عمقضخامت- تمام عمیق

Body Surface Area Estimation

• Rule of Nines– Adult

• Palm Rule

Body Surface Area Estimation

• Rule of Nines– Peds

• For each yr over 1 yoa, subtract 1% from head and add equally to legs

• Palm Rule

Critical Burn Criteria

• 30 > 10% BSA• 20 > 30% BSA

– >20% pediatric• Burns with respiratory injury• Hands, face, feet, or genitalia• Burns complicated by other trauma• Underlying health problems• Electrical and deep chemical burns

Depth Classification

• Superficial• Partial thickness• Full thickness

Classification of Burn Depth“Second-Degree”

• Second-degree• Involves:• Entire epidermal layer• Part of underlying

dermis• Mottled and red, painful,

swelling and blisters

• Healing in 10 to 21 days

Cause: Hot Water Scald

Burn Injuries

• Often it is not possible to predict the exact depth of a burn in the acute phase. Some 2nd degree burns will convert to 3rd when infection sets in. When in doubt call it 3rd degree.

1. First degree burn: affects only the epidermis

2. Second degree burn: affects epidermis and upper part of the dermis

3. 3rd degree burn: affects epidermis, all of the dermis and into the tissue below

4. 4th degree burn: affects the same area as 3rd degree and continues down to muscle

Thermal Burn Injury Pathophysiology

• موضعی 20سوختگی > پاسخ بدن ٪سطح• موضعی 20سوختگی< پاسخ بدن ٪سطح

• عمومی پاسخ

عمومی پاسخهای

• Cardiovascular• Fluid&electrolites change• Pholmunary chang• Kidney change• Immunologic change• Termoregulation change• Entero gasteric change