BURNS

• BURNS -Tissue injury caused by excessive heat (greater than 40 C)  Second greatest cause of unintentional injury in children 1 to 4 years of age  Can be caused by child abuse
• Superficial - 1st degree (Superficial burn)  Involves the epidermis  Characterized by reddening  Tenderness and Pain  Increased warmth  Edema may occur, but no blistering  Burn blanches under pressure Example - sunburn  Usually heal in ~ 7 days
• Treating First Degree Burn - Running cool (not cold) water over the burned area. If water is not available, any cold, drinkable liquid will do
• Treating First Degree Burn -A cold, clean compress can also be held over the burned area for three to five minutes.
• NOT TO DO IN 1ST DEGREE BURN - X Do not use ice because it could damage the affected area and cause thehealing time to be longer. X Do not apply butter, grease or powder to the burn area to prevent therisksof infection.
• Treating First Degree Burn-If the burned area is small, it can be loosely covered with a sterile gauzepador bandage
• Treating First Degree Burn-Children can be given acetaminophen or ibuprofen for pain as prescribed.
•  Treating First Degree Burn - Always keep the affected clean to prevent the risk for infection.
• MEDS FOR 1ST DEGREE BURN - acetaminophen or ibuprofen for pain
• Partial thickness - 2nd degree burn  Damage extends through the epidermis and involves the dermis.  Not enough to interfere with regeneration of the epithelium  Moist, shiny appearance  Salmon pink to red color  Painful  Does not have to blister to be 2nd degree  Usually heal in ~7-21 days
• Full thickness - 3 rd Degree burn  Both epidermis and dermis are destroyed with burning into SQ fat  Thick, dry appearance  Pearly gray or charred black color  Painless - nerve endings are destroyed  Pain is due to intermixing of 2nd degree  May be minor bleeding  Cannot heal and require grafting
• Treating Second and Third Degree Burns - Keep the child lying down with the burned area elevated. - The instructions for treating first degree burns should be followed in this situation also.
• Treating Second and Third Degree Burns - Remove all jewelry and clothing from around the burn (in case there'sany swelling after the injury), except for clothing that's stuck totheskin.
• Treating Second and Third Degree Burns -Clothing may need to be cut off. - Do not break any blisters.
• Treating Second and Third Degree Burns- Apply cool water over the area for at least 3 to 5 minutes, thencoverthe area with a clean white cloth or sheet until help arrives.
• For critically injured: - Fluid therapy - Systemic antibiotic therapy - Pain management - Physical therapy
• Palm Method - used to estimate percentage of scattered burns, using the size of the patient’s palm (about 1% of body surface area) to assess the extent of burn injury
• RULE OF NINE - the body surface is divided into areas representing 9% or multiplies
• preventing burns - Thermostats on hot water heaters should be set at 120° Fahrenheit or lower. A child’s bath water should not be set at higher than 100° Fahrenheit
• 2nd preventing burns - Children should be supervised around water faucets, as they could turn theseonand burn themselves
• 3rd Preventing - Burns Avoid spills by not drinking hot liquids while holding a child. Pan handles should be turned inward on the stove. Tablecloths should be avoided with toddlers, as they could pull on them and drop hot food on themselves.
• 5th Preventing Burns- Keep hot objects such irons and curling irons unplugged when not in use. Makesure electrical cords are not accessible to little hands.
• Nursing Management of Burn Injuries- Monitor fluid intake (IV fluids) and output (urinary catheter) andmeasurehourly. Note amount of urine obtained when catheter is inserted(indicates pre burn renal function and fluid status).
• Nursing Management of Burn Injuries- Continue to assess the extent of the burn; assess depth of wound, and identify areas of full and partial thickness injury
• Nursing Management of Burn Injuries - Check peripheral pulses on burned extremities hourly; use Doppler as needed.