Recently in Burn Severity Category

October 14, 2010

Burn Severity (Part II)

It is important to determine the severity of the burn as this will determine the type of treatment that is necessary and where the burned patient should receive treatment. Minor burns may be treated at home or in a doctor's office. These are defined as first- or second-degree burns covering less than 15 percent of an adult's body or less than 10 percent of a child's body, or a third-degree burn on less than 2 percent BSA. Moderate burns should be treated at a hospital. These are defined as first- or second-degree burns covering 15 percent to 25 percent of an adult's body or 10 percent to 20 percent of a child's body, or a third-degree burn on 2 percent to 10 percent BSA. Critical, or major, burns are the most serious and should be treated in a specialized burn unit. These are defined as first- or second-degree burns covering more than 25 percent of an adult's body or more than 20 percent of a child's body, or a third-degree burn on more than 10 percent BSA. In addition, burns involving the hands, feet, face, eyes, ears, or genitals are considered critical.

NOTE: these are only guidelines. Classification of the type and extent of a burn should be done only by medical professionals. It is best to err on the side of caution and seek medical attention. What you may consider minor may in fact be severe.

This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.

October 13, 2010

Burn Severity (Part I)

A burn is an injury to the tissue; it can be caused by heat, chemicals, electricity, radiation or friction.
Burns can be classified according to the depth of burn: first degree, second degree and third degree burns. It can also be classified into superficial partial thickness which is the first degree, deep partial thickness which is the second degree and the full thickness area which is the third degree burns.
The severity of burn is affected by many factors which are:


  1. The degree (depth) of burned area: first, second and third degree burn.

  2. The total body surface area (percentage) affected: burns are measured as a percentage of the total body surface area affected; one of the ways used is the rule of nines which divides the body into sections of 9 percent. This rule is adjusted for children and infants because they have a larger head and neck surface area and smaller limbs surface area.

  3. Location of burn: there are certain areas in the body that require special care when they are affected, if the face is affected there will be a risk of breathing problems because of swelling and inflammation. If the hands and feet are affected there is a risk of having limitation of movement because of scarring. If the perineum (the area of the body extending from the anus to the genitals) is affected, there is a risk of having contractures (tightening of skin) and infection. Circumferential burn (one that goes around a finger, toe, arm, leg, neck, or chest) is considered more severe than a non circumferential one because it can have a tourniquet effect on circulation or breathing (compress the vessels or airways). Eye burns are also important as they may cause blindness.

  4. The age of the person: toddler aged children have more damage to their skin than similar burns in older children and adults because they have thinner skin.

  5. Associated injuries like fractures or pre-existing medical conditions like heart conditions and immune suppression.

This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.

February 18, 2010

Third Degree Burns (Part I)

A third degree burn is a burn that causes injury to all three layers of the skin (epidermis, dermis and hypodermis). There may also be damage to fat tissue, muscle and bone. It is the most serious type of burn and may result in extensive scarring as well as other injuries and limitations.

Causes:


Clinical features:

  • Black, white, brown or yellow colored skin.

  • Dry and leathery skin.

  • The burned area may not be painful because the nerve endings have been burned and destroyed but the area around the burn may be painful.

  • Swelling.

  • Blister may be present in some areas of the wound.

  • Shock, see clinical features of shock.


This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.

February 17, 2010

Second Degree Burns

A second degree burn is caused by injury to the epidermis which is the first layer of the skin and the dermis which is the second layer of the skin.
Causes:

  • Severe sunburns.

  • Contact with hot liquids.

  • Exposure to flames.

  • Contact with chemicals.

  • Clinical features:

  • Blisters.

  • Deep redness.

  • Swelling.

  • Pain, they are the most painful because nerve endings are intact.

  • Peeling of the skin.

  • Shock because of loss of fluid (see clinical features of shock).

  • Burned area may appear wet and shiny or white.


  • Treatment:
    Second degree burns can be treated at home if they are minor. Moderate and critical burns require treatment in a hospital. You need to seek medical treatment immediately if the burn is greater than 2-3 inches in diameter, if it is on the face, hands, feet, or genitals; or if the burn is caused by an electrical source.

    The goal of treatment for second degree burns is to ease the pain and prevent infection.

    1. Remove any jewelry or clothes from the burned area.
    2. Hold the burn under cool running water for 10-15 minutes or apply cold water compresses like a wet towel.
    3. Don't break blisters because it will increase the risk of infection.
    4. You can apply an antibiotic cream or an aloe based cream then cover the burn with a dry sterile gauze pad.
    5. Use pain reducing medications like Tylenol or Motrin.
    6. If the burn is on the arms or legs, keep them raised to reduce swelling.

    Don't do the following things:

    1. Don't use ice or ice water. (may cause more injury).
    2. Don't remove clothing if it is stuck to the burn (it will remove burned tissue with it).
    3. Don't put grease, ointments, petroleum jelly or home remedies, these substances can hold the heat in and make the burn worse.
    4. Don't use bandages with adhesive material (it will stick to the wound).
    5. Don't give aspirin to a child under the age of 18 years.
    • If there is any change or worsening of the burned area you should see your doctor. These include: puss drainage from the burned area, increased redness, excessive swelling, blister filled with greenish or brownish fluid, fever, swollen lymph nodes, numbness or coolness of the skin beyond the burned area.
    • A second degree burn heals between 10 days to 3 weeks, deep second degree burns may take more than 3 weeks to heal.
    This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.
    February 16, 2010

    First Degree Burns (Part II)

    Prevention:
    Burns of all degrees including first degree can be avoided or decreased by following simple measures, burns caused by scalding with hot water can be prevented by careful handling of hot liquids, turning pot handles on the stove out of the reach of children, check the temperature of the bath water before putting the child in the tub, setting the water heater thermostat no higher than 120°F (49°C), install radiator covers, insulate exposed stem pipes, properly placed and working smoke detectors, children must be taught never to play with matches, lighters, gasoline, never allow children to handle fireworks without adult supervision.

    Sunburns may be prevented by the liberal use of a sunscreen with a SPF of 15 and above, use protective coverings like hats, loose clothing, and umbrellas, avoid spending time in the sun between 10 am and 3 pm when the most damaging ultraviolet rays are present.

    According to the consumer product safety commission, in most adults 5 minutes of exposure to 120 degree hot water causes a third degree burn, 30 seconds of exposure to 130 degree hot water causes a third degree burn, 6 seconds of exposure to 140 degree hot water causes a third degree burn and 2 seconds of exposure to 150 degree hot water causes a third degree burn.

    This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.

    February 15, 2010

    First Degree Burns (Part I)

    A first degree burn is caused due to injury to the epidermis which is the outer first layer of the skin; it involves minimal tissue damage and is the least serious type of burn.
    Causes:


    1. Spending too much time in the sun (sun burn part I, II).

    2. A brief contact with a dry, moist heat or chemicals.

    3. Friction like rubbing the skin (against a rug).


    Hot water, hot beverages and cigarettes are the most common sources of heat that cause first degree burns; it is called a scald when it is caused by hot water of hot steam.

    Symptoms:


    1. Redness.

    2. Swelling.

    3. Pain and sensitivity to touch, pain usually lasts 48 - 72 hours and then subsides.

    4. Peeling of the skin

    5. They don't usually blister or leave scar.

    6. You must watch for signs of infection, such as increased pain, redness, fever, swelling or oozing. If infection develops, seek medical help.


    Treatment:

    First degree burns are minor burns and can be treated at home, the treatment is as follows:


    1. Remove any clothing or jewelry from the burned region.

    2. Hold the burned skin under cool running water for 5 - 10 minutes. Cold compresses can also be used.

    3. You can soothe the area with aloe-vera cream or burn ointment

    4. Place clean and dry sterile gauze around the burned area; wrap the gauze loosely to avoid putting pressure on burned skin.

    5. Use Tylenol, ibuprofen or aspirin to relieve pain.

    6. Call your doctor.


    Things not to do: don't use ice to cool the burn as it can cause further damage the burned skin, don't use bandages that are adhesive as it might adhere to the burned skin, don't apply oils or butter to the burned area as it interferes with healing and can make the burn worse, never give aspirin to children under the age of 18 because of the risk of Reye's syndrome which is a serious illness affecting mostly the liver and the brain. Ask your doctor about children's pain relievers.
    Minor burns usually heal on their own within a week. They may heal with pigment changes.
    For treatment of chemical burns, see chemical burns part I, II.

    This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.