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Out Patient Care of Burns (Part II)

Patients with small partial thickness burns can be treated as outpatients. Adults with less than 15% body surface area (BSA) partial thickness burns and children with less then 10% body surface area partial thickness burns can be candidates for outpatient treatment.

Treatment:
A- Emergency treatment:

  • The first thing to do to minimize the injury is removing the person from the source of heat and remove any burned or tight clothes, jewelry and any plastic coverings that may retain heat causing deeper injury.
  • Run cool (not cold) water over the burned areafor at least 15 minutes.Aviod using ice, butter or other types of grease as it may cause more damage.
  • For chemical burns, if the chemical that caused the burn is dry then it should be brushed off the skin by a person wearing gloves. If the chemical is wet, it should be flushed the affected area with cool running water for at least 20 minutes. You have to call the poison control center specially if the chemical substance was swallowed then call 911.
  • Tetnas prophylaxis is only indicated when the burned patient is a child and he/she is not up to date with the immunization schedule or if the burned patient is an adult whose last tetnus immunization was more than 10 years ago.

B- Non Emergent Treatment:

  • Use soap and water to clean the wound
  • Don’t open blister, leave them intact as opening the blisters may lead to infection
  • If the burn is on the face, apply bacitracin, neomycin or other similar agents. Protect the affected area of the face from the exposure to sun.
  • If the burns are on the trunk and/or extremities, apply 1% silver sulfadiazine or other iodine creams and cover the area with a clean dressing. The patinet and the family should be given instructions on how clean and care for the wound.
  • Follow up outpatient appointments should be scheduled for the patient to follow up the healing process.
  • Pain relief medications such as acetaminophen and anti-itching medications such as benadryl are given to the patient with teaching on how to use the medicine. Pain medicine should be taken approximately 30 minutes before dressing change. Emolient cream shoud be used once the burn wound is heald to lubricate the area, decrease itching and protect the skin.
  • Burned areas should be protected from sun exposure by using protective clothes and sun screens for at least one year after healing, also avoid going out in the sun peak hours. Patients should also be instructed about the importance of balanced nutrition and wound healing
  • (see also how to care for your burn following hospital discharge)

Infection Prevention:

  • Patients and their families when discharged home should be tought and given written instructions on how to do home wound care and dressing change in an asepic technique.
  • Hand wash both bofore and after wound care is an important step in decreasing the incidance of infection. Places where wound care is done should be cleaned before and after they have been used.
  • Patients and their families should be tought the sings and symptoms of wound infection including fever, increased pain and/or tenderness, increased redness, increased swelling, increased warmth in the area around the wound, bad odor drainage from the wound, wound dehiscence (opening of the edges of the wound)

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.