Subject is Medical Surgical Nursing - II & Topic is Burn, Presented by Mohammed Haroon Rashid Basci B.Sc Nursing 3rd Year in Florence College of Nursing

1. BURN

2. INTRODUCTION OF BURN
 A burn is a type of injury to skin ot other tissue caused
by heat, cold, electricity, chemical, friction and
radiation.
 Most burn are due to heat from hot liquid solid or fire.
 Burn are common and serious childhood or adulthood
injury.
 The incidence of burn injury varies greatly between
culture.

3. INTRODUCTION OF BURN
 A scald is a burn caused by contact with a hot liquid or
steam.
 Most burn only affect the skin ( Dermis)
 Managing burns is important because they are
common, painful and can result in disfiguring and
disabling scarring.
 Burn injuries can be complicated by infection, multiple
organ dysfunction syndrome electrolyte imbalance and
respiratory distress.

4. According to “ Parul
Datta”
Burn is a condition in
which the damage to the
skin and other part of the
skin caused by extreme
heat, contact with heated
object and chemical,
radiation is known as
burn.

5. According to “ Op
Ghai”
A burn is a injury to the
skin or other organic
tissue caused by heat
or due to radiation,
chemical, electricity or
other type of
etiological factor.

6. INCIDENCE
Burn are the global public health
problem accounting for estimated
180000 death annually.
The incidence or burn increased
during diwali festival in winter
season. The children are high risk
for burn.

7. ANATOMY AND PHYSIOLOGY
OF SKIN

8. CLASSIFICATION OF
BURN
• The burn classification
devided into two categories
:-
I. Body surface area injury
II. Depth of injury

9. BODY SURFACE INJURY
• First-degree burns
are considered mild
compared to other
burns. They result in
pain and reddness of
the epidermis (outer
layer of the skin).

10. BODY SURFACE INJURY
• Second-degree burns
(partial thickness burns)
affect the epidermis and
the dermis (lower layer
of skin). They cause
pain, redness, swelling,
and blistering.

11. BODY SURFACE INJURY
• Third-degree burns
Third-degree burns
destroy the epidermis
and dermis and may go
into the subcutaneous
tissue. The burn site
may appear white or
charred.

12. BODY SURFACE INJURY
• Fourth degree burns.
Fourth degree burns
also damage the
underlying bones,
muscles, and
tendons. There is no
sensation in the area
since the nerve
endings are
destroyed.

13. DEPTH OF INJURY
• SUPERFICIAL
PARTIAL THICKNESS
A first-degree burn is
also called a superficial
burnor wound. It's an
injury that affects the first
layer of your skin. First-
degree burns are one of
the mildest forms of skin
injuries, and they usually
don't require medical
treatment.

14. DEPTH OF INJURY
• FULL PARTIAL
THICKNESS
A partial thickness burn (a
lso known as a second
degree burn) is a burn that
affects the top two layers of
skin, called the epidermis
and hypodermis Partial
thickness burns can
continue to change over
time and can evolve to
a full thicknessburn (or
third degree burn), even
after initial treatment.

15. DEPTH OF INJURY
• DEEP PARTIAL
THICKNESS
A burn is an injury to the
tissue of the body,
typically the skin. Burns
can vary in severity from
mild to life-threatening.
Most burns only affect the
uppermost layers of skin,
but depending on the
depth of the burn,
underlying tissues can
also be affected.

16. METHOD OF ESTIMATION OF TBSA
 RULES OF NINE
 LUND BROWDER CLASSIFICATION
 PALM METHOD

17. RULES OF NINE
 The rule of nines assesses the
percentage of burn and is used
to help guide treatment decisions
including fluid resuscitation and
becomes part of the guidelines
to determine transfer to a burn
unit.

18. RULES OF NINE

19. LUND BROWDER METHOD
 a method for estimating the extent of burns t
hat allows for the varying proportion of body
surface in persons of different ages.It is use
d instead of the RULE OF
NINES for children, in whom the head occupi
es a larger area and the lower limbs a small
erarea than in adults. See illustration.

20. LUND BROWDER METHOD

21. PALM METHOD
 The "rule of palm" is another way to
estimate the size of a burn. The palm of the
person who is burned (not fingers or wrist
area) is about 1% of the body. Use the
person's palm to measure the body surface
area burned. It can be hard to estimate the
size of a burn.

22. PALM METHOD

23. CAUSES OF BURN
ELECTRICITY BURN
An electrical burn is a burn that results
from electricity passing through the body
causing rapid injury. Approximately 1,000
deaths per year due to electrical injuries
are reported in the United States,
Electrical burns or injuries are classified
as high voltage (greater than or equal to
1000 volts), low voltage (less than
1000 volts), or as flash burns secondary
to an electric arc.[1] The most common
causes of electrical burns in children are
electrical cords (60%) followed by
electrical outlets (14%).[2] Lightning may
also result in electrical burns

24. CAUSES OF BURN
CHEMICAL BURN
A chemical burn is
irritation and destruction of
human tissue caused by
exposure to a chemical,
usually by direct contact
with the chemical or its
fumes. Chemical burnscan
occur in the home, at work
or school, or as a result of
accident or assault.

25. CAUSES OF BURN
THERMAL BURN
A thermal burn is a type
of burn resulting from making
contact with heated objects,
such as boiling water, steam,
hot cooking oil, fire, and hot
objects. Scalds are the most
common type of thermal
burn suffered by children, but
for adults thermal burns are
most commonly caused by fire.

26. CAUSES OF BURN
RADIATION BURN
A radiation burn is damage to
the skin or other biological tissue as
an effect of radiation. The radiation
types of greatest concern
are thermal radiation, radio
frequency energy, ultraviolet
light and ionizing radiation.
High exposure to X-rays during
diagnostic medical
imaging or radiotherapy can also
result in radiation burns

27. CAUSES OF BURN
NON ACCIDENTAL BURN
In those hospitalized from scalds or
fire burns, 3–10% are from
assault.[35] Reasons include: child
abuse, personal disputes, spousal
abuse, elder abuse, and business
disputes.[35]An immersion injury or
immersion scald may indicate child
abuse.

28. PATHOPHYSIOLOGY
Due to etiological Factor like a burn, electricity etc
Vessels start parmeable
Fluid plasma leak out on to the interstial space
Fluid plasma accumulate
Result, Edema

29. PATHOPHYSIOLOGY
Fluid and blood is losses from vessel
The blood are very concentrated
Reduced blood flow to the vital organ like a GI tract and
kidney
Lead to Kidney failure
To componsate normal function of cardiac output

30. PATHOPHYSIOLOGY
Ischemia of brain, kidney and vital organ
Lead to burn

31.  AIRWAY OBSTRUCTION
An airway obstruction is
a blockage in any part of
the airway. The airway is a
complex system of tubes that
conveys inhaled air from your
nose and mouth into your
lungs. An obstruction may
partially or totally prevent air
from getting into your lungs.

32.  RAPID PULSE RATE
Atrial or Supraventricular
tachycardia (SVT) is a fast
heart rate that starts in the
upper chambers of the
heart. Some forms are called
paroxysmal atrial
tachycardia (PAT) or
paroxysmal supraventricular
tachycardia (PSVT).

33.  ABNORMALVOICE
CHANGE
Hoarseness (abnormal voice
changes) Hoarseness is a
condition in which the pitch or
quality of the voice changes.
The voice may sound weak,
breathy, raspy, scratchy or
husky. Many health conditions
can cause hoarseness.

34. RESTLESSNESS
 Restlessness means
unable to be quiet or
calm. It can be either
physically or mentally. It
is one of the common
symptom of anxiety.

35. DECREASE URINE
OUTPUE
Oliguria is the medical term for
a decreased output of urine.
Oliguria is considered to be
a urinary output of less than
400 milliliters, which is less than
about 13.5 ounces, over the
course of 24 hours. The absence
of urine is known as anuria

36. UNCONSCIOUSNESS
Unconsciousness is a state
which occurs when the
ability to maintain an
awareness of self and
environment is lost. It
involves a complete or near-
complete lack of
responsiveness to people
and other environmental
stimuli.

37.  RAPID BREATHING
The average person takes
between 12 to 20 breaths
per minute. Rapid,
shallowbreathing, also
called tachypnea, occurs
when you take more breaths
than normal in a given
minute

38.  EDEMA
Edema (or Oedema) is the
abnormal accumulation of
fluid in certain tissues
within the body. The
accumulation of fluid may
be under the skin - usually
in dependent areas such as
the legs (peripheraledema,
or ankle edema), or it may
accumulate in the lungs
(pulmonary edema).

39.  POOR MUSCLETONE
A child is said to have
low muscle tone —
hypotonia — if
his muscles are on the loose,
floppy side. You may find it
unusually easy to move your
child's arms and legs when
they are relaxed, or that he
seems to slip through your
arms when you pick him up.

40. • HISTORY TAKING
Taking a patient history:
the role of
the nurse. History
taking is a key
component of patient
assessment, enabling the
delivery of high-quality
care. Understanding the
complexity and processes
involved in history
taking allows nurses to
gain a better
understanding of patients'

41. • ASSESSMENT OF
BURN AREA
Severity of Burn Injury. To
determine the severity of
a burn injury, assess bot
h the TBSA burned and
the depth of
the burn injury.
... Burn depth is used
to assess theburned pati
ent's need for
hospitalization, the need
for surgical intervention,
as well as the probability
of scar development after
the wound heals

42. • COMPLETE BLODD
COUNT
A complete blood count,
or CBC, is an easy and
very common test that
screens for certain
disorders that can affect
your health.
A CBC determines if there
are any increases or
decreases in your blood
cell counts.

43. • ABGS TEST
The blood gas test can
determine how well your
lungs
are able to move oxygen
into the blood and remove
carbon dioxide from the
blood. Imbalances in the
oxygen, carbon dioxide,
and pH levels of your
blood can indicate the
presence of certain
medical conditions.

44. • CHEST X RAY
An X-ray is an
imaging test that uses
small amounts of radiation
to produce pictures of the
organs, tissues, and bones
of the body. When focused
on the chest, it can help
spot abnormalities or
diseases of the airways,
blood vessels, bones,
heart, and lungs

45. MANAGEMENT OF BURN
PATIENT
 MEDICAL MANGAGEMENT
 SURGICAL MANAGEMENT
 PHARMACOLOGICAL
MANAGEMENT
 NURSING MANAGEMENT

46. MEDICAL MANAGEMENT OF BURN
PATIENT
•FIRST AID

47. MEDICAL MANAGEMENT OF
BURN PATIENT
• AIRWAY BREATHING AND CIRCULATION

48. MEDICAL MANAGEMENT OF
BURN PATIENT
•IV FLUID THERAPY

49. MEDICAL MANAGEMENT OF BURN
PATIENT
•WOUND CLEANING

50.  SKIN GRAFT
 PLASTIC SURGERY
 AMPUTATION AND RECONTRUCTIVE SURGERY

51. SKIN GRAFT
Skin grafting is a type
of graft
surgery involving the
transplantation of skin.
The transplanted tissue
is called a skin
graft. Skin grafting is
often used to treat:
Extensive wounding or
trauma. Burns.

52. • DEBRIDEMENT ∙ CLEANING
THE WOUND
Patients with serious burn injuries
will undergo a surgical procedure
called debridement before any
other surgeries are
contemplated. Debridement
involves cleaning the entire burn
area and removing dead or
infected skin cells and
vascularized bone. Debridement
is an essential procedure in the
beginning of a burn patient’s

53. • DERMABRASION ∙ SURGICAL
SKIN PLANNING
• This surgical technique has been
around for more than 100 years.
Dermabrasion uses either a laser or
a sterile wire brush or diamond
wheel to remove raised scars. A
scar can never be erased, but its
appearance can be changed.
Dermabrasion is an extremely
useful tool to lessen the
appearance of scars from a burn
injury. Dermabrasion will be
performed on an in-patient or out-

54. PLASTIC SURGERY
the process of reconstructing or
repairing parts of the body by the
transfer of tissue, either in the
treatment of injury or for cosmetic
reasons. A surgical specialty that
is dedicated to reconstruction of
facial and body defects due to
birth disorders, trauma, burns,
and disease. Plastic surgery is
also involved with the
enhancement of the appearance
of a person through cosmetic

55. DERMABRASION SURGICAL
SKIN
Dermabrasion is a surgical
procedure involving the
removal (sanding) of the
damaged top layer of the skin
using a specialized instrument
called a dermabrader. This
procedure is used for scars as
well as other skin conditions
such as wrinkles and tattoos.

56.  TABLET - Amoxyclave 625mg
 IV FLUID - RL 1000 ML
 TABLET – Dynapar 100mg
 Tablet – Gentamycin
 Oint – Silver supherdiazene

57.  RISK FOR INFECTION RELATED TO LOSS OF
SKIN IMPAIRMENT IMMUNE RESPONSE AND
INVASIVE THE RAPIES.
 ACUTE PAIN RELATED TO BURN TRAUMA
 DEFICIENT FLUID VOLUME RELATED TO LOSS
OF FLUID FROM INJURY SKIN

58. COMPLICATION
• Infection. Burns can leave
skin vulnerable to bacterial
infection and increase your
risk of sepsis. Sepsis is a life-
threatening infection that
travels through the
bloodstream and affects your
whole body. It progresses
rapidly and can cause shock
and organ failure.

59. COMPLICATION
• Low blood volume. Burns
can damage blood vessels and
cause fluid loss. This may
result in low blood volume
(hypovolemia). Severe blood
and fluid loss prevents the
heart from pumping enough
blood to the body

60. COMPLICATION
• Dangerously low body
temperature. The skin helps
control the body's temperature,
so when a large portion of the
skin is injured, you lose body
heat. This increases your risk
of a dangerously low body
temperature (hypothermia).
Hypothermia is a condition in
which the body loses heat
faster than it can produce heat.

61. COMPLICATION
• Breathing
problems. Breathing hot
air or smoke can burn
airways and cause
breathing (respiratory)
difficulties. Smoke
inhalation damages the
lungs and can cause
respiratory failure

62. COMPLICATION
• Scarring. Burns can
cause scars and ridged
areas caused by an
overgrowth of scar
tissue (keloids)

63. COMPLICATION
• Bone and joint
problems. Deep burns
can limit movement of
the bones and joints. Scar
tissue can form and cause
shortening and tightening
of skin, muscles or
tendons (contractures).
This condition may
permanently pull joints
out of position

64. HEALTH EDUCATION