BURN

INTRODUCTION
Burns are tissue damage that results from heat, overexposure to the sun or other radiation, or
chemical or electrical contact. Burns can be minor medical problems or life-threatening
emergencies.

Burns are tissue damage brought on by heat, chemicals, electricity, radiation or the sun. Nearly
half a million Americans seek medical care for accidental burns each year. First-degree burns,
and most second-degree burns, heal with at-home treatments. Third-degree burns can be life-
threatening and require specialized medical care.

CAUSE S OF BURN

Many things can cause a burn. Thermal sources, including fire, hot liquids, steam and contact
with hot surfaces, are the most common causes of burns. Other causes include exposure to:

 Chemicals, such as cement, acids or drain cleaners.

 Radiation.
 Electricity.
 Sun (ultraviolet or UV light).
 PATHOPH7Y6SIOLOGY OF BURN

SIGN& SYMPTOMS OF BURN

Burn symptoms vary depending on the severity or degree of the burn. Symptoms are often worse
during the first few hours or days after the burn. Burn symptoms include:

 Blisters.
 Pain.
 Swelling.
 White or charred (black) skin.
 Peeling skin.

DIAGNOSIS AND TESTS

Healthcare provider will examine the burn to determine the degree or severity. This process
involves estimating the percentage of the body affected by the burn and its depth. Your provider
may classify the burn as:

Minor: First- and second-degree burns that cover less than 10% of the body are
considered minor and rarely require hospitalization.

 Moderate: Second-degree burns that cover about 10% of the body are classified as
moderate. Burns on the hands, feet, face or genitals can range from moderate to severe.
 Severe: Third-degree burns that cover more than 1% of the body are considered severe

RULE OF NINE

When measuring burns in adults, 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.

How to measure burns in adults

You can estimate the body surface area on an adult that has been burned by using multiples of 9.
In an adult who has been burned, the percent of the body involved can be calculated as follows:

 If both legs (18% x 2 = 36%), the groin (1%) and the front chest and abdomen were
burned, this would involve 55% of the body.
 Consumer online tools are not intended to provide professional advice or recommend
particular products.
 Physicians and healthcare professionals should exercise their own clinical judgment when
assessing the results of our tools or calculators.
 Consumers should consult a doctor for advice when assessing the results.

TREATMENT

Most minor burns can be treated at home. They usually heal within a couple of weeks.
For serious burns, after appropriate first aid and wound assessment, your treatment may involve
medications, wound dressings, therapy and surgery. The goals of treatment are to control pain,
remove dead tissue, prevent infection, reduce scarring risk and regain function.

People with severe burns may require treatment at specialized burn centers. They may need skin
grafts to cover large wounds. And they may need emotional support and months of follow-up
care, such as physical therapy.

MEDICAL TREATMENT

After you have received first aid for a major burn, your medical care may include medications
and products that are intended to encourage healing.

 Water-based treatments. Your care team may use techniques such as ultrasound mist
therapy to clean and stimulate the wound tissue.

 Fluids to prevent dehydration. You may need intravenous (IV) fluids to prevent
dehydration and organ failure.

 Pain and anxiety medications. Healing burns can be incredibly painful. You may need
morphine and anti-anxiety medications — particularly for dressing changes.

 Burn creams and ointments. If you are not being transferred to a burn center, your care
team may select from a variety of topical products for wound healing, such as bacitracin
and silver sulfadiazine (Silvadene). These help prevent infection and prepare the wound to
close.

 Dressings. Your care team may also use various specialty wound dressings to prepare the
wound to heal. If you are being transferred to a burn center, your wound will likely be
covered in dry gauze only.

 Drugs that fight infection. If you develop an infection, you may need IV antibiotics.

 Tetanus shot. Your doctor might recommend a tetanus shot after a burn injury.

PHYSICAL AND OCCUPATIONAL THERAPY

If the burned area is large, especially if it covers any joints, you may need physical therapy
exercises. These can help stretch the skin so that the joints can remain flexible. Other types of
exercises can improve muscle strength and coordination. And occupational therapy may help if
you have difficulty doing your normal daily activities.
SURGICAL AND OTHER PROCEDURES

You may need one or more of the following procedures:

 Breathing assistance. If you've been burned on the face or neck, your throat may swell
shut. If that appears likely, your doctor may insert a tube down your windpipe (trachea) to
keep oxygen supplied to your lungs.

 Feeding tube. People with extensive burns or who are undernourished may need
nutritional support. Your doctor may thread a feeding tube through your nose to your
stomach.

 Easing blood flow around the wound. If a burn scab (eschar) goes completely around a
limb, it can tighten and cut off the blood circulation. An eschar that goes completely around
the chest can make it difficult to breathe. Your doctor may cut the eschar to relieve this
pressure.

 Skin grafts. A skin graft is a surgical procedure in which sections of your own healthy skin
are used to replace the scar tissue caused by deep burns. Donor skin from deceased donors
or pigs can be used as a temporary solution.

 Plastic surgery. Plastic surgery (reconstruction) can improve the appearance of burn scars
and increase the flexibility of joints affected by scarring.

COMPLICATIONS OF BURNS

Third-degree burns that are deep and affect a large portion of skin are very serious and can be
life-threatening. Even first- and second-degree burns can become infected and cause
discoloration and scarring. First-degree burns don’t cause scarring.

Potential complications of third-degree burns include:

 Arrhythmia, or heart rhythm disturbances, caused by an electrical burn.

 Dehydration.
 Disfiguring scars and contractures.
 Edema (excess fluid and swelling in tissues).
 Organ failure.
 Pneumonia.
 Seriously low blood pressure (hypotension) that may lead to shock.
 Severe infection that may lead to amputation or sepsis
PREVENTION OF BURN

Burns have many accidental causes. You can take these steps to reduce the risk of burns:

 Wear sunscreen.
 Set your home’s hot water heater below 120 degrees Fahrenheit.
 Always test the water in a shower or bath before getting in or bathing a child.
 Lock up chemicals, lighters and matches.
 Use the stove’s back burners as much as possible when cooking, turn handles of pots and
pans where they won’t be bumped and don’t leave the stove unattended.
 Don’t hold a child when you’re near hot objects, such as the stove.
 Set safeguards around a fireplace and never leave a child unattended.
 Install and regularly test smoke detectors in your home.
 Stock your home with fire extinguishers and know how to use them.
 Cover electrical outlets

LIFESTYLE AND HOME REMEDIES

To treat minor burns, follow these steps:

 Cool the burn. Hold the burned area under cool (not cold) running water or apply a cool,
wet compress until the pain eases. Don't use ice. Putting ice directly on a burn can cause
further damage to the tissue.

 Remove rings or other tight items. Try to do this quickly and gently, before the burned
area swells.

 Don't break blisters. Fluid-filled blisters protect against infection. If a blister breaks, clean
the area with water (mild soap is optional). Apply an antibiotic ointment. But if a rash
appears, stop using the ointment.

 Apply lotion. Once a burn is completely cooled, apply a lotion, such as one that contains
aloe vera or a moisturizer. This helps prevent drying and provides relief.

 Bandage the burn. Cover the burn with a sterile gauze bandage (not fluffy cotton). Wrap it
loosely to avoid putting pressure on burned skin. Bandaging keeps air off the area, reduces
pain and protects blistered skin.

 Take a pain reliever. Over-the-counter medications, such as ibuprofen (Advil, Motrin IB,
others), naproxen sodium (Aleve) or acetaminophen (Tylenol, others), can help relieve
pain.
 Consider a tetanus shot. Make sure that your tetanus booster is up to date. Doctors
recommend that people get a tetanus shot at least every 10 years.