BURNS

Involves heat coming in contact with our body causing invasion on our bodily integrity.

Causes: Stages Degrees

1. Thermal I. Period of Shock/Emergent Phase I. First Degree Burn
 Hot objects or liquid  Day 1,2  Epidermis
 Init Tubig  Patient at risk for severe dehydration  Red
 Kayo, Flames, Fire  Fluid from intravascular compartment/IVC will shift towards  (+) pain
 Hot Coffee the interstitial compartment/ISC  SFB / Superficial Burn
2. Chemical (strong acids or  Dehydration/Fluid Volume Deficit (FVD) II. Second Degree Burn
strong alkalines)  Hemoconcentration / Hct ↑  Epidermis
 Acetic Acid  Period of Oliguria  Dermis
 Muriatic Acid  ↑ K+ / Hyperkalemia  Red + Blisters
 Things used to make  ↓ Na / Hyponatremia  (+) pain
batteries II. Diuretic Phase  PTB / Partial Thickness
 Sulod sa transformer  Day 3,4 Burn
3. Electricity  Fluid from ISC will return to IVC III. Third Degree Burn
 Electrical current  The shifting of fluid from ISC to IVC can lean to Cardiac Overload  Epidermis
 Lightning  Hct ↓ / Hemodilution  Dermis
4. Radiation  Diuresis  Subcutaneous Fats
 Exposure to sunlight /  ↓ K+ / Hypokalemia (SQF)/Muscle
Sunburn (most common)  ↓ Na / Hyponatremia  Leathery
 Time most III. Recovery Phase  Black
harmful to sun  Day 5  (-) pain
exposure: 10am –  ↓ Ca / Hypocalcemia (because the calcium inside the body will  FTB / Full Thickness Burn
3pm be used to create scars)
 Burns caused by  With hypocalcemia patient will manifest Chvostek's sign (facial
chemotherapy spasm) and Trousseau's sign (carpopedal spasm)
 Promote ↑ Protein diet
Management PARKLAND FORMULA
I. STOP the burning process  50% - for first 8 Hrs
 Cool water  25% - for next 8 Hrs
 Stop, Drop, Roll  25% - for next 8 Hrs
 Blanket (wet)  100% in 24 Hrs
 Fire Extinguisher (PASS)
Pull, Aim, Squeeze, Swipe side to side PARKLAND FORMULA
II. Fluid and Electrolyte replacement 4ml X %TBSA X kg(weight)
 ISOTONIC [P, 0.9%]  To determine %TBSA we use Rule of 9
 SHOCK [↓ BP, ↑ HR, ↑ RR]  11 parts of the body = 9% = total of 99% + 1% sex organ
III. PAIN 1. Head = 9%
 DOC: Morphine Sulfate 2. Right Arm = 9%
 WOF: Respiratory Depression 3. Left Arm = 9%
 Antidote: Naloxone (Narcan) 4. Upper Chest = 9%
 Bed Cradle 5. Lower Abdomen = 9%
6. Upper Back = 9%
 Avoid Drafts
7. Lower Back = 9%
8. Right Upper Leg = 9%
9. Right Lower Leg = 9%
10. Left Upper Leg = 9%
11. Left Lower Leg = 9%