Types of Burns
Superficial Burn
- Damage to epidermis
- Mild to severe redness
- Skin blanches
- Painful w/ tingling sensation
- Cooling helps pain
- No scaring, no blisters, no grafting needed
- Heals in 3-6 days
- E.g. Sunburn
Superficial Partial-Thickness
- Deeper into the dermis,which has ⇓ blood supply
- Pink/red/wet/broken epidermis/weeping surface
- Large blisters
- Blanches w/pressure
- Edema present but it is mild/moderate
- Painful and sensitive to cold/cool air
- Heals in 20 to 21 days. Grafting may be needed if not healing
- E.g. hot liquids, brief contact with flames, or hot objects
Deep Partial Thickness
- Damage extends to dermis
- Red/White
- Moderate edema and pain
- May not blanch
- Soft/dry eschar, No blisters
- Possible scarring/grafting
- Heals in 3-6 weeks
- e.g., flames, scalds, grease, tar, or chemicals
- May convert to full thickness if there is tissue hypoxia, infection or ischemia
Full Thickness Burn
- Damage to epidermis, dermis, and nerve damage
- Dry, hard, leathery eschar (burn crusts or dead tissue)
- Waxy white, deep red, yellow, brown, white (multicolor)
- Severe edema
- ⇓ or absent sensation due to nerve damage
- Pain may not be present
- NO blisters
- Skin grafting/scarring
- Healing time: weeks to months
- Wound contractures if no preventive measures are taken
Deep Full-Thickness
- Down to tendons, muscles, bones
- Area is black and without senssation
- Eschar is hard and inelastic
- Healing takes months
- Grafts are required
- Think black, no edema, no pain
Inhalation Injuries
Smoking Inhalation Injury: Think Airway
- Facial burns
- Swollen oropharynx, nasal pharynx and hoarse voice
- Brassy cough
- Wheezing, stridor, dyspnea, drooling, and difficult swallowing
- Trouble speaking, confusion, & anxiety
- Sooty sputum, nose and mouth
- Singed nasal hairss
Carbon Monoxide Poisoning: colorless, odorless, tasteless
- ⇓ LOC
- Headache
- Nausea, vomiting, vertigo, and tinnutis
- Breathlessness
- “cherry red”/purple skin
- Tachycardia and hypotension
- Confusion, stupor, coma and death
- So Carbon monoxide binds to hemoglobin ⇒ hypoxia. Treatment is 100% oxygen. Put on a 100% non-rebreather mask or 100% FIO2 if ventilated