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Types of Burns

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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