Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Download BURNS - SilverCross EMS
Transcript
BURNS SILVER CROSS EMS SYSTEM EMD CE NOVEMBER 2012 Burns Account for over 10,000 deaths a year Among the most serious and painful of all injuries A burn occurs when the body receives more radiant energy than it can absorb. Sources of this energy include heat, toxic chemicals, and electricity. Burns The skin serves as a barrier that prevents foreign substances from entering the body. The skin helps regulate body temperature and acts as a sense organ. It also prevents loss of body fluids. When the skin is damaged, it can no longer perform these essential functions. Any break in the skin allows bacteria to enter and raises the possibilities of: Infection Fluid loss Loss of temperature control The Anatomy and Physiology of the Skin Skin varies in thickness. Thinner in the very young and very old Thinner on the eyelids, lips, and ears than on the scalp, back, soles of feet Thin skin is more easily damaged than thick skin. Skin has two principal layers: the epidermis and the dermis. Epidermis is the tough, external layer Dead skin and pigment Watertight, protects Dermis is the inner layer. Blood vessels, nerves, hair follicles, sweat glands, sebaceous glands The Anatomy and Physiology of the Skin The Anatomy and Physiology of the Skin Skin covers all the external surfaces of the body. Bodily openings are lined with mucous membranes. Mucous membranes secrete a watery substance that lubricates the openings. These are wet, whereas skin is dry. Burn Depth Superficial burns (first- degree burns) Reddened and painful skin The injury is confined to the outermost layers of the skin. The patient experiences minor to moderate pain. © Amy Walters/ShutterStock, Inc. Burn Depth Partial-thickness burns (second-degree burns) Do not damage the deepest layers of the skin Blistering Fluid loss and moderate to severe pain Usually heal within 2 to 3 weeks © E. M. Singletary, M.D. Used with permission. Burn Depth Full-thickness burns (third- degree burns) Damage all layers of the skin Pain is absent because the nerve endings have been destroyed. Patients lose large quantities of body fluids and are susceptible to shock and infection. Extent of Burns (BSA) Rule of nines Method for determining what percentage of the body has been burned In an adult, the head and arms each equal 9% of the total body surface. The front and back of the trunk and each leg are equal to 18% of the total body surface. This formulation is slightly modified for children. For smaller burns the Palmar Method is used. The patient’s palm is 1%. Extent of Burns - Rule of 9’s Cause or Type of Burns Thermal burns Caused by heat Place the burned area in clean, cold water. Cover it with a dry, sterile dressing or a burn sheet. Do not break blisters. Patients with large burns must be treated for shock and transported to a hospital. Cause or Type of Burns Respiratory burns A burn to any part of the airway Look for signs and symptoms: Burns around the face Singed nose hairs Soot, redness or swelling in the mouth or nose Difficulty breathing or swallowing Hoarse voice Excessive coughing Loss of consciousness as a result of fire Breathing problems can be progressive Swelling and Edema can develop Cause or Type of Burns Chemical burns Many strong substances can cause chemical burns. The longer the chemical remains in contact with the skin, the more damage it does. Initial treatment Remove as much of the chemical as possible. Brush away any dry chemical. Flush with water for at least 10 minutes. Cover the area with a dry, sterile dressing. Arrange for prompt transport. Cause or Type of Burns Chemical burns (cont’d) Chemical burns to the eyes cause extreme pain and severe injury. Flush the eye(s) with water for at least 20 minutes. Hold the eye open to allow water to flow over its entire surface. Loosely cover the injured eye(s) with gauze bandages. Arrange for prompt transport. Cause or Type of Burns Electrical burns Occur when an electrical current enters the body at one point, travels through the body tissues and organs, and exits at the point of ground contact Electricity causes major internal damage. Patients may experience irregularities of cardiac rhythm or full cardiac arrest and death. Cause or Type of Burns Electrical burns (cont’d) Be certain that a patient is not still in contact with the electrical power source before you touch or treat him or her. Call for assistance from the power company or from a qualified rescue squad. Monitor the ABCs of electrical burn patients and arrange for prompt transport. Burn Severity Burn severity depends on: Depth of burn Extent of burn Critical areas involved Face, upper airway, hands, feet, genitalia Preexisting medical conditions Patient younger than 5 or older than 55 Children have a greater BSA (body surface area) in proportion Complications of Burns Burns to the airway are of significant importance. Cough, carbonaceous sputum, hoarse voice Circumferential burns of the chest can compromise breathing. Circumferential burns of the extremity can lead to neurovascular compromise and irreversible damage. Critical Burns Full thickness burns of critical areas or circumferential burns Full thickness > 10% BSA Partial thickness > 30% Airway or respiratory burns Burns complicated by fractures >55y/o or < 5y/o burns that would be classified as moderate Example: partial thickness burn 20% BSA Moderate Burns Full thickness 2-10% (excluding critical areas) Partial thickness covering 15-30% BSA Superficial burns covering > 50% BSA Minor Burns Full thickness <2% BSA Partial thickness covering <15% BSA Superficial burns covering < 50% BSA EMD Care for Burns Stop the burning process If victim still on fire or smoldering, advise them to STOP, DROP and ROLL. If it is safe to do so, roll patient in a blanket or coat or douse them with water. Move them to a safe area. Do Not remove and clothing that is stuck to the patient’s skin. Monitor patient’s ABCs and Level of Consciousness. For red or blistered skin: Flush area with cool, clean water Do Not apply ice Do Not apply ointments, grease or butter Do Not break blisters Cover burned area with clean cloth or sheet (lint free) Elevate burned extremities EMD Care for Burns Chemical Burns: Determine what type of chemical and follow instructions, if available. Flush with water unless contraindicated Avoid contact with chemical If dry particles are present, completely brush off without touching and then flush Carefully remove contaminated clothing and jewelry If chemical is in the eyes and patient is wearing contacts, they must be removed prior to flushing Resources AAOS Emergency Medical Responder, 5th edition AAOS Emergency Care and Transport of the Sick and Injured, 10th edition Will County 9-1-1 EMDPRS, June 2012 Next EMD CE packet available January 2013 Please contact Rhonda with topic ideas for next year: [email protected] or 815-258-9637. Enjoy the Holiday Season!
