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ETIOLOGY
Thermal
Chemical
Electrical
Radiation
CHEMICAL BURN
ELECTRICAL BURN
4/1/2011
SUPERFICIAL BURNS
(FIRST DEGREE)
Epidermal tissue only affected
Reddened skin
Erythema, blanching on pressure,
Not serious unless large areas
involved
Do not result in scarring
i.e. sunburn, minor scald from a
kitchen acciddent
Intense pain
White to red skin
Blisters
Involves epidermis and papillary layer
of dermis
Spares hair follicles, sweat glands etc
Erythematous and blanch to touch
Very painful/sensitive
No or minimal scarring
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Calculation
of Burned
Body Surface Area
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17
Evans, 18.1, 2007)
RULES OF NINES
Head & Neck = 9%
Each upper extremity (Arms) = 9%
Each lower extremity (Legs) = 18%
Anterior trunk= 18%
Posterior trunk = 18%
Genitalia (perineum) = 1%
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PATHOPHYSIOLOGY
Circulatory
FLUID SHIFT
Occurs
FLUID IMBALANCES
Occur
FLUID REMOBILIZATION
Occurs
after 24 hours
Capillary leak stops
See diuretic stage where edema fluid
shifts from the interstitial spaces into the
vascular space
Blood volume increases leading to
increased renal blood flow and diuresis
Body weight returns to normal
See Hypokalemia
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CURLINGS ULCER
Acute ulcerative gastro duodenal disease
Occur within 24 hours after burn
Due to reduced GI blood flow and mucosal
damage
Treat clients with H2 blockers, mucoprotectants,
and early enteral nutrition
Watch for sudden drop in hemoglobin
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SYSTEMIC CHANGES
Cardiac
Decreased
Pulmonary
cardiac output
Respiratory
distress syndrome
Gastrointestinal
Decreased
or absent motility
Curlings ulcer formation
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SYSTEMIC CHANGES
Metabolic
Increased
Immunologic
Supression
response
Increased risk of infection
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