A burn that affects the epidermis only, causes erythema w/o blistering. Sunburn.
- Burns through epidermis into dermis. Pink/red, moist and painful.
- Scarring and hyperpigmentation
- Grafting may be necessary
How long does it take for a 2nd degree burn to heal?
Which burn type is described as full thickness, leathery, dry, waxy. Pain is typically not present bc destruction of nerves
T/F: Healing of 3rd degree burns may occur without grafting.
What are the top 3 common causes of burns?
- Flame (33%)
- Scald (30%)
- Contact (15%)
What is the estimation of burn SA for adults?
Rule of 9s
What is the estimation of burn SA for kids?
Lund Browder diagram
What burns should not be self treated?
- If larger than 3 in.
- If multiple large burns
- If there is high risk of infection
- If burn is on hands, feet, face, groin, butt, over major joint
Why should aspirin be avoided for burns?
- Risk of Reyes in kids
- GI upset
- Potential to cause bleeding
Why is tylenol not a great first choice for burns?
No anti-inflammatory effect
What are the immediate goals for treating a burn?
- Stop the burning process
- Cool burn w/ cool tap water (no ice)
- Clean area if skin is broken
- Provide pain relief PO or topical
- Cover burn to help relieve pain
- Select dressings
What can you cool a burn with?
- Wet compresses
- Running water
- Immersion into tub
What should you clean the area with (if the skin is broken?)
- Soap and warm water
- Antibact. hand soap
T/F: If there are blisters present in the burned area, break the blister with w/ a sterilized needle to relieve pressure.
How long should a burn be cooled down for?
What can be used for pain relief for burns?
- Oral NSAIDs
- Oral acetaminophen
- Topical/local anesthetics
T/F: If the skin is broken, use a lower concentration of a topical/local anesthetic.
How long does pain relief from topical/local anesthetic last?
T/F: Maximum use of topical/local anesthetic is 4-5 times per day.
List some examples of topical/local anesthetic.
- Benzocaine 5-20%
- Lidocaine 0.5-4%
- Pramoxine 1%
- Benzyl alcohol
- Menthol 1% or less
High concentrations of Menthol are used as ____________
What is an example of esters?
What is a disadvantage of benzocaine?
Sensitive skin/allergies = rash will form
What is the max amount of lidocain available OTC?
If you need a spray, what product will you not be able to use?
What is a disadvantage of lidocaine?
Systemic toxicity w/ overuse; only recommend for small, minor burns
What is the most popular example of pramoxine?
What are symptoms of lidocaine toxicity?
- Irreg. heartbeat
- Ringing in ears
- Double vision
- Decreased HR
- Weak, shallow, slow breathing
- Feeling hot/cold
- Loss of consciousness
- Decreased BP
T/F: Hydrocortisone is FDA approved for burns
What concentration of HC is used for burns, esp. sunburns?
What should you caution about using topical steroids?
- Can increase risk of infection/impair healing
- Can be applied to re-epithelialized wounds to decrease itching
When choosing a covering for a burn, what qualities would you look for?
- Sterile preffered
What is the purpose of skin protectants?
- Reduce pain
- Prevent drying and irritation
List some examples of skin protectants
- Petrolatum, Shark liver oil, A&D oint.
- Cocoa butter
- OTC topical antibiotics (unless allergy)
T/F: Topical antibiotics are not necessary for minor burns w/ intact epidermis.
What is a complementary therapy for burns?
Aloe gel for cooling effects
What dose of Iburofen would you recommend for a sunburn?
400 mg (1-2 tabs q 6 to 8 hr)
What dose of Acetaminophen would you recommend for pain from a burn?
500 mg (2 tabs q 6 hr)
A pt has a sunburn over both arms, chest, and back. What topical agent would you recommend?
Pramoxine or Benzocaine
A pt obtained a quarter sized burn on her arm from setting her arm down on a quarter that had been held over an open flame (idk. ppl do weird things.). This pt informs you she has sensitive skin. What topical product would you recommend?
What oral agent would you suggest for a minor burn for a pt who has a history of peptic ulcers and CV disease?