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Burns template

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Description of BurnsInjury to skin and tissue caused by chemicals, thermal energy, radiation, or electricity
Assessment Findings for BurnsPartial Thickness: First and Second degree burns Full Thickness: Third degree burns General distribution of burns may indicate source Straight burn lines may indicate child abuse Geriatric burns heal more slowly
Degrees of Burns and Assessment FindingsFirst Degree - Superficial layers of epidermis. Redness, Tenderness, No blisters Second Degree - Epidermal injury with blister formation. Redness, Tenderness, Presence of blisters Third Degree - Destruction of all skin elements. Charred, leathery appearance of skin, skin may be white with red edges, very little tenderness
Diagnostic Studies for BurnsUsually non indicated for first or second degree burns of limited area Culture and sensitivity if infected EKG if electrical burns
Nonpharmacologic Management of BurnsDo NOT apply ice to burns, apply cool water or saline to clean. May use mild soap. Remove clothing, jewelry, over and around burned areas Flush chemical burns with cool water for 30 minutes to 2 hours depending on substance and severity Remove blistered skin after rupturing blisters Clean and redress burn 1-2 times/day Encourage good nutrition during convalescence
Pharmacologic Management for BurnsApply antibacterial cream: Bacitracin (around mucus membranes and face), Silver sulfadiazine Consider a biologic dressing (Very expensive) Analgesics for pain Tetanus prophylaxis if not within 10 years
Consultation/ReferralRefer to specialist all burns non considered minor; second degree burns >20% of body; all third degree burns; burns of eyes,hands, face, feet, or perineum; lightening burns; electrical burns; or burns over joints
Follow-Up for BurnsMost burns are minor and can be managed on an outpt basis Depends on severity and age of pt, but follow up 1-3 days until resolved
Expected Outcome for BurnsFirst degree burns resolve without complications Second degree burns resolve in about 2 weeks
Prevention of BurnsLiberal sunscreen use Limit access to electrical cords, wires, chemicals for children Parental supervision Use of home smoke detectors and plan for evacuation Knowledge of proper use of home fire extinguisher Set home water heaters 120-130F

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