What are the main causes of burns?
- Thermal
- Chemical
- Electrical
What simple measures can be taken to manage a burn?
- Stop the burning process
- Cool the burn
- Cover the burn
What methods can you use to stop the burning process?
- Remove source of burning
- Remove burnt clothes if possible
- Remove contrictive jewellery
- Douse chemical burns with large amounts of water
What simple measures could you use to cool a burn?
Douse with water for approx 20 minutes
What simple measures could you use to cover a burn?
Take a photo before hand
- If blistered - covered with dressing/plastic film to keep clean
What is important to remember when dressing a burn?
Do not wrap circumferentially - allow room for tissue swelling
What airway problems can occur due to burns?
- Swelling of soft tissue of the neck and oropharynx
- Inhalation injury
What are features of an inhalation injury?
- Soot around face
- Singed nasal hairs
- Facial/neck burns
- Mechanism of injury
- Hoarse voice
- Stridor
How might you manage airway problems caused by burns?
- High flow humidified O2 (15L/min)
- Intubation may be necessary (are they unconscious?)
What breathing problems may occur due to burns?
- Full thickness chest burns
- Circumferential burns
How might you manage breathing problems caused by burns?
- Escharatomies - decompress the chest
- High flow O2
Why should pulse oximetry be used with caution in burns victims?
Carbon monoxide toxicity will not be detected on pulse oximetry
What are important things to consider doing when managing C as part of an ABCDE assessment in a burns victim?
IV access + ANALGESIA + FLUIDS
What are important things to assess as part of your exposure assessment in a burns victim?
- Assess extent of the burns - estimate percentage
- Temperature
Why are individuals who have been burned at risk of hypothermia?
They lose vast amounts of heat through their broken skin
When should adults with burns be given fluid resuscitation?
Those with > 20% surface area burns
When should children with burns be given fluid resuscitation?
>10% surface area burns
How many attempts should be taken to cannulate a burns patient?
2 - if fail go straight to IO to try to minimise delay to definitive care
In terms of time to definitive care, what threshold should be used to determine whether to start fluid treatment for a burns victim?
If greater than 1 hour away from definitive care, start fluids
What are the main depths of burns?
- Epidermal/superficial
- Superficical partial thickness
- Deep partial thickness
- Full thickness
What are the different methods used to determine the total body surface area affected by a burn?
- Wallace rule of 9’s
- Lund and Browder chart
- Palmar surface
When using the palmar surface area method for determining burn surface area, what percentage body surface area dose one palm represent?
1% - very crude measurement
What is the most accurate method for measuring burns surface area?
Lund and browder method
