Burns part 1


Burns incidents can present very challenging situations for clinicians depending on the severity of the burn and surrounding circumstances. Several complications can arise, and clinicians need to be aware or numerous considerations.

Burns can manifest through a number of forms, such as electrical, thermal, and chemical:

  • Electrical burns will have an entry and exit site. Depending on the voltage and power, the burn can also occur within the deep tissues and path of travel. Electrical injuries can also affect the electrical rhythm of the heart.
  • Thermal burns occur from items that give off heat. The temperature of the source and time in contact will determine the severity and depth of burn.
  • Chemical burns can vary depending on the substance. Further effects such poisoning could also occur.

Burns can be classed as superficial, partial thickness, or full thickness depending on their depth. It can be difficult assessing what level a burn is early in the injury and is best to focus on patient management. As a review on burn assessment;

  • Superficial involves the epidermis of the skin only. It appears pink to red, there are no blisters, and it is dry. This burn can be moderately painful.
  • Partial thickness involves the superficial dermis to deeper dermis. It appears red with blisters and is wet. This burn can cause significant pain.
  • Full thickness involves the full thickness of skin and subcutaneous structures. It appears white or black/brown. With pressure, no blanching occurs. The burn is leathery and dry. There may be little to no pain due to the burn damage to the nerve ends.

On assessing burn area, the Wallace’s Rule of Nines or the Lund and Browder chart can be used to assess total body surface area affected. On assessing, use the whole of the burn area, and consider factors that may alter the assessment tools such as obesity.