Burn

Burns can cause minor medical issues or serious emergencies. Chemical or electrical burns can be among the most serious. Children most frequently sustain burn injuries from scalding liquids.

Small scales and sunburns are typically treatable at home, but severe or extensive burns require rapid medical attention. Treatment at specialized burn units is frequently necessary for those with serious burns. Large wounds may require skin grafts to be repaired.

The initial step in treating most burns is to drench the area in cool tap water. Ice is not suggested since it may further harm the damaged tissue.

Causes:

• Chemical burn:
  • A chemical burn occurs when living tissue is exposed to a corrosive substance such as strong acid or base.
  • Chemical burn may include:
    • Need no source of heat.
    • Occur immediately on contact.
    • Extremely painful
• Electric burn:
  • It commonly occurs after contact with faulty electric wiring or high voltage power lines.
  • Electric burns might not be visible on the surface but they can cause critical internal injuries.
• Radiation burn:
  • A radiation burn is damage to the skin or other biological tissue caused by exposure to radiation.
  • The most common type of radiation burn is a sunburn.

Symptoms:

Because burns don't impact the skin consistently, they might vary in depth. Identifying the extent of damage to the body's tissues is necessary to differentiate between a small burn and a more serious burn. There are four categories for burns, as follows:

• First-degree burn:
  • This tiny burn merely penetrates the skin's surface layer (epidermis). It produces discomfort and redness and typically goes away with first aid within a few days to a week. The classic example is sunburn.
• Second-degree burn:
  • Redness, pain, and swelling are brought on by these burns, which affect both the epidermis and the dermis, the second layer of skin. A second-degree burn frequently seems damp or wet. Pain may become intense and blisters may form. Scarring may result from second-degree burns that are deep.
• Third-degree burn:
  • Third-degree burns are those that penetrate the fat layer under the dermis. The skin may have a tight, waxy, leathery, or brown appearance. Burns of the third degree can kill nerves, resulting in numbness.
• Fourth-degree burn:
  • The most serious type of burn impacts tissues other than the skin, like muscle and bones. The skin could appear burned or scorched. You might not feel any pain at all if there has been severe nerve damage.

Tests and Diagnosis:

• You will check your burned skin during the physical examination to ascertain how much of your total body surface area (TBSA) is affected. Generally speaking, 1 percent of your TBSA corresponds to a skin region about the size of your palm.
• You should undergo a physical examination to check for any additional injuries and to see whether the burn may have harmed the rest of your body. You could require laboratory testing, X-rays, or other diagnostic procedures depending on the severity of the burn and the conditions that led to it.

Treatments and Drugs:

• First-degree burns and minor second-degree burns can be treated at home using over-the-counter medications or aloe vera. Minor burns typically heal in a couple of weeks.
• If you have moderate, severe, or extensive burns, or if they include your hands, feet, groin, or face, get emergency care.

Medications:

Depending on the severity of your burn, you may require:

• Intravenous (IV) fluids: 
  • Doctors deliver fluids continuously through a vein (intravenously) to prevent dehydration and organ failure.
• Pain relievers: 
  • Healing burns can be incredibly painful. In many cases, morphine is required — particularly during dressing changes. Anti-anxiety medications may also be helpful.
• Burn creams:
  • A variety of products can be applied to the burn to help keep it moist, reduce pain, prevent infection and speed healing.
• Antibiotics: 
  • If you develop an infection, you may need intravenous antibiotics.
• Tetanus shot: 
  • Your doctor might recommend a tetanus shot after a burn injury.

Physical Therapy

Physical therapy techniques to stretch the skin may be necessary if the burned area is sizable, especially if it covers any joints. This will allow the joints to stay flexible. Other forms of exercise can enhance muscle coordination and strength.

Surgical and other Procedures:

In some cases, you may need one or more of the following procedures:

• Breathing assistance: 
  • Your throat could close up if your face or neck have been burned. If that seems possible, your doctor may place a tube in your trachea to maintain the flow of oxygen to your lungs.
• Tube feeding: 
  • When your body begins to treat your burns, your metabolism accelerates. A feeding tube may be inserted through your nose and into your stomach to supply enough sustenance for this task.
• Skin grafts: 
  • The scar tissue left over from deep burns must be replaced with sections of your own healthy skin. As a temporary fix, donor skin from cadavers or pigs can be used.
• Reconstruction: 
  • Plastic surgeons can increase the flexibility of joints affected by scarring and improve the appearance of burn scars.

Complications

• Infection
• Low blood volume ( hypoglycemia )
• Hypothermia
• Respiratory distress
• Scarring
• Bone and joint problems.

Nursing management:

• Provide humid oxygen.
• Be ready for escharotomies and intubations.
• Prepare for mechanical ventilation and keep an eye on it.
• Maintain a patent airway by situating the patient correctly.
• Instruct the patient to cough, turn, and take a deep breath. As required, suction.
• Watch your vital signs and your urine flow.
• Maintain IV line while controlling fkuid at the proper pace.
• Check for excess or deficit of another electrolyte and serum sodium.
• Elevate the patient's bed and the burned limbs.
• Support you emotionally.

References

• drugs.com › Mayo Clinic Disease Reference
• health.vezeeta.com/en/burns/
• Mandal, G. (August 2013). A Textbook of Adult Health Nursing (2nd ed.). Dilllibazar kathmandu: Makalu publication house. Retrieved August 2013
• mayoclinic.org/diseases-conditions/burns/basics/symptoms/con-20035028
• medlineplus.gov › Medical Encyclopedia
• pharmacypedia.org/diseases-and-conditions/burns/
• prezi.com/ehbhu3vkjnu9/tissue-integrity/
• prezi.com/jluobm05wvr-/burns/
• webhealthnetwork.com/disease/5-332/burns