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Burn Injuries
One of the most painful
injuries that one can ever experience is a burn
injury. When a burn occurs to the skin, nerve
endings are damaged causing intense feelings of
pain. Every year, millions of people are burned
in one way or another. Of those, thousands die
as a result of their burns. Many require
long-term hospitalization.
Serious burns are complex
injuries. In addition to the burn injury itself,
a number of other functions may be affected.
Burn injuries can affect muscles, bones, nerves,
and blood vessels. The respiratory system can be
damaged, with possible airway obstruction,
respiratory failure and respiratory arrest.
Since burns injure the skin, they impair the
body's normal fluid/electrolyte balance, body
temperature, body thermal regulation, joint
function, manual dexterity, and physical
appearance. In addition to the physical damage
caused by burns, patients also may suffer
emotional and psychological problems that begin
at the emergency scene and could last a long
time.
Burn Injuries
The Skin
The
skin is the largest organ in the body and
performs many important functions. It protects
against infection by keeping out bacteria. It
prevents loss of body fluids and helps control
body temperature.
Depth of Burn
The depth of
burn is usually categorized as superficial
partial-thickness, deep partial-thickness or
full-thickness.
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Superficial
partial-thickness (also know as superficial
second degree)
A superficial partial-thickness
burn resembles a deep sunburn and is very
painful. It will usually heal on its own within
ten days.
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Deep partial-thickness
(also known as deep second degree)
A deep
partial-thickness burn is also very painful and
blisters will form over the burned area. It may
take at least three weeks to heal.
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Full-thickness (also known
as third degree)
A full-thickness burn involves
damage to all the layers of the skin, including
the skin-reproducing cells. This wound will
require skin grafting to heal.
The severity of a burn
injury depends on the depth and size of the burn
wound, patient’s age, the patient’s past medical
problems and part of the body that has been
burned. It is difficult to predict how long it
will take for a patient’s injury to heal as all
individuals recover at different rates.
It is not always possible
to tell the depth of the injury when a patient
is admitted. It often takes several days to
determine whether the burn wound will heal on
its own or if it will require skin grafting.
Determining the severity of
burns
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Source of the burn - a minor burn caused
by nuclear radiation is more severe than a burn
caused by thermal sources. Chemical burns are
dangerous because the chemical may still be on
the skin.
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Body regions burned - burns to the
face are more severe because they could affect
airway management or the eyes. Burns to hands
and feet are also of special concern because
they could impede movement of fingers and toes.
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Degree of the burn - the degree of the burn is
important because it could cause infection of
exposed tissues and permit invasion of the
circulatory system.
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Extent of burned surface
areas - It is important to know the percentage
of the amount of the skin surface involved in
the burn. The adult body is divided into
regions, each of which represents nine percent
of the total body surface. These regions are the
head and neck, each upper limb, the chest, the
abdomen, the upper back, the lower back and
buttocks, the front of each lower limb, and the
back of each lower limb. This makes up 99
percent of the human body. The remaining one
percent is the genital area. With an infant or
small child, more emphasis is placed on the head
and trunk.
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Age of the patient - This is
important because small children and senior
citizens usually have more severe reactions to
burns and different healing processes.
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Pre-existing physical or mental conditions -
Patients with respiratory illnesses, heart
disorders, diabetes or kidney disease are in
greater jeopardy than normally healthy people.
Burn Prevention Tips in the Home
Kitchen
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Keep
hot items in the centre of the table and hot
liquids and drinks away from children;
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Keep young
children away from the cooking area;
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Use place
mats instead of tablecloths - young children use
tablecloths to pull themselves up;
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Roll up
electrical cords and unplug appliances when not
in use;
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Use pot holders, not towels;
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Turn pot
handles inward, toward the back of the stove;
use back elements of stove for cooking;
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Store pot
holders, paper towels and seasonings away from
the stove top;
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Avoid full or puffy sleeves while
cooking;
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Keep food away from the stove so no one
will be tempted to reach across hot stove
elements;
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Use a large lid or baking soda to put
out small grease fires in pans;
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Do not store
candy or toys above the stove.
Living/Family Room
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Do not use extension cords in place of permanent
wires;
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Cover unused electrical outlets with
safety plugs;
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Use fireplace matches to light a
fireplace;
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Keep matches and
lighters away from children;
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Soak cigarettes in water before placing
in garbage to ensure they are fully extinguished.
Bathroom
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Run hot and cold water together;
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Set the
hot water heater thermostat to low 120F / 50C;
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Never leave children alone in the bathroom;
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Use a
’no slip’ plastic mat in the bathtub to prevent
falls.
Did You Know?
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Children under 5 years old
suffer the highest number of scald burns;
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Some
fabrics burn faster and hotter. Cotton burns
readily and produces great heat, while wool is
difficult to ignite and burns with a smaller
flame;
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Children aged 5 to 9 years suffer clothing
burns most frequently;
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Ventilation is required
when painting or varnishing. Vapours accumulate
and ignite easily. Make sure nearby pilot lights
in stoves and furnaces are off;
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The most common
scald burns from microwaves occur when plastic
wraps/lids are removed from heated items;
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Most
reported infant burn injuries from a microwave
involve mouth burns from heated bottles;
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Using
butter to relieve a burn is a myth. Lotion,
ointments or oil dressings keep heat in. Use
cool water to let heat out;
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Using a liniment and
heating pad together increases the risk of burn;
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Adult males often receive burns when flammable
liquids are used improperly;
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Adult females are
often burned removing a burning container of
grease from the stove;
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Grease fires should be
smothered with a lid or cookie sheet;
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In 1987,
the Federal Government passed legislation
concerning flame retardant sleepwear for sizes 1
to 12x - look for the protective label;
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More than
50% of burn injuries are preventable;
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Most burn
injuries occur in the kitchen;
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The peak times for
burn injury incidents occur at noon, 6 to 7pm
and 11pm to 1am.
First Aid
If your clothing
catches fire:
If a burn
occurs COOL immediately and pour cool water (not
ice) on the burn. Cover the burn with a clean
sheet and seek medical attention.
Never apply ointment,
grease or butter to the burned area. Applying
such products, actually confine the heat of the
burn to the skin and do not allow the damaged
area to cool. In essence, the skin continues to
"simmer." After the initial trauma of the burn
and after it has had sufficient time to cool, it
would then be appropriate to put an ointment on
the burn. Ointments help prevent infection.
In the event of any serious
burns, call 9-1-1.
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