Burns

1. Burns • 70% of burn injuries occur in the home

2. Prevention • Smoke alarms • Candles (xmas) • Pan placement on stoves • Fire extinguisher • Care around flammable products • (gasoline, kerosene) Nephew • Appliances off • Fireplace and wood stoves inspected

3. Practice A Family Fire Drill • Ladder for upstairs • Baseball bat for windows • Stickers on windows • Plan an alternate escape route • Meet outside at a designated place

4. House Fire Scenario • You are in a bedroom, the door is closed, what do you do?

5. House Fire Scenario • Drop to hands and knees (more toxic next to the floor) • Crawl to door • Feel door, knobIf hot, do not open • Most deaths are fromsmoke inhalation

6. Burns • Thermal • Chemical • Electrical

7. Thermal Burns • Caused by : • Flames • Hot objects • Flammable vapor that ignites • Steam or hot liquid • (baby in Texas)

8. Thermal Burns: What To Do • Stop • Drop • Roll

9. Thermal Burns: What To Do #2 • Remove smoldering, hot, or burned clothing • Do not remove “stuck” clothing • Remove jewelry if possible (necklace burn)

10. Thermal Burns: What To Do • Make quick assessment • Check ABC’s • It is appropriate to consider the following but don’t waste time • Determine depth of burn • Determine extent of burn (rule of 9’s • Head = 9% (18% child & infant) • One hand and arm = 9% • Each leg = 18 % (14% child and infant) • Front torso = 18% (9% upper half, 9% lower half) • Back torso = 18% (9% upper half, 9% lower half)

11. Thermal Burns: What To Do • Rule of palm = 1% • Use for scatter burns • See physician for burns to face, hands, feet or genitals • Circumferential burn? See physician • Does victim have other medical problems?

12. Chemical Burns • Caused by: • Acids (batteries) • Alkalis (drain cleaners- often more extensive) • Organic compounds (oil products)

13. Chemical Burns • If substance is dry: • Brush off before rinsing with water • Protect yourself • After brushing off chemical, or after exposure to liquid chemical: • Rinse with water for 20/30 minutes or longer • Remove contaminated clothing while flushing with water • Final rinse? Use soap • Burn may develop slowly

14. Chemical Burns #2 • Call poison control • Cover with dry sterile dressing • Do not try to neutralize a chemical • (save label) • Seek medical attention for all chemical burns

15. Electrical Burns • Prevention: • Outlet covers • Breakers • Gadget for checking power • Excessive number of power cords plugged in

16. Electrical Burns • External burns may not be present • May induce: • ventricular fibrillation (cardiac problems) • Respiration problems • “Freeze” due to muscle spasms

17. Electrocution • Electricity travels along nerves and vessels • Exits body where it is in contact with ground • May have several exit sites • Surface injury may be “tip of the ice berg”

18. Car Accident Involving Power Line • What should you do first? • Should you remove victim from the vehicle? • What if you feel tingling in your legs? • Should you try to remove downed wires or poles? • (buried power line)

19. Someone Has Made Contact with Power Inside Your House • What would you do first? • Then : • Check ABC’s • Treat for shock • Seek medical attention

20. What to do for Electrical Burns • Once the power is off, Check ABC’s • Spinal injury from fall? • Treat for shock • Most are 3rd degree • Cover with sterile dressing, elevate body part • Seek medical attention (burn center) • (combine / lift)

21. Degree of Burns • First-degree (superficial) • Second-degree (partial thickness) • Third-degree (full thickness)

22. First Degree Burns (superficial) • Affects outer layer of skin • Redness, swelling, tenderness, pain • Usually heals without scarring

23. Care of First-Degree Burns • Immerse in cold water (or other cold fluids or use cold, wet, cloths) • At least 10 minutes • Do not apply cold on burn covering >20% of the body • Aspirin or ibpuprofen • Acetaminophen will not reduce inflammation • Bacitracin (no other OTC products) • Aloe vera , moisturizer lotion • Dressing? • Drink plenty of water • Protect burn from friction or pressure

24. Second Degree Burns (partial thickness) • Extends into the inner layer of skin • Blisters, swelling, weeping, severe pain

25. Care of Second Degree Burns • Immerse in cold water / wet pack • Aspirin or ibuprofen • Drink plenty of water • Apply bacitracin or Silvedene (do not use home remedies) • Cover burn with non-sticking dressing • If burn is extensive: • Treat for shock / seek medical attention • Do not break blisters • Hot tar on lip • Medical help required: 10% of adult burned, 5% child

26. Third Degree Burns • Extends through skin, muscle and bone -Nerve endings are destroyed • Discoloration • Area larger than a half-dollar requires tissue removal and grafting to properly heal

27. Care of Third Degree Burns • Usually not necessary to apply cold to areas of third degree • If more than 20% of body is burned, do not immerse • Do not apply ointments • Apply sterile, non-stick dressings (do not use plastic) • Check ABC’s • Treat for shock • Medical help • (radiator burn)

28. Sunburn • Usually 1st degree, sometimes 2nd degree • Cool compresses • Drink plenty of fluids • Fever / chills • Use lotions, bacitracin (lake, snow skiing, lips, ears) • Prevention: • Sunscreen: SPF 30 has only 3% > protection than SPF 15 • Skin cancer

29. Respiratory Tract Burns • All must receive medical care • Nose to trachea receives brunt of the burn • Swelling may appear in 2 to 24 hours • Chlorine • Add to water • Wall paper removers • Bathroom cleaning agents (chemistry set) • Use products in well ventilated area • Don’t mix ammonia and bleach • Toilet bowl flushes

30. Other Moderate to Severe Burns Requiring Medical Care • Under 5 years old / over 55 • Breathing difficulties • Other injuries • Electrical injury • Suspected child abuse (teacher liability) • 2nd degree >10% of body • Third degree