CARE OF PATIENTS WITH BURNS

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CARE OF PATIENTS WITH BURNS

• Susie Forehand, RN, MSN, MEdProfessor of
  NursingValencia Community College

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Statistics in the United States
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Classification of Burns

• Partial Thickness
• First Degree
• Second Degree
• Full- Thickness
• Third Degree

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Severity of Burn

• Depth
• Age
• Part of Body Burned
• Existing Medical Problems
• Extent of Burn

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Stages of Burns

• Immediate Hypovolemic
• Diuretic

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Periods of Treatment

• Emergent
• Acute
• Rehabilitation

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Initial Treatment of Patient
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Classification of Severity of Burns

• Rule of Nine
• Lund and Browder

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Fluid Replacement

• Formula 4ml (LR) x weight (kg) x BSA
• Types of Fluids
• Electrolyte
• Nonelectrolyte
• Colloid given only after 24 hours following
  burn injuryNOTE Fluid should be titrated to
  obtain at least 30ml to 50 ml urine per hour.

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Laboratory Measurements

• Serum and Urine Electrolyte
• Serum and Urine Osmolality
• Hematocrit

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Signs of Adequate Resuscitation

• Clear Sensorium
• Pulse lt120
• Urine Output 30 50ml/h
• Systolic B/P at least 100 torr
• Blood pH 7.35 7.45
• CVP 5- 10 torr

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Complications

• Curlings Ulcer (stress ulcer)
• Renal Failure
• Heart Failure
• Ileus Formation
• Infection (wound respiratory)
• Contractures

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Wound Care

• Eschar Removal
• Hydrotherapy
• HBO

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Methods of Treatment

• Closed Method
• Open or Exposed
• Semiopen

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Topical Agents

• Silvadene (silver sulfadiazine)
• Sulfamylon (mafenide)
• Betadine (providine iodine)
• Silver Nitrate

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Types of Grafts

• Autograft
• Homograft
• Heterograft
• Synthetic

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Pain Management

• Drug of Choice
• Morphine Sulfate

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Emotional Considerations
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Comprehensive Team Approach
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Summary of Nursing Care