Summary NSG4430: Complex Nursing Care of Burns (c.27)
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Course
NSG4430 (NSG4430)
Institution
University Of Ottawa (U Of O
)
This document includes a detailed summary/review of burns, burn prevention, the types of burns and definitions. In addition, it discusses the classification of burns and their physiology, the phases of burn management (E-A-R, emergent, acute, and rehabilitation), and the complications of burns caus...
Burn: “an injury to the tissues of the body caused by heat, chemicals, electrical current, or
radiation. The resulting effects are influenced by the temperature of the burning agent, the
duration of contact time, and the type of tissue that is injured” (Tyerman et al., 2023, p. 518).
Burn prevention has shifted from an individual level based on blaming or ostracizing the
individual to burn prevention programs that use legislative changes to reduce environmental
hazards and risks.
Thermal (Heat): “caused by flame, flash fire, scald, or contact with hot objects. They are the
most common type of burn injury” (Tyerman et al., 2023, p. 519).
examples : liquid steam fire
, ,
Electrical: “result from intense heat generated from an electric current and are considered the
most severe type of thermal trauma, generally associated with greater damage of functional
structures, such as muscle and bone” (Tyerman et al., 2023, p. 520).
liceberg effect" ① muscles- electrical changes risk of dysrythmias occurs
bone fx >
-
C-spine fx Jull thickness
↑
muscles release myo s hemoglobin-causes acute
tubular necrosis ATAKI burns
Chemical: “the result of contact with acids and alkalis” (Tyerman et al., 2023, p. 519).
alali burns-hard to manage causes hydrolysis and liquifaction examples drain o even cleaners
:
Smoke & Inhalation Injuries: “from breathing noxious chemicals and hot air can cause damage
to the tissues of the respiratory tract . . . smoke inhalation injuries are a major predictor of
mortality in burn patients” (Tyerman et al., 2023, p. 519).
**
gasses are commonly cooled before reaching lung tissue ; vocal cords & glottis is protective mechanism
1. Carbon Monoxide Poisoning: cause of a majority of deaths at a fire scene
Of is displaced by co altering binding to Hb the causing↓ tissue perfusion hypoxia
causes bright red lips
-
2. Injury Above the Glottis is more often thermally produced Signs & Symptoms
:
causes mucosal burns >
-
can lead to mechanical obstruction .
↳burn in enclosed struct
↳ sooty nose or mouth
3. Injury Below the Glottis is more commonly chemically produced 4 sooty black spotum
↳ hoarse voice
tissue damage related to duration of exposure to smoke or toxic fumes ↳ difficulty talking
edema may not appear until 12-24hors ↳ singed hair aroundnose
pulmonary post-burn ↳ confusion , anxiety
, Week 14: Burns ASYNCHRONOUS
Classification of Burn Severity & Type:
Treatment is individualized based on the severity of the burns, including the depth of the burn,
the percentage of TBSA, the location of the burn, and patient risk factors.
1)epidermis
1. Burn Depth: classified by type of tissue damaged 2) dermis
3) hypodermis
2. % Total Body Surface Area: also known as TBSA
uses "rule of 95"
causes changes to capillary permeability
3. Location of Burn:
risk
face neck , and circumfrential burns to trunk or back causes mechanical respiratory risks and
,
of mechanical obstruction dit pulmonary edema.
4. Patient RFs:
diabetes impairs healing
age comorbidities discussed further p S example
:
- .
↳ effects from epidermis - hypodermis
↳ Dor v pain
↳ skina heal dif hypodermis
will need skin grafts
4th-degree FULL THICKNESS
↳ alllayers of skin effected
↳ cosmetic surgery & skin grafts
why does experience o or t pain from 3rd degree onwards?
the pt .
the nerve endings located in the hypodermis is damaged 0 or ↓
=
pain
Phases of Burn Management:
E. Emergent -
period of time required to resolve immediate life-threatening conditions.
the ,
lasts 24-12hours Primary Concerns hypovolemic shock and edema ends whenfluid mobilization and diuresis
:
begins
A. Acute begins i mobilization of ECF and subsequent dirresis Concludes when the buned area is compl
-
.
etley covered by skin grafts or when wounds are healed. May take weeks to months.
R. Rehabilitation time when wounds are covered - skin grafts or healed until the patient goes
-
home. Importance on encouraging patient and family to participate in care. Some patient's may
go home a small and uncovered wounds.
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