Burns Essays

Skin Disorders/Burns Essays Skin Disorders/Burns Essay Skin Disorders/Burns Essay The incidence of burn injuries has been declining during the past several decades. Approximately 2 million people require medical attention for burn injury in the United States each year (Kao Garner, 2000). The risk of death increases significantly if the patient has sustained both a cutaneous burn injury and a smoke inhalation injury.Young children and elderly people are at particularly high risk for burn injury. The skin in people in these two age groups is thin and fragile; therefore, even a limited period of contact with a source of heat can create a full-thickness burn. The National Center for Injury Prevention and Control lists â€Å"fire/burn† among the categories of the 1998 Unintentional Injuries and Adverse Effects.Most burn injuries occur in the home, usually in the kitchen while cooking and in the bathroom by means of scalds or improper use of electrical appliances around water sources (Gordon Goodwin, 2001). Careless cooking is one of the leading causes of household fires in the United States. The U.S. Fire Administration reports that nearly one third of all residential fires begin in the kitchen. The major factors contributing to cooking fires include unattended cooking, grease, and combustible materials on the stovetop.Burns can also occur from work-related injuries. Education to prevent burn injuries in the workplace should include safe handling of chemicals and chemical products and increasing awareness of the potential for injuries caused by hot objects and substances. The national Institute for Burn Medicine, which collects statistical data from burn centers throughout the United States, notes that most patients (75%) are victims of their own actions. Contributing to the statistics are scalds in toddlers, school-age children playing with matches, electrical injury in teenage boys, and smoking in adults combined with the use of drugs and alcohol. One of the major culprits of burn injuries is the inappropriate u se of gasoline. The U.S. Home Product Report, 1993-1997 (2001), indicated that there were over 140,000 gasoline-related fires and approximately 500 people died from gasoline-related injuries during this period.Many burns can be prevented. Medical personnel can play an active role in preventing fires and burns by teaching prevention concepts and promoting the use of smoke alarms has had the greatest impact on decreasing fire deaths in the United States.There are four major goals relating to burns:PreventionInstitution of lifesaving measures for the severely burned personPrevention of disability and disfigurement through early, specialized, individualized treatmentRehabilitation through reconstructive surgery and rehabilitative programsII. DiscussionA. Classification of BurnsBurn injuries are described according to the depth of the injury and the extent of body surface area injured.a.)  Ã‚  Ã‚   Burn DepthBurns are classified according to the depth of tissue destruction as superfici al partial-thickness injuries, deep partial-thickness injuries, or full-thickness injuries. Burn depth determines whether epithelialization will occur. Determining burn depth can be difficult even for the experienced burn care provider.In a superficial partial-thickness burn, the epidermis is destroyed or injured and a portion of the dermis may be injured. The damaged skin may be painful and appear red and dry, as in sunburn, or it may blister.A deep partial-thickness burn involves destruction of the epidermis and upper layers of the dermis and injury to deeper portions of the dermis. The wound is painful, appears red, and exudes fluid. Capillary refill follows tissue blanching. Hair follicles remain intact. Deep partial-thickness burns take longer to heal and are more likely to result in hypertrophic scars.A full-thickness burn involves total destruction of epidermis and dermis and, in some cases, underlying tissue as well. Wound color ranges widely from white to red, brown, or bla ck. The burned are is painless because nerve fibers are destroyed. The wound appears leathery; hair follicles and sweat glands are destroyed.The following factors are considered in determining the depth of the burn: ·Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   How the injury occurred ·Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Causative agent, such as flame, or scalding liquid ·Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Temperature of the burning agent ·Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Duration of contact with the agent ·Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Thickness of the skinB. Management of the Patient with a Burn InjuryBurn care must be planned according to the burn depth and local response, the extent of the injury, and the presence of a systematic response. Burn care then proceeds through three phases: emergent/resuscitative phase, acute/intermediate phase, and rehabilitation phase. Although priorities exist for each of the phases, the phases overlap, and assessment and management of specific problem s and complications are not limited to these phases but take place throughout burn care.C. Planning and GoalsThe major goals for the patient may include restoration of normal fluid balance, absence of infection, attainment of anabolic state and normal weight, improved skin integrity, reduction of pain and discomfort, optimal physical mobility, adequate patient and family coping, adequate patient and family knowledge of burn treatment, and absence of complications. Achieving these goals requires a collaborative, interdisciplinary approach to patient management.III. ConclusionContinued assessment of the burn patient during the early weeks after the burn injury-focuses in hemodynamic alterations, wound healing, pain and psychosocial responses, and early detection of complications.Other significant and ongoing assessment focus on pain and psychosocial responses, daily body weights, caloric intake, general hydration, and serum electrolyte, hemoglobin, and hematocrit levels. Assessment fo r excessive bleeding from blood vessels adjacent to areas of surgical exploration and debridement is necessary as well.