Notes
A burn is tissue damage from heat, chemicals, electricity or radiation. The main dangers are fluid loss (leading to shock), infection, and loss of heat regulation.
- First-degree (superficial): only epidermis; red, painful, no blisters (mild sunburn). Heals in days.
- Second-degree (partial thickness): epidermis and part of dermis; blisters, pain. Heals in weeks, with possible scarring.
- Third-degree (full thickness): destroys epidermis and dermis, may reach deeper; skin appears white, brown or charred and is often painless because nerve endings are destroyed. Needs skin grafts.
- The rule of nines estimates the percent of body surface burned: head 9%, each arm 9%, chest and abdomen (anterior trunk) 18%, back 18%, each leg 18%, perineum 1%.
- Burns over more than 10% of the body (in a child, less) or involving face, hands, feet or genitals are critical.
- Example: burns on the anterior trunk (18%) and the whole left arm (9%) total 27%.
Practice
A burn that is red and painful with no blisters involves only the:
Superficial first-degree burns affect only the epidermis.
Why is a third-degree burn often painless in the center?
Full-thickness burns destroy the dermal nerve endings that sense pain.
A patient has burns to the entire front of the trunk and both entire legs. Using the rule of nines, about what percent of the body is burned?
Front of trunk 18% plus 18% plus 18% for two legs equals 54%.
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