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Rule of Nines

body regions

Major Burn Injuries Greater than 25% TBSA Exception: Children under 10, adults over 40 = greater than 20% Greater than 10% TBSA full thickness Involve face, eyes, ears, hands, feet, perenium Electrical burns inhalation injury or major trauma preexisting disease
Moderate Burn Injuries 15%-25% TBSA partial thickness Exception: Children under 10, adults over 40 = 10%-20% Less than 10% TBSA, full thickness Burns with no concurrent injury Burns in patients with no preexisting disease
Minor Burn Injuries Less than 15% TBSA Exception: less than 10% Less than 2% TBSA, full thickness burns in patients with no preexisting disease
Medical Management of Burn Phases 1. Emergent - stop the burning process, NO ICE, rinse all chemicals off skin 2. Provide open airway - 3. Control bleeding 4. remove nonadherent clothing and jewelry 5. Cover victim with clean cloth or sheet 6. Transport to hospital
Electrical burns result in... cardiac arrest, requiring CPR or cardiac monitoring
Primary priority in ALL BURNS OPEN AIRWAY
S/S of inhalation injury singed facial hair, black-tinged sputum, soot in throat, hoarseness, neck or face burns. STRIDOR is LIFE THREATENING
During Emergent Phase, patient should be monitored q 30min to 1 hr
Moderate to Severe burns treated with 1. est airway& admin O2 2. Ringer's lactate. Amt dep %age of TBSA Weigh pt to ind fluid loss. 3. Foley Cath nn 30-50mL/h Out 4. NG prevent aspiration 5. Analgesics 6. maintain airway, fluids, monitor vitals 7. tetanus shot unless w/in 5 years ago
Primary goals of Emergent Phase burn treatment (hrs 1-72 post burn) Maintain respiratory integrity prevent hypovolemic shock (which can lead to death)
Acute Phase (72h after burn) can last 10 days to several months MAIN PURPOSE - Treat wound; prevent and manage complications metabolism increases fluid shifts back into circulation, therefore output increases and edema decreases
complications of burns infection - #1 cause of death after first 72 hours heart failure, renal failure, contractures, paralytic ileus, Curling's ulcer - first sign usually vomiting bright red blood
Burn Care Nursing Interventions ***Prioritize airway, breathing, circulation 1. respiratory pattern 2. vital signs 3. circulation 4. intake & output 5. ambulation 6. bowel sounds 7. inspection of wounds 8. mental status
assessment for infection increasing erythema, odor, green or yellow exudate
Monitor closely during acute phase elevated creatine, BUN, electrolyte levels, serum potassium levels may rise sharply, DAILY NUTRITIONAL STATUS - increase protein, vitamins, calories, SKIN GRAFTS REQUIRE ADEQUATE NUTRITION
Created by: Perfectlysusan