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ComPbms.Derm.11

Burns (Minor)

QuestionAnswer
When to refer to MD IBurns that cause respiratory injury (inhalation or facial burns). Burns of the hands, feet, genitals, or perianal area.
Refer to MD Full thickness burns of more than 2% of the total body surface area. Minor burns more than 10% TBSA in age >50 or >15% in ages 10-50.
First degree burn involve only the epidermis.
Second degree burn Involves the dermis.
3rd degree burn Extend to the subcutaneous fat. Hallmark of 3rd degree burn is that the burn site is insensate.
Method of determining TBSA back of patients hand = 1%.
Diagnostics. For simple burns, nothing. BUt for more serious, CBC, glucose, electrolytes, BUN/Cr, UA, and tissue cultures.
Differential Certain skin conditions such as staphylococcal scalded skin syndrome, toxic epidermal necrolysis can resemble a generalized burn.
Treatment (Chemical) Remove agent causeing burn and being aggressive irrigation.
Treatment (First line) Start with analgesics; Ibuprofen and a narcotic like codeine is a good start.
Treatment (Cleaning the wound) Mild soap and water or saline. Blisters should be debrided.
Treatment (Dressing) Cover with a layer of antimicrobial cream or ointment. Most common is Silvadene but can't be used with Sulfa allergies.
Wound care Should be washed and redressed twice daily for 7-10 days until healed.
Discharge and f/u All burn patients should be seen in 24 hours for a wound check and for assessment of the depth and extent of the burn. Clear instructions on wound care should be given.
Created by: DianaB
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