Lecture 12

A burn is a traumatic injury to the skin (and sometimes the underlying tissues as well) caused by contact with extreme heat, chemicals, radiation or electricity

Burns range in severity from minor to critical. A critical burn is one that is life threatening or potentially disfiguring or disabling, and it requires immediate medical attention. When evaluating whether a burn is critical or not, consider the following factors:

• The depth of the burn. Burns can be classified according to depth. Superficial burns only involve the epidermis (the top layer of skin). Partial-thickness burns involve the epidermis and the dermis (the layer of skin underneath the epidermis that contains blood vessels, nerves, hair follicles and glands). Full-thickness burns involve both layers of skin and may extend into the subcutaneous tissue, muscle or bone underneath. Generally speaking, the deeper the burn, the greater the severity.

• The percentage of the body’s surface area that is burned. A burn that covers more than one part of the body or covers a large percentage of the person’s total body surface area requires medical attention. Even a superficial burn can be a critical burn if it affects a large percentage of the person’s total body surface area.
• The location of the burn. Burns that affect the hands, feet or groin; those that involve the head, neck, nose, or mouth or affect the person’s ability to breathe; and circumferential burns (i.e., those that go all the way around a limb) are considered critical burns.
• The age of the person. If the person is younger than 5 years or older than 60 years, the burn should be considered critical, unless it is very minor.
• The cause of the burn. Burns caused by electricity, exposure to chemicals, exposure to nuclear radiation or an explosion are considered critical burns.

Signs and symptoms of burns

Burned areas can appear red, brown, black (charred) or white. The burned area may be extremely painful or almost painless (if the burn is deep enough to destroy the nerve endings). There may be swelling, blisters or both. The blisters may break and ooze a clear fluid. Burns involving blistering or broken skin should be evaluated by a healthcare provider.