can look black, yellow or red and hard and matte/dry.skin can NOT heal…will need skin grafting.not painful or the pain is dramatically decreased because damage to the sensation receptors.redness that will blanch, swelling, shiny red/pink and moist in areaģ rd degree: “full-thickness” : all skin layers are damaged along with the hair follicles, sweat glands, nerves.very painful…nerve sensation still present.severity varies throughout…if severe (deep partial-thickness this burn can easily turn into 3 rd degree).brisk capillary refill (the faster the capillary refill, the more superficial the burn is)Ģnd degree (partial-thickness)can be superficial or deep partial-thickness affecting various areas of the dermis.skin is very red or pink, painful, warm to touch, no blisters or usually no scar left behind.Then below this are muscles, bones, and ligaments.ġ st Degree (superficial): affects the top layer of the skin “epidermis” Patients who have burns that extend down into this layer will have problems regulating their body temperature. Skin LayersĮpidermis: top layer….it’s very thin compared to the dermis…keeps us protected for the environmental hazards…preventing infection.īelow that is the dermis, which is thicker than the epidermis….it contain the blood vessels along with the nerve endings, sweat/oil glands and the cells that help create new skin cells (thiswhy patients who have burns that involve deep into the dermis will need skin grafts because the body CAN’T remake the skin cells).īelow the dermis is the subcutaneous tissue (also called hypodermis): which contains fatty tissue, veins and arteries, nerves and helps insulate the muscles, bones, organs and REGULATES our body temperature. However, to understand the various depth of burns let’s review the skin layers. There are first, second, third, and fourth degree burns….based on the depth of the burn… partial-thickness to full-thickness. So, first let’s talk about: Degrees of Burns (depth of burn damage) Therefore, if a patient has a large amount of total body surface area affected by a burn and the burns extends deep past the epidermis and dermis the patient is at risk for many problems…because severe burns affect all the systems of the body (immune system, renal, fluid/electrolytes, respiratory, GI etc. did the patient experience an inhalation injury?.THINK respiratory issues or is it a circumferential burn….a burn that “circles” or surrounds an extremity or the torso? where the burn is located (front and back of trunk, face and neck….medical history ( diabetic already has issues with circulation already).patient’s age (children at most risk due to small size and elderly slower healing….usually have extensive medical history…skin is thin),.percentage of the total surface of the skin affected (check out my video on rule of nines).Friction: force abrasion to the skin….car accident…road rash, rope burn.Cold: coldness comes into contact with the skin too long….example: frostbite.Remember alkali burns are harder to treat because these type of burns are NOT neutralized by the skin when compared to acidic burns. Chemical: toxic substances come into contact with the skin (powders, gases, or certain foods…no heat needed).This can happen with full-thickness burns as well because the muscle layer can be involved in this severe burn. These substances block the tubules in the kidneys, which leads to acute tubular necrosis. Watch for renal failure: WHY? if the electrical current is strong enough this can cause the muscles to release myoglobin and cells to release hemoglobin.Watch for heart dysrhythmias and if the current is strong enough this can lead to bone fractures (watch for cervical spine injuries).It’s hard to determine the extent of damaged from this type of burn because the damage can extend under the skin.Electrical: an electric current passes through the body and damages tissues.that comes into contact with the skin… most common type Heat (thermal): this can be hot liquid, steam, fire etc.What are burns? It is damage to the skin’s integrity from some type of energy source, such as: This review will include the types of burns, causes, nursing interventions, pathophysiology, and much more!ĭon’t forget to take the FREE burns NCLEX quiz after reading this review.
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