Caring for
patients with severe burns can be a very difficult job. There are a number of challenges for critical
care nurses when caring for burn patients in the event a burn center is not
available.
Burn Victim Statistics
There are
about 3500 fire and burn deaths every year.
Many of the deaths are a result of smoke inhalation, which is often the
case in fires, especially when they occur at night. About 50,000 patients sustain burns annually
and require medical treatment or hospital stays. Burn injuries are the most expensive
catastrophic injuries to treat, a burn over 25% of an adult's body can end up
costing $250,000 in initial care.
Burn Patients Skin
When the
layers of skin are destroyed on burn Patients, it results in local and systemic
disturbances. The skin is the body’s
largest organ, and provides a protective barrier against infections and injury. When skin is severely burned, it can lead to
compromised immunity, hypothermia, and infection. The three layers of the skin will describe
the severity of the burn. The epidermis,
dermis, and subcutaneous tissue. Burns
used to be described as first, second, third, however, are now defined by the
layer of skin destruction.
- Epidermal- superficial, first degree
- Partial-thickness, second degree, also called partial thickness
- Full thickness- third degree burns
Any burn over
10% of the body that is considered full thickness should be admitted to a burn
center. There are several methods to
determine how much of the body is burned; however, it's fairly easy to
visualize if 10 or 30 percent of the body is burned.
Types of Burns
Burn
injury descriptions are classified, thermal, chemical, electrical, radiation,
smoke, or inhalation. Thermal burns come
as a result of being burned by a hot substance, kitchen fires, etc. oil type liquids have very high boiling
rates, and can cause very deep burns, much more so than water or other
liquids. The longer the skin is exposed
to oil burns, the deeper the burn will be.
Chemical burns destroy the tissue.
These burns have a residual effect and can burn the skin 72 hours after
contact. Chemical burns come from acid,
or organic compounds. Many household
chemicals have an acid base, and when mixed inappropriately can cause a
burn. The longer the chemical burns
continue to burn the skin, the more likely there is to have an infection. Electrical Burns- These Burns are diagnosed
in two classifications, low voltage and high voltage. Electrical injuries can be deadly, when
ventricular fibrillation or paralysis of the respiratory muscles occurs. As a general rule, death only occurs in high
voltage burns, however, lower voltage Burns could also result in death. The severity of an electrical burn can appear
minor, appearing to have only burned a small portion of skin. The problem that can occur is that the burn
is severe under the first layer of skin, in which case looks are deceiving. One burn patient was told they could receive
no more treatment, as his burn appeared minor.
He insisted he was in pain, yet he was discharged. The following day he was readmitted, and
spent 3 weeks in intensive care.
Radiation Burns- A radiation burn can come from the sun, tanning booths,
X-rays, or nuclear events. While sunburn
is usually not severe, radiation burns can be severe, to the point of death in
some cases. Smoke and inhalation burns
can come with thermal or chemical burns.
Hoarseness, soot in the nose or mouth area, lip edema, or singed facial
hair can indicate inhalation or smoke burn.
Frostbite is also a burn, and can result in loss of fingers or
toes. This type of burn is especially
dangerous, as it can be numb, and the individual may not realize they are
injured.
Related: Premature Births
Burns can be
very serious, and are extremely painful to the patient. It can also be very hard on the families,
burns can look as painful as they are, and it can be quite upsetting. Burn patients can end up spending months
hospitalized, and often face multiple surgeries to repair skin and
scarring. Nurses often become attached
to burn patients due to their extended stays.
It's always nice to see a patient go from a very serious injury, to
eventually walk out of the hospital doors.
Nurses often
choose to specialize in burn care, which usually involves a specialty in
critical care. For any nurse that has an
interest in this field, verify what certifications are needed to specialize in
this area. Burn specialty nurses are
generally classified as pediatric or adult specialists.
Related: List of nursing organizations
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