Samira omer warsame RN, BSN

< oung children who have been severely burned

have a higher mortality rate than adults.
< Shorter exposure to chemicals or temperature can
injure child sooner.
< ncreased risk for for fluid and heat loss due to
larger body surface area.
< Burns involving more that 10% of TBSA require
fluid resuscitation
< nfants and children are at increased risk for
protein and calorie deficiency due to decreased
muscle mass and poor eating habits
< Scarring in more severe
< mmature immune system can lead to increased
risk of infection.
< Delay in growth may follow extensive burns.
< The most common cause of unconsciousness in
the flame burn patient is hypoxia due to smoke
inhalation.
< Look for ash and soot around nares.
< Ascertain adequacy of airway, give oxygen,
prepare for intubation if indicated
< Large bore needle to deliver sufficient fluids at a
rapid rate
< &se Ringer Lactate with D5, Normal saline with
5% Dextrose or Normal Saline with Dextrose
< 1
st
24 hours: Calculate fluid requirements by
adding maintenance fluids plus additional
resuscitation fluids (4ml/kg for every 1% of burn
area)
< Administer half of the fluids in the first 8 hours and
then rest in the next 16 hours.
< A 4 year old little girl weighing 20 kg comes into the
hospital with one arm one leg and half of her anterior trunk
burned.
What is the total percentage of area burned?
Arm 9%, Leg 15.5 %, half trunk 6.5 % = 31%
What are her total fluid requirements?
Maintenance?
1500 ml/24 hours
Resuscitation?
20kg x 4 x 31 = 248 ml
1500 ml + 248 ml = 1748 ml
How many ml in the first 8 hrs?
Half = 874 ml
< nvolves only the epidermis and part of the
underlying skin layers.
< Area is hot, red, and painful, but without swelling
or blistering.
< Sunburn is usually a first-degree burn.
< nvolves the epidermis and part of the underlying
skin layers.
< Pain is severe.
< Area is pink or red or mottled.
< Area is moist and seeping, swollen, with blisters.
< nvolves injury to all layers of skin.
< Destroys the nerve and blood vessels
< No pain at first
< Area may be white, yellow, black or cherry red.
< Skin may appear dry and leathery.
< Admission weight
< Nasogastric tube to maintain gastric
decompression
< Foley catheter for urine specimen and monitor
output
< Evaluate burn area and determine the extent and
depth of injury
< Monitor VS (for signs and symptoms of Shock/Sepsis)
< Prevent/Treat nfection with topical antibiotics
(silvadene)
< Clean and dress the wound daily
< May leave small wounds or areas that are difficult to
cover open to air.
< Give Tetanus Vaccine if appropriate
< Treat secondary infections
< Begin feeding as soon as practical in the first 24 hours
(high protein, high vitamin/iron)
< Should receive 1.5 times normal diet.
Dead skin and debris are
Carefully trimmed.
Cauze with ointment is applied
to burn wound.
lasticized garment and
airplane" splints.
Physical therapy to prevent contracture
deformity.