Burns: Key Concepts and Management

Introduction

• Focus on understanding burns for EMS medicine.
• Importance for EMT, paramedic training, and exams like the NRMT.

Types of Burns

1. First Degree Burns
   • Superficial, similar to sunburn.
   • Affects only the outer layer of skin.
2. Second Degree Burns (Partial Thickness)
   • More painful as nerves are intact.
   • Affects deeper skin layers.
3. Third Degree Burns
   • Severe, nerves are damaged, less pain due to nerve damage.

Types of Burns by Cause

1. Thermal Burns
   • Caused by heat; severity depends on temperature and contact time.
2. Chemical Burns
   • Result from acids or alkalis.
   • Can cause severe damage, especially in sensitive areas like eyes.
3. Electrical Burns
   • Due to electrical current or lightning.
   • High voltage is particularly dangerous.
4. Radiation Burns
   • Classified as ionizing or non-ionizing.

Zones of Burns

• Zone of Hyperemia: Peripheral area, not critically damaged.
• Zone of Stasis: Middle zone, potentially salvageable.
• Zone of Coagulation: Central, necrotic tissue, most severe damage.

Rule of Nines

• Purpose: Assess total body surface area (TBSA) affected by burns.
• Adults:
  • Head: 9%
  • Torso/Back: 18% each
  • Arms: 9% each
  • Legs: 18% each
• Children/Infants:
  • Infants have larger head proportional to body size.
  • Adjust percentages for growth (e.g., head 18% for infants).

Rule of Palms

• Used for scattered burns.
• Patient's palm equals 1% of TBSA.

Classification by Severity

1. Minor Burns
   • Adults: <15% TBSA
   • Children: <10% TBSA
   • Full thickness <2%
2. Moderate Burns
   • Adults: 15-25% TBSA (second degree)
   • Children: 10-20% TBSA
   • Full thickness >10%
3. Major Burns
   • Include chemical, inhalation, and high voltage.
   • Special attention to sensitive areas like eyes, respiratory.
   • Adults: >25% TBSA
   • Pediatrics: >20% TBSA

Conclusion

• Emphasized learning for EMT and paramedic prep.
• Importance of understanding EMS medicine.
• Encouragement to use supplementary learning resources and communities for support.