Caring for Burn Patients

Caring for Burn Patients 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.

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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.

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