Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content +++ INTRODUCTION ++ Test Taking Tips Count on using the Parkland formula to calculate the volume of fluids that you need to give to your burn patient. Don’t forget that the start time of volume resuscitation is at the time of the burn, not at the time of arrival to the hospital. Review topical antimicrobials such as silver nitrate or Sulfamylon and their side effects and what they have the best coverage for. +++ CLASSIFICATION +++ What are the 5 mechanisms for burn injury? ++ Heat: damage from thermal injury; related to contact temperature, duration of contact with heat source, and skin thickness Electrical: damage from conduction of electrical current through body tissues; severity of injury depends on pathway of the current, resistance of current through tissues, and strength and duration of current Friction: damage due to mechanical disruption of tissues, as well as the generated heat Chemical: damage due to contact with caustic chemicals; severity of injury depends on duration of contact, as well as the type of agent Radiation: damage caused by ionizing radiation interaction with DNA; severity depends on dose, duration of exposure, and type of particle +++ What is a superficial burn? ++ Injury localized to the epidermis +++ What is a superficial partial-thickness burn? ++ Injury to the epidermis and superficial dermis +++ What is a deep partial-thickness burn? ++ Injury through the epidermis and into the deep dermis +++ What is a full-thickness burn? ++ Full-thickness injury through the epidermis and dermis into the subcutaneous fat +++ What is a deeper injury (fourth-degree) burn? ++ Injury through the skin and subcutaneous fat into underlying muscle or bone +++ Identify the depth of the burn: ++ A painful, erythematous burn with an intact epidermal barrier that blanches to the touch Superficial Painful burn with blebs and blisters; hair follicles intact; blanches to the touch Superficial partial thickness Sensation decreased; loss of hair follicles Deep partial thickness Leathery feeling, no sensation Full thickness ++ FIGURE 23-1 Illustration of the zones of injury after a burn. Factors likely to affect the zone of stasis determine the extension of injury from the original zone of coagulation. (Reproduced with permission from Moore EE, Feliciano DV, Mattox KL. Trauma, 8th ed. New York, NY: McGraw Hill; 2017.) Graphic Jump LocationView Full Size||Download Slide (.ppt) +++ PATHOPHYSIOLOGY +++ What are the 3 zones of injury from a burn? ++ Zone of coagulation, zone of stasis, zone of hyperemia +++ Define the zone of coagulation: ++ Irreversibly damaged necrotic area of a burn where cells have been disrupted ... Your Access profile is currently affiliated with [InstitutionA] and is in the process of switching affiliations to [InstitutionB]. Please select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Download the Access App: iOS | Android Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.