Chapter 55 Burn Types/Causes MATCHING*

A second-degree burn

(also called a partial-thickness burn) involves the epidermis and part of the dermis. The leakage of plasma and electrolytes from the capillaries damaged by the burn into the surrounding tissues raises the epidermis to form blisters and results in mild to moderate edema and pain.

A first-degree burn

(also called a superficial burn) involves an injury primarily to the epidermis, resulting in reddening of the skin and moderately severe pain. A sunburn or contact with boiling water or steam can cause this type of burn

Third- or fourth-degree burns

(also called full-thickness burns) involve the epidermis, dermis, and subcutaneous skin layers, including fat and muscle tissue (Figure 55-9C). No blisters appear, but white, leathery tissue and thrombosed vessels are visible. Although most providers have combined the third- and fourth-degree burns into the same category and consider them third-degree burns, some use the term fourth-degree burn for burns involving all layers of the skin, muscle, and bone. This can result from an industrial injury such as contact with molten metal.

Thermal

Caused by residential fires; automobile accidents; playing with matches; accidents with gasoline, space heaters, or firecrackers; scalding water from the stove or tub; and coming in contact with curling irons, stoves, or clothing irons. Some childhood burns, such as from cigarettes, can be traced to deliberate abuse. Sunburn occurs from overexposure to the sun.

Chemical

From contact with, ingestion, inhalation, or injection of acids or alkalines.

Electrical

Occur after contact with faulty electrical wiring, a child chewing on an electrical cord, or from downed high-voltage power lines. Although rare, an electrical burn can also come from a lightning strike.

Classification of Burns

____________________ is at the discretion of the provider or the treatment facility involved.

A MINOR burn

has less than 2 percent of BSA at the third-degree level and burns on less than 15 percent for adults and 10 percent for children at the second-degree level.

A MAJOR burn

is when a third-degree burn covers more than 10 percent of BSA or second-degree burns cover more than 25 percent in adults or 20 percent in children; burns of the hands, feet, or genitalia are also major burns; burns that are complicated by fractures, affect poor-risk patients, or are electrical are also major burns.

A MODERATE burn

is when third-degree burns cover 2 to 10 percent of BSA; second-degree burns cover from 15 to 25 percent on adults or over 10 percent on children.

The Rule of Nines

methods to estimate the size of the burn. These methods establish a standard by which all injuries can be estimated. The Lund and Browder chart is more specific and has a way to estimate areas for different age groups because body proportions are quite different for infants and small children as compared with adults.

body surface area (BSA)

the percentage, depth and width