BURNS
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Burns are characterized by degree, based
on the severity of the tissue damage. A first-degree burn causes
redness and swelling in the outermost layers of skin (epidermis). A
second-degree burn involves redness, swelling and blistering, and
the damage may extend beneath the epidermis to deeper layers of skin
(dermis). A third-degree burn, also called a full-thickness burn,
destroys the entire depth of skin, causing significant scarring.
Damage also may extend to the underlying fat, muscle, or bone.
The severity of the burn is also judged by the amount of body
surface area (BSA) involved. Health care workers use the "rule of
nines" to determine the percentage of BSA affected in patients more
than 9 years old: each arm with its hand is 9% of BSA; each leg with
its foot is 18%; the front of the torso is 18%; the back of the
torso, including the buttocks, is 18%; the head and neck are 9%; and
the genital area (perineum) is 1%. This rule cannot be applied to a
young child's body proportions, so BSA is estimated using the palm
of the patient's hand as a measure of 1% area.
The severity of the burn will determine not only the type of
treatment, but also where the burn patient should receive treatment.
Minor burns may be treated at home or in a doctor's office. These
are defined as first- or second-degree burns covering less than 15%
of an adult's body or less than 10% of a child's body, or a
third-degree burn on less than 2% BSA. Moderate burns should be
treated at a hospital. These are defined as first- or second-degree
burns covering 15%-25% of an adult's body or 10%-20% of a child's
body, or a third-degree burn on 2%-10% BSA. Critical, or major,
burns are the most serious and should be treated in a specialized
burn unit of a hospital. These are defined as first- or
second-degree burns covering more than 25% of an adult's body or
more than 20% of a child's body, or a third-degree burn on more than
10% BSA. In addition, burns involving the hands, feet, face, eyes,
ears, or genitals are considered critical. Other factors influence
the level of treatment needed, including associated injuries such as
bone fractures and smoke inhalation, presence of a chronic disease,
or a history of being abused. Also, children and the elderly are
more vulnerable to complications from burn injuries and require more
intensive care. |
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| BURNS RELATED ITEMS |
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