{"id":1902,"date":"2018-01-16T09:07:07","date_gmt":"2018-01-16T09:07:07","guid":{"rendered":"http:\/\/papergp.com\/index.php\/others\/burns-and-scalds\/"},"modified":"2023-01-24T11:25:26","modified_gmt":"2023-01-24T11:25:26","slug":"burns-and-scalds","status":"publish","type":"page","link":"https:\/\/papergp.com\/index.php\/others\/misc\/burns-and-scalds\/","title":{"rendered":"Burns and Scalds"},"content":{"rendered":"<div class=\"content-box-blue\">\n<h4><strong>Data gathering<\/strong><\/h4>\n<ul>\n<li>History\n<ul>\n<li>Type of burn &#8211; flame, scald, electrical, chemical<\/li>\n<li>Inhalation injury &#8211; singed nasal hair, black carbon in sputum<\/li>\n<li>PMH<\/li>\n<li>Evidence of NAI &#8211; see below<\/li>\n<li>Social circumstances<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>Examination\n<ul>\n<li>Assess extent of burn &#8211; Lund and Browder chart<\/li>\n<li>Assess depth of burn<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div>\n<table id=\"tableid1\" class=\"tlarge table table-striped table-bordered table-responsive\" data-role=\"table\">\n<thead>\n<tr>\n<th><b>Depth<\/b><\/th>\n<th><b>Former terminology<\/b><\/th>\n<th><b>Appearance<\/b><\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td>Superficial epidermal<\/td>\n<td>First degree<\/td>\n<td>Red and painful<\/p>\n<p>Normal cap refill<\/p>\n<p>e.g. flash burns, sunburn<\/td>\n<\/tr>\n<tr>\n<td>Partial thickness (superficial dermal)<\/td>\n<td>Second degree<\/td>\n<td>Pale pink, painful, blistered<\/p>\n<p>Slower cap refill<\/p>\n<p>e.g. scalds<\/td>\n<\/tr>\n<tr>\n<td>Partial thickness (deep dermal)<\/td>\n<td>Second degree<\/td>\n<td>Blotchy, cherry red, may be painless<\/p>\n<p>Non-blanching cap refill<\/p>\n<p>e.g. flames<\/td>\n<\/tr>\n<tr>\n<td>Full thickness<\/td>\n<td>Third degree<\/td>\n<td>White\/brown\/black in colour, no blisters, no pain<\/p>\n<p>Non-blanching cap refill<\/p>\n<p>e.g. contact, chemical, electrical<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<div class=\"content-box-blue\">\n<p><em>NB:<\/em><\/p>\n<ul>\n<li><em>assess capillary refill by pressing a sterile cotton bud<\/em><\/li>\n<li><em>baseline skin colour can cause confusion e.g. white skin may mask full thickness burns, dark skin may mask superficial\/partial thickness burns<\/em><\/li>\n<\/ul>\n<h4><strong>Clinical management<\/strong><\/h4>\n<ul>\n<li>Treatment\n<ul>\n<li>Heat\n<ul>\n<li>within 20 minutes of injury, irrigate burn with cool water for 10-30 minutes<\/li>\n<li>cover the burn using cling film (layer rather than wrap)<\/li>\n<li>Analgesia<\/li>\n<\/ul>\n<\/li>\n<li>Electrical\n<ul>\n<li>Refer to A+E<\/li>\n<\/ul>\n<\/li>\n<li>Chemical\n<ul>\n<li>Irrigate with water for an hour<\/li>\n<li>Refer to A+E<\/li>\n<\/ul>\n<\/li>\n<li>Consider early advice from local burns unit if uncertainty<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>Follow-up \/ Safety net\n<ul>\n<li>Immediately refer\n<ul>\n<li>All deep dermal and full-thickness burns<\/li>\n<li>All circumferential burns (burns that go all the way around the surface of a limb or body)<\/li>\n<li>Superficial dermal burns of more than 3% total burn surface area in adults or more than 2% in children (&lt;16yo)<\/li>\n<li>Superficial dermal burns involving the face, hands, feet, perineum, genitalia, any flexure (esp neck or axilla)<\/li>\n<li>Inhalation injury<\/li>\n<li>Electrical, friction, cold or chemical burn injury<\/li>\n<li>Burns associated with other injuries &#8211; crush injuries, fractures, head injury, penetrating injury<\/li>\n<li>Any burn with suspicion of NAI or self harm (for expert assessment within 24 hours)<\/li>\n<li>Any significant infection<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li style=\"list-style-type: none;\">\n<ul>\n<li>Consider referral\n<ul>\n<li>Superficial dermal burns other than those mentioned above<\/li>\n<li>Age &lt;5 or &gt;60<\/li>\n<li>Co-existing medical problems &#8211; cardiorespiratory, hepatic, diabtes, immunocompromised, pregnant<\/li>\n<li>Require admission for social reasons, pain control or if dressings are difficult to manage<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div>\n<div class=\"content-box-blue\">\n<h4>Non accidental injury<\/h4>\n<ul>\n<li style=\"list-style-type: none;\">\n<ul>\n<li>Suspect if\n<ul>\n<li>History &#8211; evasive, changing, inadequate, poor previous compliance with healthcare<\/li>\n<li>Child not independently mobile<\/li>\n<li>Unusual area of burn<\/li>\n<li>Unusual shape of burn<\/li>\n<li>Evidence of forced immersion<\/li>\n<li>Delayed presentation or inconsistency between age of burn on examination and history<\/li>\n<li>No splash marks<\/li>\n<li>Signs of restraint on limbs<\/li>\n<li>Sparing of flexion creases (i.e. child in the foetal position when burnt)<\/li>\n<li>Other signs of physical abuse<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li style=\"list-style-type: none;\"><\/li>\n<\/ul>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Data gathering History Type of burn &#8211; flame, scald, electrical, chemical Inhalation injury &#8211; singed nasal hair, black carbon in sputum PMH Evidence of NAI &#8211; see below Social circumstances Examination Assess extent of burn &#8211; Lund and Browder chart Assess depth of burn Depth Former terminology Appearance Superficial epidermal First degree Red and painful &hellip; <a href=\"https:\/\/papergp.com\/index.php\/others\/misc\/burns-and-scalds\/\" class=\"more-link\">Continue reading <span class=\"screen-reader-text\">Burns and Scalds<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":2487,"menu_order":198,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-1902","page","type-page","status-publish","hentry"],"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/1902","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/comments?post=1902"}],"version-history":[{"count":3,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/1902\/revisions"}],"predecessor-version":[{"id":2460,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/1902\/revisions\/2460"}],"up":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/2487"}],"wp:attachment":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/media?parent=1902"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}