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Burns, Emergency Medicine

Gabriel Wardi and Anthony J. Medak Reviewed 06/2017
 


Basics

Description

Burns represent an acute injury to the flesh. 

Etiology

Burns can be classified into 7 categories 
  • Scalds: Hot liquids, grease, or steam

  • Contact: Hot or cold surfaces

  • Thermal: Fire or fla...

Diagnosis

Signs and Symptoms

  • Most burns will have external signs of trauma to the skin

  • Inhalation injury

    • Facial burns, pharyngeal injection

    • Singed nasal hair/eyelashes

    • Carbonaceous sputum

    • Change in respirat...

Treatment

Pre-Hospital

  • Stop the burning process, remove smoldering/contaminated clothes/jewelry

  • Keep patient warm, cool affected areas

  • Establish patent airway, frequent reassessment, start 100% oxygen

    • Ear...

Follow-Up

Disposition

Admission Criteria

  • Injuries requiring admission

    • Partial-thickness burns of noncritical areas (excludes eyes, ears, face, hands, feet, or perineum) involving 10–20% of BSA in adults ...

Pearls and Pitfalls

  • Early IV fluid rehydration is essential

  • Intubate early for signs of respiratory distress; must recognize potential for airway involvement

  • Early pain control in all burns

  • Monitor for h...

Additional Reading

  • Committee on Trauma, American College of Surgeons. Guidelines for the operation of burn units. Resources for Optimal Care of the Injured Patient;  2006:79–86.

  • Pham  TN, Cancio  ...

Codes

ICD9

  • 949.0 Burn of unspecified site, unspecified degree

  • 949.1 Erythema [first degree], unspecified site

  • 949.2 Blisters, epidermal loss [second degree], unspecified site

  • 949.3 Full-thickness skin los...

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