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General Medicine

Burns

Caleb J. Mentzer, DO, Cragin D. Currence, MD and James R. Yon, MD Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Tissue injuries caused by application of heat, chemicals, electricity, or irradiation

  • Extent of injury (depth of burn) is a result of intensity and duration of exposure.

    • 1st degree inv...

DIAGNOSIS

HISTORY

  • History of source of burn

  • In children or elderly: Check for consistency between the history and the burn’s physical characteristics.

PHYSICAL EXAM

  • 1st degree: erythema of involved tissue...

TREATMENT

  • Prehospital care

    • Remove the patient from the source of burn.

    • Extinguish and remove all burning clothing.

    • Room-temperature water may be poured onto burn but only in the first 15 minutes followin...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Early mobilization is the goal. 

DIET

  • High-protein, high-calorie diet when bowel function resumes

  • Nasogastric tube feedings may be required in early postburn period.

  • ...

REFERENCES

1
Dries DJ, Endorf FW. Inhalation injury: epidemiology, pathology, treatment strategies. Scand J Trauma Resusc Emerg Med.  2013;21:31. [View Abstract on OvidMedline]
2
Bezuhly M, Fish JS....

CODES

ICD10

  • T30.0 Burn of unspecified body region, unspecified degree

  • T30.4 Corrosion of unspecified body region, unspecified degree

ICD9

  • 949.0 Burn of unspecified site, unspecified degree

  • 949.1 Erythema [...

CLINICAL PEARLS

  • 1st degree: erythema of involved tissue; skin blanches with pressure. Skin may be tender.

  • 2nd degree: Skin is red and blistered. Skin is very tender.

  • 3rd degree: Burned skin is tough and...

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FIG. 20.1. A: Second-degree umbilical burn due to silver nitrate. B: Second-degree burn of the leg from contact with an iron. C: The buttocks of this infant show a second-degree burn as a result of being intentionally immersed in scalding water.
FIG. 20.1. A: Second-degree umbilical burn due to silver nitrate. B: Second-degree burn of the leg from contact with an iron. C: The buttoc...
FIG. 20.1. A: Second-degree umbilical burn due to silver nitrate. B: Second-degree burn of the leg from contact with an iron. C: The buttocks of this infant show a second-degree burn as a result of being intentionally immersed in scalding water.
FIG. 20.1. A: Second-degree umbilical burn due to silver nitrate. B: Second-degree burn of the leg from contact with an iron. C: The buttoc...
FIG. 20.2. Second-degree sunburn.
FIG. 20.2. Second-degree sunburn.
FIG. 20.4. Deep partial-thickness burns.
FIG. 20.4. Deep partial-thickness burns.
FIG. 20.5. Full-thickness burns.
FIG. 20.5. Full-thickness burns.
FIG. 20.8. This circumferential burn carries a high risk of leading to complications and disability.
FIG. 20.8. This circumferential burn carries a high risk of leading to complications and disability.
FIG. 20.12. Electrical hand burn.
FIG. 20.12. Electrical hand burn.
Burn: partial thickness, forearm
Burn: partial thickness, forearm
FIG. 26.3. Immersion burns. A: Hot water burn in an immersion pattern. B: Hot liquid spill burns sustained by a 6-month-old child.
FIG. 26.3. Immersion burns. A: Hot water burn in an immersion pattern. B: Hot liquid spill burns sustained by a 6-month-old child.
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