Burn Injury Resource Center

Published on: November 6, 2012

Endotrachial Intubation

It is a medical procedure in which a tube is placed into the trachea to open the airway, remove blockages and to provide oxygen, medication or anesthesia. It may be attached to a machine called a respirator that will breathe for the patient while the tube is still in place. Airway control and mechanical ventilation are often necessary in the treatment of severe burn injuries.

Swelling in the upper airway is a major concern in any person with a burn injury. Swelling may lead to acute respiratory insufficiency, in children the airway is smaller therefore they are more prone to develop airway obstruction from burn. Swelling and damage to the airway may be caused by inhalation of the gases and fumes caused by combustion and/or the effect of heat on the tissue (see smoke inhalation). The extent of the damage to the airways is not directly related to the severity of skin burns and in some cases it may become the greatest therapeutic problem in a gravely burned patient.

Although obstruction of the upper airways caused by edema (swelling of the tissue) may happen acutely, it may not be present until the edema is sufficient enough to produce clinical evidence of impaired airway patency which may take 12-18 hours. Therefore it is important to monitor the patient for any difficulty in respiration even though the patient may not have any problems initially.

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Published on: October 9, 2012

Visiting a Burned Patient In The Hospital

By Larry Kramer

Burned patients need all the support they can get from family, relatives and friends. A burn injury is one of the most painful traumas a patient can ever experience.

One of the major concerns and challenges a burned patient faces is infection, (see wound infection). Burn centers have strict guidelines regarding infection control, depending on the patient’s condition. When visiting a patient with burns, you should know the visiting hours and the number of visitors allowed which may be limited depending on the patient’s condition.

Visitors may be required to wear a gown, mask, cap and gloves when visiting the patient. The nurse will give you instructions on the protective clothing to decrease the risk of infection. Look for any signs outside the patient’s door that will tell you if you have to wear these protective garments when entering the patient’s room. It’s important to follow these instructions. You have to wash your hands prior to entering and after leaving the patient. Avoid visiting the patient if you have an active cold or an infection and inform the nurse about it if you do visit.

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Published on: October 3, 2012

Tracheostomy

By Larry Kramer

It is a surgical procedure, in which a hole is created through the front of the neck and into the windpipe (trachea). A breathing tube (trach tube) is placed directly into the trachea through the opening to help the patient with breathing and to remove secretions from the lungs.

The condition that necessitated tracheostomy and the overall health of the patient will determine how long the tracheostomy will stay. A tracheostomy is usually temporary but some patients may need them for a longer period of time or even permanently.

Patients of all ages may need tracheostomy. It can be done on an emergency basis such as when there is trauma to the neck or on an elective basis. The type of anesthesia used for the procedure is general anesthesia.

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Published on: September 20, 2012

Intentional Burns

By Larry Kramer

Intentional burns are less frequent than accidental burns but can happen. They are either burns that are caused by the person to him/herself or burns caused by one person to another one. Children and elderly are susceptible to abuse by burns. In children scald and contact burn injuries are the most common type of intentional burn injury. These injuries have a higher death rate than accidental burns and require a longer stay period in the hospital. Elderly cases are reported with much less frequency than children due to embarrassment or fearing that the person who is causing the injury will repeat it again. Things that raise a suspicion of abuse are:

The story given doesn’t go along with the injury that happened.
Giving different explanations about how the accident happened.

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Published on: August 30, 2012

People’s Reaction To Scars

By Larry Kramer

One of the challenges that a burn survivor faces after discharge is the reaction of society to his/her scars. According to George Pessotti a burn survivor and the author of Reasons for Living, “most people mean no harm when they stare or ask questions. They’re simply curious; they want to know what happened to you for different reasons”

The face is the mirror of the person, the first thing that most people look at when they see a person is the face, and it gives clues about the person like background, age and mood. Scarring of the face after a burn injury may lead to psychological and social difficulties for the patient.

Burn survivors deal with scars differently, each will cope with it in his/ her own way, some will try to move on with life and forget what happened as much as they can. Others will isolate themselves from the community, live their lives in the shadow or turn to drugs and alcohol.

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Published on: August 28, 2012

Dermabrasion

By Larry Kramer

Is a surgical procedure involving the removal (sanding) of the damaged top layer of the skin using a specialized instrument called a dermabrader. This procedure is used for scars as well as other skin conditions such as wrinkles and tattoos.

Dermabrasion improves the appearance of the scar or other skin abnormality as a new layer of skin will replace the skin that has been treated. This procedure won’t entirely remove the scar or other abnormality but it will improve its appearance by softening the edges of the scar or other lesion.

The procedure can be done in a surgeon’s office or in an outpatient surgical facility. After the procedure the skin will be swollen, red and tender. Swelling gradually subsides within 2-3 weeks. You may feel some burning, itching, aching or discomfort for a while after the surgery. Pain medication, antibiotics and anti-swelling medications can be prescribed. Ointment and special dressing will help speed the healing process and your physician will give you instructions on how to care for the wound. Healing usually occurs within seven to ten days.

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Published on: August 22, 2012

Third Degree Burns to the Fingers

By Larry Kramer

Skin is a sensative organ that has many functions among which is the protection of the body against external harmful enviromental factors. The skin may be damaged when it comes in contact with a hot object. The severity of the burn depends on the intensity of the heat and the duration of time heat is applied.

Hand and finger burns are usually common and are caused by the accidental touch of boiling water or hot objects. Most of these burns are not dangerous but they are of heigh priority becauase of the functional importance of the hand and fingers therefore they have to be treated as soon as possible to avoid serious complications. Burns to the fingers can be first, second or third degree burns.

First degree burns are superficial were there is redness and blisters of the skin.

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Published on: August 21, 2012

Flammable Liquids

By Larry Kramer

Flammable and combustible liquids are liquids that can burn. These liquids give off vapors that mix with air and can catch on fire from a source of ignition causing serious burns. The vapor is actually what burns, not the liquid. The lowest temperature at which the liquid gives off enough vapor to be ignited is called the flashpoint.

Flammable and combustible liquids include gasoline, kerosene, paint and paint thinners, solvents, cleaners, polishes and others. There are certain rules to be followed to avoid serious burns from flammable liquids which include:

Read the manufacturer’s label on the flammable liquid container before its use.

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Published on: August 15, 2012

Third Degree Burns due to Natural Gas Explosion

By Larry Kramer

Natural gas can leak and lead to a gas explosion if there is a source of ignition. Gas explosions may lead to serious burn injuries including third degree burns part I, part II and smoke inhalation injuries. Appliances that may leak gas and lead to gas explosion include:

Ovens, cook tops
Gas generators.

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Published on: July 25, 2012

Factors Affecting The Healing of Burns

By Larry Kramer

Burns are wounds. Wound healing is a complex process that can be affected by many factors. These factors may include:

The age of the patient: elderly patients have delayed wound healing due to the fact that the blood supply is decreased to some parts of the skin with the presence of relative hypoxia (decreased oxygen). Very young and the elderly may not be able to mount an effective inflammatory response due to immature cells and less efficient physiological functioning respectively. See burns in geriatrics, Burns in pediatrics.
Nutrition: nutrition plays an important factor in wound healing; patients who are malnourished have a decreased collagen formation. Wound healing requires protein synthesis therefore protein requirement increases in the presence of wound. Vitamins are also important for wound healing, vitamin C is important in collagen synthesis and in maintaining the immune function. Vitamin A is also important in promoting wound healing. zinc is important for wound healing as it’s deficiency may impair wound healing, elderly are more liable for zinc deficiency due to poor intake and absorption. Zinc is important for many enzymes involved in the repair of tissue. Iron is important in collagen synthesis. Copper is also important as it’s a co-factor for an enzyme called lysyl oxidase which is needed for cross linking of collagen molecules. See Nutrition and burns, Burns and fluid replacement.

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