Burn Injuries & Related Information
Burn injury refers to damage and/ or destruction of superficial layers of skin/ superficial fascia/ organs or tissues as a result of intense exposure to heat. The severity of burn injury is usually discussed in terms of total body surface area affected (TBSA). Other clinical criteria that are helpful in ascertaining the nature, severity and extent of damage are; involvement of sensitive tissues (like eyes, pelvis, genitals, as well), injury to air-way, the age of patient and degree of burns.
Burn injuries may occur at any place (home setting or at workplace) and although most burn are minor (also referred to as first degree burns); sometimes the deeper tissue may also get affected with much brief and intense exposure to heat.
Some common types of severe burn injuries that may take place at domestic setting are:
- Spillage of hot water from stove or scalding burns due to poorly adjusted thermostat temperature
- Accidental contact with a hot object like iron, or stove
Other examples of burn injuries that may take place at work or in domestic setting are:
- Fire eruption due to poor maintainence, mismanagement or neglect of safe storage of explosives and chemicals
- Inhalational injury to airway as a result of exposure to hot fumes, chemicals and hazardous gases
- Friction burns as a result of traumatic injuries, abrasions, road traffic accidents
- Exposure to electric current due to poorly secured electric outlets, wires and circuits
- Accidental ingestion or spillage of chemicals, bleaching agents, and corrosives
- Exposure to radiations, x- rays, sun- rays and other ionizing radiations
In order to minimize the risk of complications, it is very important to initiate prompt treatment and management to control the deeper tissue destruction and organ collapse.
Classification of burn injuries
Classification of burn injuries is somewhat complex since a lot of criteria are used in clinical practice. One well- documented and well- recognize criteria is involvement of deeper tissues.
- First degree burns are usually superficial burns that include sun- burns, Erythema (or redness of skin) after contact with an extremely brief hot object. These type of injuries usually require no long- term treatment
- Second degree burns are somewhat serious and involve deeper tissues of skin and dermis. Timely management is critical to the optimal and early healing
- Third degree burns are serious due to extensive involvement of skin, superficial fascia, deep fascia and viscera. Hospital management, surgical debridement and post- injury rehabilitation is needed in most cases.
Why are some common complications of moderate burn injuries?
Moderate to severe burns are almost always associated with short- term or long-term complications. Most common ones are:
For the sake of easy understanding, the complications of second degree or third degree burn injuries are classified into early and late:
Early complications are:
- Bacterial infection (can be prevented if appropriate prophylactic antibiotics are initiated in time). However, since most burn patients require steroids for the control of inflammation, the chances of infection are always very high.
- If bacterial infection is not controlled in time, the risk of widespread sepsis increases that may culminate in circulatory collapse
- Burn injuries destroy blood vessels and lymphatics that further delay healing and recovery.
- Electrolyte imbalance like hyperkalemia, hyponatremia
- Acute renal failure due to free filtration of myoglobin in the kidney tubules
- Multi-organ failure
- Hepatic failure
- Coagulation disorders
- Impaired mobility that may lead to permanent loss of functional independence and locomotion. Exposure to intense heat destroy connective tissue framework (ligaments, tendons and joints) leading to permanent disability.
- Overgrowth of scars (or abnormal scarring of skin in those with inherited tendency like keloids) is a leading cause of cosmetic disfigurement that may require plastic surgeries.
- Emotional or psychological trauma, depression and anxiety disorders
Assessment of burn injuries and initiating treatment for early recovery
The chances of overall survival and recovery are dependent upon the initial management and preliminary assessment of burn victim. First and foremost step of burn injury assessment and management is securing air-way and ventilation. Other measures that should be taken are:
- Securing and maintaining circulation and circulatory pressure
- Assessment of the overall severity and magnitude of burn injury
- Management of pain by neuropathic pain- killers and nerve blockers
- Taking measures to prevent infection by initiating empiric antibiotics
- Assessment of fluid and caloric requirements and delivery of macro as well as micronutrients according to American Burn Association
- Periodic change of positions and excellent nursing care to prevent bed- sores or infectious lesions.
- Management of emotional and psychological health by initiating counseling
Long term management of burn patient
In severe burn injuries the treatment and rehabilitation process continues even after the patient is discharged from hospital. This includes ensuring that physical and emotional recovery is progressive and the patient is receiving support and care from care-givers and family members. The long term management is dependent on several factors like:
- The effectiveness and relevance of the treatment given to patients
- Efficiency of care- givers in providing optimal and quality care to the burn injury victim
- Education and training of patients to optimize recovery
- Occupational therapy of patients and post- injury rehabilitation to hasten the independence of patients.
If you are looking to gather more information regarding burn injuries and possible management options and legal course of action, feel free to contact US for free legal consultation.