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Encyclopedia > Burn (injury)
Burn (injury)
Classification & external resources
ICD-10 T20.-T31.
ICD-9 940-949.99
DiseasesDB 1791
MeSH D002056

In medicine, a burn may be an injury caused by heat, cold, electricity, chemicals, friction or radiation (e.g. a sunburn). Look up burn, burning, burned in Wiktionary, the free dictionary. ... Image File history File links Emblem-important. ... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO). ... // S00-T98 - Injury, poisoning and certain other consequences of external causes (S00-S09) Injuries to the head (S00) Superficial injury of head (S01) Open wound of head (S02) Fracture of skull and facial bones (S03) Dislocation, sprain and strain of joints and ligaments of head (S04) Injury of cranial nerves... // S00-T98 - Injury, poisoning and certain other consequences of external causes (S00-S09) Injuries to the head (S00) Superficial injury of head (S01) Open wound of head (S02) Fracture of skull and facial bones (S03) Dislocation, sprain and strain of joints and ligaments of head (S04) Injury of cranial nerves... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... The Disease Bold textDatabase is a free website that provides information about the relationships between medical conditions, symptoms, and medications. ... Medical Subject Headings (MeSH) is a huge controlled vocabulary (or metadata system) for the purpose of indexing journal articles and books in the life sciences. ... For the chemical substances known as medicines, see medication. ... For other uses, see Heat (disambiguation) In physics, heat, symbolized by Q, is energy transferred from one body or system to another due to a difference in temperature. ... This article is about a medical condition. ... Electricity (from New Latin ēlectricus, amberlike) is a general term for a variety of phenomena resulting from the presence and flow of electric charge. ... A chemical burn occurs when living tissue is exposed to an extremely reactive chemical substance such as a strong acid or base. ... This article does not cite any references or sources. ... A radiation burn is damage to the skin or other biological tissue caused by exposure to ionizing radiation. ...

Contents

Classification

First, Second, and Third Degree Burns.
First, Second, and Third Degree Burns.
  • First-degree burns are usually limited to redness (erythema), a white plaque, and minor pain at the site of injury. These burns usually extend only into the epidermis.
  • Second-degree burns additionally fill with clear fluid, have superficial blistering of the skin, and can involve more or less pain depending on the level of nerve involvement. Second-degree burns involve the superficial (papillary) dermis and may also involve the deep (reticular) dermis layer.
  • Third-degree burns additionally have charring of the skin, and produce hard, leather-like eschars. An eschar is a scab that has separated from the unaffected part of the body. Frequently, there is also purple fluid. These types of burns are often painless, because nerve endings have been destroyed in the burned areas.

Burns that injure the tissues underlying the skin, such as the muscles or bones, are sometimes categorized as fourth-degree burns. These burns are broken down into three additional degrees: fourth-degree burns result in the skin being irretrievably lost, fifth-degree burns result in muscle being irretrievably lost, and sixth-degree burns result in bone being charred.


A newer classification of "Superficial Thickness", "Partial Thickness" (which is divided into superficial and deep categories) and "Full Thickness" relates more precisely to the epidermis, dermis and subcutaneous layers of skin and is used to guide treatment and predict outcome.


Table 1. A description of the traditional and current classifications of burns.

Nomenclature Traditional nomenclature Depth Clinical findings
Superficial thickness First-degree Epidermis involvement Erythema, minor pain, lack of blisters
Partial thickness — superficial Second-degree Superficial (papillary) dermis Blisters, clear fluid, and pain
Partial thickness — deep Second-degree Deep (reticular) dermis Whiter appearance, with decreased pain. Difficult to distinguish from full thickness
Full thickness Third- or fourth-degree Dermis and underlying tissue and possibly fascia, bone, or muscle Hard, leather-like eschar, purple fluid, no sensation (insensate)

Serious burns, especially if they cover large areas of the body, can cause death; any hint of burn injury to the lungs (e.g. through smoke inhalation) is a medical emergency. Erythema is an abnormal redness of the skin caused by capillary congestion. ... The dermis is a layer of skin beneath the epidermis that consists of connective tissue and cushions the body from stress and strain. ... Fascia is specialized connective tissue layer which surrounds muscles, bones, and joints, providing support and protection and giving structure to the body. ... This article is about the skeletal organs. ... For other uses of Muscles, see Muscles (disambiguation). ... For other uses, see Death (disambiguation), Dead (disambiguation), Death (band) or Deceased (band). ... Human respiratory system The lungs flank the heart and great vessels in the chest cavity. ... {{Otheruses4|the medical term|the Australian television series|Medical Emergenc an immediate threat to a persons life or long term health. ...


Chemical burns are usually caused by chemical compounds, such as sodium hydroxide (lye), silver nitrate, and more serious compounds (such as sulfuric acid). Most chemicals (but not all) that can cause moderate to severe chemical burns are strong acids or bases. Nitric acid, as an oxidizer, is possibly one of the worst burn-causing chemicals. Hydrofluoric acid can eat down to the bone and its burns are often not immediately evident. Most chemicals that can cause moderate to severe chemical burns are called caustic. A chemical compound is a chemical substance formed from two or more elements, with a fixed ratio determining the composition. ... Flash point Non-flammable. ... Lye is a caustic solution used for glass and soap making. ... R-phrases , S-phrases , , , , Flash point non-flammable Supplementary data page Structure and properties n, εr, etc. ... R-phrases S-phrases , , , Flash point Non-flammable Related Compounds Related strong acids Selenic acid Hydrochloric acid Nitric acid Related compounds Hydrogen sulfide Sulfurous acid Peroxymonosulfuric acid Sulfur trioxide Oleum Supplementary data page Structure and properties n, εr, etc. ... For other uses, see Acid (disambiguation). ... Acids and bases: Acid-base extraction Acid-base reaction Acid dissociation constant Acidity function Buffer solutions pH Proton affinity Self-ionization of water Acids: Lewis acids Mineral acids Organic acids Strong acids Superacids Weak acids Bases: Lewis bases Organic bases Strong bases Superbases Non-nucleophilic bases Weak bases edit In... The chemical compound nitric acid (HNO3), also known as aqua fortis and spirit of nitre, is an aqueous solution of hydrogen nitrate (anhydrous nitric acid). ... R-phrases , S-phrases , , , , Flash point nonflammable Related Compounds Other anions Hydrochloric acid Hydrobromic acid Hydroiodic acid Related compounds Hydrogen fluoride fluorosilicic acid Supplementary data page Structure and properties n, εr, etc. ... A caustic substance, in chemistry, is one that causes corrosion, the deterioration of a material. ...


Electrical burns are generally symptoms of electric shock, being struck by lightning, being defibrillated or cardioverted without conductive gel, etc. The internal injuries sustained may be disproportionate to the size of the "burns" seen - as these are only the entry and exit wounds of the electrical current. Sign warning of possible electric shock hazard An electric shock can occur upon contact of a human or animal body with any source of voltage high enough to cause sufficient current flow through the muscles or nerves. ... Not to be confused with lighting. ... Typical view of defibrillation in progress, with the operator at the head, but clear of contact with the patient Defibrillation is the definitive treatment for the life-threatening cardiac arrhythmias ventricular fibrillation and pulseless ventricular tachycardia. ...


Survival and outcome (scars, contractures, complications) of severe burn injuries is remarkably improved if the patient is treated in a specialized burn center/unit rather than a hospital.


Scald

Two day-old scald caused by boiling radiator fluid.
Two day-old scald from taking a frying pan from an oven.
Two day-old scald from taking a frying pan from an oven.

Scalding is a specific type of burning that is caused by hot fluids or gasses. Examples of common liquids that cause scalds are water and cooking oil. Steam is a common gas that causes scalds. The injury is usually regional and usually does not cause death. More damage can be caused if hot liquids enter an orifice. However, deaths have occurred in more unusual circumstances, such as when people have accidentally broken a steam pipe. Young children, with their delicate skin, can suffer a serious burn in a much shorter time of exposure than the average adult. Also, their small body surface area means even a small amount of hot/burning liquid can cause severe burns over a large area of the body. Image File history File links Question_book-3. ... Image File history File links Download high-resolution version (1024x771, 73 KB) Scalding caused by a radiator explosion. ... Image File history File links Download high-resolution version (1024x771, 73 KB) Scalding caused by a radiator explosion. ... Not to be confused with radiata. ... Image File history File links Metadata Size of this preview: 750 × 600 pixelsFull resolution (1024 × 819 pixel, file size: 108 KB, MIME type: image/jpeg) Edited using GIMP. Attribute this work as by KevinVreeland and all works derived from it. ... Image File history File links Metadata Size of this preview: 750 × 600 pixelsFull resolution (1024 × 819 pixel, file size: 108 KB, MIME type: image/jpeg) Edited using GIMP. Attribute this work as by KevinVreeland and all works derived from it. ...


Table 2. Scald Time (Hot Water)

Temperature Max duration until injury
155F (68.3C) 1 second
145F (62.9C) 3 seconds
135F (57.2C) 10 seconds
130F (54.4C) 30 seconds
125F (51.6C) 2 minutes
120F (48.8C) 5 minutes

Cold burn

A cold burn (see frostbite) is a kind of burn which arises when the skin is in contact with a low-temperature body. They can be caused by prolonged contact with moderately cold bodies (snow and cold air for instance) or brief contact with very cold bodies such as dry ice, liquid helium, liquid nitrogen, or canned air, all of which can be used in the process of wart removal. In such a case, the heat transfers from the skin and organs to the external cold body (as opposed to most other situations where the body causing the burn is hotter, and transfers the heat into the skin and organs). The effects are very similar to a "regular" burn. The remedy is also the same as for any burn: for a small wound keep the injured organ under a flow of comfortably temperatured water; the heat will then transfer slowly from the water to the organs and help the wound. Further treatment or treatments of a more extended wound also are usual. Image File history File links Question_book-3. ... This article is about a medical condition. ... For other uses, see Snow (disambiguation). ... Look up air in Wiktionary, the free dictionary. ... Small pellets of dry ice sublimating in air. ... Helium exists in liquid form only at very low temperatures. ... General Name, Symbol, Number nitrogen, N, 7 Chemical series nonmetals Group, Period, Block 15, 2, p Appearance colorless gas Standard atomic weight 14. ... A can of canned air Canned air, also called duster or Mega-Duster, is a product consisting of liquified difluoroethane, trifluoroethane, or tetrafluoroethane in a spray can, with a very long nozzle that enables the user to direct a precisely focused blast of air. ... A wart is generally a small, rough tumor, typically on hands and feet, that can resemble a cauliflower or a solid blister. ...


Assessing burns

Burns are assessed in terms of total body surface area (TBSA), which is the percentage affected by partial thickness or full thickness burns (superficial thickness burns are not counted). The rule of nines is used as a quick and useful way to estimate the affected TBSA. Total body surface area (TBSA) is an assessment measure of burns of the skin. ...

Table 3. Rule of nines for assessment of total body surface area affected by a burn - Adult
Anatomic structure Surface area
Head 9%
Anterior Torso 18%
Posterior Torso 18%
Each Leg 18%
Each Arm 9%
Perineum 1%
Table 4. Rule of nines for assessment of total body surface area affected by a burn - Infant
Anatomic structure Surface area
Head 18%
Anterior Torso 18%
Posterior Torso 18%
Each Leg 14%
Each Arm 9%
Perineum 1%

Management

The first step in managing a person with a burn is to stop the burning process. With dry powder burns, the powder should be brushed off first. With other burns, the affected area should be rinsed with a large amount of clean water to remove foreign bodies and help stop the burning process. Cold water should never be applied to any person with extensive burns, as it may severely compromise the burn victim's temperature status. The word Foreign means originating elsewhere or in the physiological context outside the body. ...


At this stage of management, it is also critical to assess the airway status. If the patient was involved in a fire, then it must be assumed that he or she has sustained inhalation injury until proven otherwise, and treatment should be managed accordingly.


Once the burning process has been stopped, and airway status is ensured, the patient should be volume resuscitated according to the Parkland formula. This formula dictates that the amount of Lactated Ringer's solution to deliver in the first twenty four hours after time of injury is: This article or section does not adequately cite its references or sources. ... Lactated Ringers solution is a solution that is isotonic with blood and intended for intravenous administration. ...

Fluid = 4cc x %TBSA x weight in kg
%TBSA excludes any first degree burn

Half of this fluid should be given in the first eight hours post injury and the rest in the subsequent sixteen hours. The formula is a guide only and infusions must be tailored to urine output and central venous pressure. Inadequate fluid resuscitation causes renal failure and death. This article is about the urine of animals generally. ... Renal failure is the condition in which the kidneys fail to function properly. ... For other uses, see Death (disambiguation), Dead (disambiguation), Death (band) or Deceased (band). ...


Severe edema in full thickness burns may be treated by escharotomy. An escharotomy is a surgical procedure used to treat full thickness (third-degree) circumferential burns. ...


Treatment of low-grade burns

A local anesthetic is usually sufficient in managing pain of smaller first-degree and second-degree burns. Lidocaine can be administered to the spot of injury and will generally negate most pain. A local anesthetic is a drug that reversibly inhibits the propagation of signals along nerves. ... Lidocaine (INN) (IPA: ) or lignocaine (former BAN) (IPA: ) is a common local anesthetic and antiarrhythmic drug. ...


See also

Wikimedia Commons has media related to:
Burns
Wikisource has the text of the 1911 Encyclopædia Britannica article Burns and Scalds.
Look up scald in
Wiktionary, the free dictionary.

Image File history File links Commons-logo. ... Image File history File links Wikisource-logo. ... The original Wikisource logo. ... Encyclopædia Britannica, the eleventh edition The Encyclopædia Britannica Eleventh Edition (1910–1911) is perhaps the most famous edition of the Encyclopædia Britannica. ... Wikipedia does not have an article with this exact name. ... Wiktionary (a portmanteau of wiki and dictionary) is a multilingual, Web-based project to create a free content dictionary, available in over 150 languages. ... A radiation burn is damage to the skin or other biological tissue caused by exposure to ionizing radiation. ... A bruise, also called a contusion or ecchymosis, is a kind of injury to biological tissue in which the capillaries are damaged, allowing blood to seep into the surrounding tissue. ... Branding irons Livestock branding in the American west has evolved into a complex marking system still in use today. ... This article does not cite any references or sources. ... A chemical burn occurs when living tissue is exposed to an extremely reactive chemical substance such as a strong acid or base. ...

References

  • St. John Ambulance (2000). First aid: First on the Scene: Activity Book, Chapter 19. ISBN 1-894070-20-8. 

External links


  Results from FactBites:
 
Burn Injury Lawyers San Antonio, Texas - Law Offices of Pat Maloney (878 words)
Burn injuries and other types of personal injury can also be caused from serious auto accidents that occur due to defective automobile design, such as poor crashworthiness.
Moderate burn injuries include second degree burns in 15 to 20% of the body of an adult or 10 to 20% of a child.
Burn injuries can cause a worker to lose his or her job, or be unable to hold a job and earn a living.
Burn (injury) - Wikipedia, the free encyclopedia (1485 words)
In medicine, a burn is a type of injury to the skin caused by heat, cold, electricity, chemicals, or radiation (an example of the latter is sunburn).
Serious burns, especially if they cover large areas of the body, can cause death; any hint of burn injury to the lungs, for example through smoke inhalation, is a medical emergency.
Electrical burns are generally symptoms of electric shock, being struck by lightning, being defibrillated or cardioverted without conductive gel, etc. The internal injuries sustained may be disproportionate to the size of the "burns" seen - as these are only the entry and exit wounds of the electrical current.
  More results at FactBites »


 

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