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Ambulatory Management of Burns

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Classification of Burns Based on Depth Characteristics

Classification Cause Appearance Sensation Healing time Scarring
Superficial burn Ultraviolet light,very short flash (flame exposure) Dry and red; blanches with pressure Painful 3 to 6 days None
Superficial partial thickness burn Scald (spill or splash),short flash Blisters; moist,red and weeping; blanches with pressure Painful to air and temperature 7 to 20 days Unusual; potential pigmentarychanges
Deep partial thickness burn Scald (spill), flame, oil, grease Blisters (easily unroofed); wet or waxy dry; variable color (patchy to cheesy white to red); does not blanch with pressure Perceptive of pressure only More than 21 days Severe (hypertrophic) risk of contracture
Full thickness Scald (immersion), flame, steam, oil, grease, chemical, high-voltage electricity Waxy white to leathery gray to charred and black; dry and inelastic;does not blanch with pressure Deep pressure only Never (if the burn affects more than 2 percent of the total surface area of the body) Very severe risk of contrac ture

Referral to a burn unit is indicated for patients who meet the criteria for major burns as defined by the ABA (Table 2). Included are patients who manifest inhalation injury or have burn marks from high-voltage electrical injury.

American Burn Associationís Grading System for Burnination of Patients

Type of burn Minor Moderate Major
Criteria: <10 percent TBSA burn in adult <5 percent TBSA burn in young or old <2 percent full thickness burn 10 to 20 percent TBSA burn in adult 5 to 10 percent TBSA burn in young or old 2 to 5 percent full-thickness burn High-voltage injury Suspected inhalation injury Circumferential burn Concomitant medical problem predisposing the patient to infection (e.g., diabetes, sickle cell disease) >20 percent TBSA burn in adult >10 percent TBSA burn in young or old >5 percent full-thickness burn High-voltage burn Known inhalation injury Any significant burn to face, eyes, ears, genitalia or joints Significant associated injuries (e.g., fracture, other major trauma)
Disposition: Outpatient management Hospital admission Referral to burn center
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Shondell
Excellent information!
Shondell  Sunday, May 16, 2010
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Burns - Ambulatory Treatment
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Burns - Extent of a Burn