Burn Injuries – Care, Treatment and Assessment

Burn InjuriesBurns can be caused by thermal(hot metals, steam), radiation (X-rays, UV rays), chemical (strong acids, alkalies), or electrical (alternating current, direct current) contact. Infants and the elderly are at the greatest risk for burn injury.

Burns can be classified into three degrees based on how deeply and severely they penetrate the skin’s surface. While first degree burns affect only the epidermis, or outer layer of the skin, second degree burns involve the epidermis and part of the dermis layer of the skin. Third degree burns are full thickness burns that destroy the epidermis and dermis. The burn site appears white, black or charred with a leather-like appearance. The site will be swollen, and there will be no sensation in the area since the nerve endings are destroyed.

Severe burns may even result in loss of certain physical capabilities. Acute burn wounds should be evaluated and treated by an experienced burn care provider. Non-operative management of these wounds include:

  • Cleansing
  • Debridement
  • Topical antimicrobial drugs, and
  • Dressing changes

Burn wounds need accurate assessment, effective medication and treatment by a specialist and most importantly requires appropriate follow-up. Accurate documentation of wound evaluation can be better done using advanced wound EMR software.

Healing of burn wounds depends on the depth of burns. The physician must make sure that the dressing chosen protects the wound and the surrounding skin and helps in preventing further tissue loss, removing the dead tissue and keeping the wound moist, which makes it heal faster. Burn dressing must be non- irritant and non-toxic and comfortable for the patient. It should be able to protect the wound from further physical damages and infections. It is important to keep the burn wound clean while it’s healing, and the dressing will need to be frequently changed to avoid infection.

Hydrocolloid dressings are useful for the hands and other small areas with superficial or partial thickness burns. Alginate dressings may also be appropriate as they adhere to the wound. Once the wound heals, the alginate will separate. Silver dressings aim at reducing wound bio-burden, treating local infection and preventing systemic spread.

Accurate Documentation of Burn Wounds

Regular and standardized documentation of the pain experienced is the key to successful pain management. A thorough wound assessment should occur with every dressing change. Burn wound assessment should include all details such as – severity of burns, cause of injury, depth of burn, medications and wound dressings offered. Keep the burn wound and the surrounding area clean while it’s healing. Take corresponding photos of the wound and document it with the correct dates. This can be used throughout the wound healing stages to record progress. Wound specific EMR helps document all types of wounds. It includes templates that allow nurses to enter all relevant information as well as access the patient’s history, wound assessment details and other information much faster.