Burns (DETAILED) Overview - Types, Pathophysiology, TBSA

Summary

This video discusses burns, focusing on their types, causes, and pathophysiology. It outlines the skin's anatomy, explaining how burns can damage various skin layers, leading to complications like infection and fluid loss. The presentation covers the Jackson model of burn zones and emphasizes the importance of understanding burn depth—distinguishing between superficial and deep burns. It also details the rule of nines for assessing total body surface area affected by burns, and highlights critical factors for referring patients to specialized burns units, such as burn type, depth, and patient demographics.

Takeaways

• 🔥 Burns are injuries caused by heat, friction, electricity, radiation, or chemicals, and can be categorized into various types.
• 🩺 Understanding the skin anatomy is crucial, as it consists of three layers: the epidermis, dermis (which includes the papillary and reticular layers), and hypodermis (subcutaneous fat).
• 🧪 The three dangerous types of burns are chemical burns, electrical burns, and inhalation burns, which can lead to severe complications.
• 🔬 The pathophysiology of burns includes the 'zones of burn injury': zone of coagulation (maximum damage), zone of stasis (potential for further necrosis), and zone of hyperemia (increased recovery potential).
• 🌡️ Superficial burns affect only the epidermis and upper dermis, typically presenting as red, painful, and moist with possible blistering.
• 🧊 Deep burns can be classified into deep partial thickness burns and full thickness burns, affecting all skin layers and potentially resulting in loss of sensation.
• 📏 Assessing burn depth and total body surface area (TBSA) is critical for treatment decisions; the 'Rule of Nines' is a commonly used method.
• 🤕 Full thickness burns and burns covering more than 10% of TBSA require referral to a specialized burns unit for advanced care.
• 👶 Vulnerable populations, such as the very young and elderly, as well as burns on special areas (face, hands, genitals), should also be referred to a burns unit.
• ⚠️ Circumferential burns can lead to compartment syndrome, necessitating prompt referral to prevent irreversible damage.

Q & A

What are the primary layers of skin discussed in the video?

The primary layers of skin are the epidermis, dermis (which includes the papillary and reticular layers), and the hypodermis (subcutaneous fat).

What are the different types of burns mentioned?

The different types of burns include thermal burns, chemical burns, electrical burns, inhalation burns, and radiation burns.

What is the significance of understanding skin anatomy in assessing burns?

Understanding skin anatomy is crucial for assessing the extent and depth of burns, which informs treatment and management strategies.

What are the three zones of burn injury according to the Jackson model?

The three zones of burn injury are the zone of coagulation (maximum damage), the zone of stasis (decreased perfusion), and the zone of hyperemia (increased perfusion).

What distinguishes superficial burns from deep burns?

Superficial burns affect only the epidermis and upper dermis, presenting as red and painful with blisters, while deep burns extend through all layers of the skin and often appear dry and non-blanching with minimal to no sensation.

What is the 'rule of nines' used for in burn assessment?

The 'rule of nines' is used to estimate the total body surface area affected by burns by dividing the body into sections that represent approximately 9% or multiples thereof.

What are the criteria for referring burns to a specialized burns unit?

Criteria for referral include full thickness burns, burns greater than 10% of total body surface area, burns in young or old patients, burns on special areas (head, major joints, genitals, hands, feet), and circumferential burns.

What complications can arise from circumferential burns?

Circumferential burns can lead to compartment syndrome, where pressure builds up in muscular compartments, causing diminished blood supply and potential irreversible damage.

How do superficial partial thickness burns differ from full thickness burns?

Superficial partial thickness burns involve the epidermis and upper dermis with the potential for blistering and pain, whereas full thickness burns damage all skin layers, resulting in a dry, waxy appearance with no sensation.

What is the Palmer method used for?

The Palmer method is used to estimate small scattered burns, where the area of the patient's palm and fingers represents 1% of the total body surface area.