burns%20-%20initial%20management
BURNS - INITIAL MANAGEMENT
Thermal burns are burns due to external heat sources that raises skin and tissue temperature causing tissue cell death or charring. Flame is the most common type of burn. Inhalation injury is found in 30% of victims of major flame burns.
Chemical burns are due to strong acids, alkalis, detergents or solvents coming into contact with the skin. Tissues are damaged by protein coagulation or liquefaction rather than hyperthermic activity.
Electrical burns are due to electrical current or lightning coming in contact with the body.
First degree burns or superficial burns appears similar to sunburn that is painful, dry, swollen, erythematous without blisters and involves only the epidermis.
Second degree burns or partial-thickness burns has appearance of moist blebs, formation of vesicle and blister; underlying tissue is mottled pink and white with good capillary refill; this involves the entire epidermis and a variable portion of the dermal layer.
Third degree burns or full-thickness burns appears dry, leathery eschar, mixed white waxy, khaki, mahogany and soot stained. It involves the entire epidermis and dermis, leaving no residual epidermis cells, may include fat, subcutaneous tissue, fascia, muscle and bone.
  1. Fenlon S, Nene S. Burns in children. Contin Educ Anaesth Crit Care Pain. Oxford Univ Press. 2007;7(3):76-80. http://e-safe-anaesthesia.org/e_library/08/Burns_in_children_CEACCP_2007.pdf.
  2. American Heart Association. First aid. 2005 International consensus conference on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations. Circulation. 2005 Nov;112(Suppl 3):115-125. http://circ.ahajournals.org/content/112/22_suppl/III-109.full.pdf.
  3. Hettiaratchy S, Papini R. Initial management of a major burn: 1-overview. Br Med J. 2004 Jun;328(7455):1555-1557. PMID: 15217876
  4. Antoon AY, Donovan MK. Burn injuries. In: Behrman RE, Kliegman RM, Jenson HB, eds. Nelson textbook of Pediatrics. 18th. Philadelphia, PA: Saunders, Elsevier Inc; 2007.
  5. Johnson HD. Trauma, burns, and common critical care emergencies. In: Robertson J, Shilkofski N, eds. The Harriet Lane handbook: a manual for pediatric house officers. 17th ed. Philadelphia: Mosby, Elsevier; 2005
  6. MedWorm http://www.medworm.com/rss/index.php/Dermatology/12/ http://www.medworm.com/rss/medicalfeeds/specialities/Dermatology-News.xml
  7. MedWormhttp://www.medworm.com/rss/index.php/Pediatrics/33/http://www.medworm.com/rss/medicalfeeds/specialities/Pediatrics.xml
  8. Demling RH, DeSanti L, Orgill DP. Initial management of burn patients. http://www.burnsurgery.org/Documents/index_doc.htm
  9. Bruno A, Bentley A, Cavalli M. Clinical practice guideline: fluid resuscitation and management of the burn patient. University of New Mexico Health Science Center. Mar 2004.
  10. Hartford CE. Care of outpatient burns. In: Herndon DN. Total Burn Care. 4th ed. Philadelphia, PA: Elsevier Inc; 2012.
  11. Lloyd EC, Rodgers BC, Michener M, Williams MS. Outpatient burns: prevention and care. Am Fam Physician. 2012 Jan;85(1):25-32. http://www.aafp.org/afp/2012/0101/p25.pdf. PMID: 22230304
  12. Work Loss Data Institute. Burns. Work Loss Data Institute. http://www.guideline.gov/content.aspx?id=47573. 2011.
Editor's Recommendations
Most Read Articles
21 Apr 2020
A bidirectional association exists between alopecia areata (AA) and major depressive disorder (MDD) among probands and unaffected siblings, reveals a study. This suggests that shared familial mechanisms tend to cause AA and MDD.
16 Feb 2020
A 1.5% ruxolitinib cream does not seem to be effective for patients with alopecia areata, a recent phase II study has found.
17 May 2020
Treatment with serlopitant helps lessen pruritus associated with mild-to-moderate psoriasis, results of a phase II trial have shown. This supports the continued development of serlopitant for this condition.
Roshini Claire Anthony, 18 May 2020

Post hoc analyses of the LIBERTY AD SOLO 1 & 2* and ADOL** trials demonstrated significant reductions in pruritus, anxiety, and depression with dupilumab in adults and adolescents with moderate-to-severe atopic dermatitis (AD).