Question

A young boy, age 2 years, pulled a pot of boiling water over his head, arms, and chest, resulting in a mixed burn to the anterior surface of his head and arms, chest, and feet.

Discuss the factors that determine the classification of the types of burns and determine what type(s) this victim probably has. (See Classification of Burns.)

Discuss how the physicians in the emergency room will determine the percentage of the body that may be burned and what special considerations may be involved when evaluating a child. (See Percentage of BSA Burned.)

Discuss the additional effects associated with burns and the treatments involved, which include shock, pain, electrolyte and fluid imbalances, respiratory complications, infection, metabolic problems, and anemia. (See Effects of Burn Injury.)

Discuss the actions to promote the healing of burns. Specifically address the problems that may be associated with scarring and the effects of growth that this 2-year-old may experience. (See Healing of Burns.)

Answer 1

1. Factors that determine the classification of a burn are as follow:-
- the surface of the body affected
- depth of damage to the skin.
- The child had partial thickness scald burns over his head, arms and chest.
- Partial thickness burns are involving the epidermis and part of the dermis. It is second degree burn.
- Degree of burns are as follow-
(i) first degree burn- only epidermis is involved.
(ii) second degree burn:- (partial thickness burns) affect the epidermis and the dermis.
(iii) third degree burn:- also called full thickness burn go through the dermis and deeper tissues.

2. When determining the percentage of the body that is burned the physician would use the rule of nines.
- The rule of nine breaks down sections of the body into percentages.
- it is a method of estimating the extent of burns, expressed as a percentage of total body surface.
head and neck- 9%
anterior trunk- 18%
posterior trunk -18%
upper limbs- 18%
lower limbs -36%
genitalia and perineum- 1%