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Do I have Fire?
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One goal of assessment is to determine the depth of skin and tissue damage. A partial-thickness burn damages the epidermis and part of the dermis, whereas a full-thickness burn affects the full dermis and, possibly, subcutaneous tissue. A more traditional method gauges burn depth by degrees. However, most burns are a combination of different degrees and thicknesses. (See Gauging burn depth.)
Burn degrees are classified as follows:
❑ First degree — Damage is limited to the epidermis, causing erythema and pain.
❑ Second degree — The epidermis and part of the dermis are damaged, producing blisters and mild to moderate edema and pain.
❑ Third degree — The epidermis and the dermis are damaged. No blisters appear, but white, brown, or black leathery tissue and thrombosed vessels are visible.
❑ Fourth degree — Damage extends through deeply charred subcutaneous tissue to muscle and bone.
Another assessment goal is to estimate the size of a burn, which is usually expressed as the percentage of body surface area (BSA) covered by the burn. The Rule of Nines chart usually provides this estimate, but the Lund and Browder chart is more accurate because it allows for BSA changes with age.
A correlation of the burn’s depth and size permits an estimate of its severity as follows:
❑ major — third-degree burns on more than 10% of BSA; second-degree burns on more than 25% of adult BSA (more than 20% in children); burns of hands, face, feet, or genitalia; burns complicated by fractures or respiratory damage; electrical burns; all burns in poor-risk patients
❑ moderate — third-degree burns on 2% to 10% of BSA; second-degree burns on 15% to 25% of adult BSA (10% to 20% in children)
❑ minor — third-degree burns on less than 2% of BSA; second-degree burns on less than 15% of adult BSA (10% in children).
Here are other important factors in assessing burns:
❑ Location — Burns on the face, hands, feet, and genitalia are the most serious because of possible function loss.
❑ Configuration — Circumferential burns can cause total occlusion of circulation in an extremity as a result of edema. Burns on the neck can produce airway obstruction, whereas burns on the chest can lead to restricted respiratory expansion.
❑ History of complicating medical problems — Note any disorders that impair peripheral circulation, especially diabetes, peripheral vascular disease, and chronic alcohol abuse.
❑ Patient age — Victims younger than age 4 or older than age 60 have a higher incidence of complications and, consequently, a higher mortality.
❑ Smoke inhalation — This can result in pulmonary injury. Inhalation injury should be suspected if the victim was in an enclosed space.
❑ Other injuries sustained at the time of the burn — Explosion and blast injuries can be caused by the person being thrown or falling from a height, resulting in other traumatic injuries.
Source: Professional Guide to Diseases (Eighth Edition), 2005
Symptoms will vary depending on the degree of burn. Suspect burn injury when the patient presents with blisters, pain, peeling skin, red skin, edema, white or charred skin, or signs of shock. Suspect an airway burn if you see charred mouth, burned lips, burns on the head, neck, or face; wheezing, change in voice, difficulty breathing and coughing; singed nose hairs or eyebrows; or dark carbon-stained mucous.
Source: Handbook of Diseases, 2003
These general reference articles may be of interest in relation to medical signs and symptoms of disease in general:
The symptom information on this page attempts to provide a list of some possible signs and symptoms of Fire. This signs and symptoms information for Fire has been gathered from various sources, may not be fully accurate, and may not be the full list of Fire signs or Fire symptoms. Furthermore, signs and symptoms of Fire may vary on an individual basis for each patient. Only your doctor can provide adequate diagnosis of any signs or symptoms and whether they are indeed Fire symptoms.
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