BURNSBURNS& &

FROSTBITE FROSTBITE

Assist. Prof. Hülya Akan, M.D.Assist. Prof. Hülya Akan, M.D.Yeditepe University Medical FacultyYeditepe University Medical Faculty

Department of Family MedicineDepartment of Family Medicine

BURNSBURNS

A burn is damaged A burn is damaged tissue caused by tissue caused by heat, chemicals, heat, chemicals, electricity, sunlight, or electricity, sunlight, or nuclear radiation.nuclear radiation.

Burns can be caused by dry heat (like fire), wet heat (such as steam or hot liquids), radiation, friction, heated objects, the sun, electricity, or chemicals.

TYPES OF BURNSTYPES OF BURNS

PHYSICALPHYSICAL - Heat- Heat - Electricity- Electricity - Radiation- Radiation - Friction- Friction - Freezing- Freezing

CHEMICALCHEMICAL - Acid and alkali chemicals- Acid and alkali chemicals

FACTORS AFFECTING THE FACTORS AFFECTING THE SEVERITY OF BURNSSEVERITY OF BURNS

DepthDepth

ExtensionExtension

RegionRegion

The risk of infectionThe risk of infection

AgeAge

Harm to airwaysHarm to airways

Previous diseasesPrevious diseases

DefinitionDefinition

There are three levels of burns: There are three levels of burns: First-degreeFirst-degree burns burns affect only the outer layer of affect only the outer layer of the skin. They cause pain, redness, and the skin. They cause pain, redness, and swelling. swelling. Second-degreeSecond-degree burns burns affect both the outer and affect both the outer and underlying layer of skin. They cause pain, underlying layer of skin. They cause pain, redness, swelling, and blistering. redness, swelling, and blistering. Third-degreeThird-degree burns burns extend into deeper tissues. extend into deeper tissues. They cause white or blackened, charred skin They cause white or blackened, charred skin that may be numb.that may be numb.

The First degree burns

The First degree burns damage the outer layer of skin (epidermis) and cause pain, redness and swelling (erythema).

Mild, or first degree burns cause only reddening of the epidermis (outer layer of the skin), as seen in this photograph.

Second degree burns damage the epidermis and the inner layer, the dermis, causing erythema and blistering.

Burn, Blister - Close-Burn, Blister - Close-UpUp

Second degree burns produce blistering, as seen here.

Damage from third degree burns extend into the hypodermis,

causing destruction of the full thickness of skin with its nerve

supply (numbness). Third degree burns leave scars and may cause loss of

function and/or sensation.

NEGATIVE AFFECTS OF BURNSNEGATIVE AFFECTS OF BURNS

According to depth, extensiveness and According to depth, extensiveness and region it causes organ dysfunction and region it causes organ dysfunction and failure. Due to pain and loss of water it failure. Due to pain and loss of water it causes shock. Due to the microorganisms causes shock. Due to the microorganisms which found on the patient/victims own which found on the patient/victims own body, infections occur. body, infections occur.

Children under age 4 and adults over Children under age 4 and adults over age 60 have a higher chance of age 60 have a higher chance of complications and death from severe complications and death from severe burns.burns.

Burns to the head, neck, chest, and Burns to the head, neck, chest, and groin are the most dangerous. groin are the most dangerous.

FIRST AID IN HEAT BURNSFIRST AID IN HEAT BURNS

If person is still If person is still burning, prevent burning, prevent panic and panic and STOP STOP him/herhim/her

Cover the Cover the patient/victim with a patient/victim with a blanket and blanket and ROLL ROLL over and over and over and over and over, over,

Check the vital signs ABCCheck the vital signs ABC

Check if the air ways are affected.Check if the air ways are affected.Run cool water over the burn area forRun cool water over the burn area for at least 20 at least 20 MINUTESMINUTES ( if the burn is very extensive don’t do, ( if the burn is very extensive don’t do, because of loss of heat)because of loss of heat)

Think about edema, so take off rings, bracelets, Think about edema, so take off rings, bracelets, watches etcwatches etc

Take the clothes of without peeling the skin. Take the clothes of without peeling the skin.

  

Take care of hygiene and cleannessTake care of hygiene and cleanness

Don’t burst the blistersDon’t burst the blisters

Don’t put anything on the burned areaDon’t put anything on the burned area

Cover with dry, nonstick, sterile dressing, Cover with dry, nonstick, sterile dressing, keep area cleankeep area clean

Cover the patient/victim with a blanketCover the patient/victim with a blanket

Don’t bandage the burned areas togetherDon’t bandage the burned areas together

If the burned area is large and the medical If the burned area is large and the medical aid will be late and if the person is aid will be late and if the person is conciouss, give some water to prevent conciouss, give some water to prevent dehydration: 1 litre water,1 teaspoon dehydration: 1 litre water,1 teaspoon carbonate,1 teaspoon saltcarbonate,1 teaspoon salt

Call 112Call 112

Minor Burn First Aid - Minor Burn First Aid - Series: Procedure, part 1Series: Procedure, part 1

To treat a minor To treat a minor burn, run cool burn, run cool water over the water over the area of the burn area of the burn or soak it in a or soak it in a cool water bath cool water bath (not ice water). (not ice water). Keep the area Keep the area submerged for at submerged for at least 5 minutesleast 5 minutes

Minor Burn First Aid - Series: Minor Burn First Aid - Series: Procedure, part 2Procedure, part 2

After flushing or soaking After flushing or soaking for several minutes, cover for several minutes, cover the burn with a sterile the burn with a sterile bandage or a clean cloth. bandage or a clean cloth. Over the counter pain Over the counter pain medications, such as medications, such as ibuprofen or ibuprofen or acetaminophen, may be acetaminophen, may be used to help relieve the used to help relieve the pain. Minor burns will pain. Minor burns will usually heal without usually heal without further treatmentfurther treatment

First Aid In Chemical BurnsFirst Aid In Chemical Burns

Stop the contact of the chemical with the Stop the contact of the chemical with the skin as soon is possibleskin as soon is possible

Rinse the area with water 15-20 minutes Rinse the area with water 15-20 minutes gentlygently

Take the clothes offTake the clothes off

Cover the patient/victimCover the patient/victim

Call 112Call 112

First Aid In Electrical BurnsFirst Aid In Electrical Burns

Be quite and calmBe quite and calmStop the electrical current before touching the Stop the electrical current before touching the patient/victimpatient/victimIf there is no possibilty to stop the current, cut If there is no possibilty to stop the current, cut the electrical contact with a wooden rod or fiberthe electrical contact with a wooden rod or fiberDo not interfere to the person with WATERDo not interfere to the person with WATERCheck the ABC of the patient/victimCheck the ABC of the patient/victimDo not move the patient/victimDo not move the patient/victimCover the damaged areaCover the damaged areaCall 112Call 112

Burns: Do NotBurns: Do Not

DO NOT apply ointment, butter, ice, medications, fluffy cotton DO NOT apply ointment, butter, ice, medications, fluffy cotton dressing, adhesive bandages, cream, oil spray, or any household dressing, adhesive bandages, cream, oil spray, or any household remedy to a burn. This can interfere with proper healing. remedy to a burn. This can interfere with proper healing. DO NOT allow the burn to become contaminated. Avoid DO NOT allow the burn to become contaminated. Avoid breathing or coughing on the burn. breathing or coughing on the burn. DO NOT disturb blistered or dead skin. DO NOT disturb blistered or dead skin. DO NOT remove clothing that is stuck to the skin. DO NOT remove clothing that is stuck to the skin. DO NOT give the person anything by mouth, if there is a severe DO NOT give the person anything by mouth, if there is a severe burn. burn. DO NOT immerse a severe burn in cold water. This can cause DO NOT immerse a severe burn in cold water. This can cause shock. shock. DO NOT place a pillow under the person's head if there is an DO NOT place a pillow under the person's head if there is an airway burn and he or she is lying down. This can close the airway burn and he or she is lying down. This can close the airway. airway.

HEAT STROKEHEAT STROKE

High temperatures and humidity results High temperatures and humidity results uncontrolled body heat. The signs of heat uncontrolled body heat. The signs of heat stroke: stroke:

- Muscle cramps- Muscle cramps

- Tiredness- Tiredness

- Vertigo, dizziness- Vertigo, dizziness

- Behavioural disorders, anxiety- Behavioural disorders, anxiety

- Pale and warm skin- Pale and warm skin

HEAT STROKEHEAT STROKE

- Sweating (later on decreases)Sweating (later on decreases)- Stomach crampsStomach cramps- Nausea, vomitingNausea, vomiting- Loss of consiousness, day dreamsLoss of consiousness, day dreams- Rapid pulseRapid pulse

FİRST AID IN HEAT STROKEFİRST AID IN HEAT STROKE

Take the patient cool and airfresh placeTake the patient cool and airfresh place

Take the clothes offTake the clothes off

Lay down back and elevate arms and legsLay down back and elevate arms and legs

If conciouss and no vomiting, to replace If conciouss and no vomiting, to replace salt and water loss give 1 liter water- 1 salt and water loss give 1 liter water- 1 teaspoon baking powder- 1 teaspoon salt teaspoon baking powder- 1 teaspoon salt mixture or soda mixture or soda

RISK GROUPS IN HEAT STROKERISK GROUPS IN HEAT STROKE

Cardiac patientsCardiac patientsHypertensive patientsHypertensive patientsDiabetic patientsDiabetic patientsCancer patientsCancer patientsVery low or very high body weightVery low or very high body weightPhyscologic or physciatric patientsPhyscologic or physciatric patientsNephrology patientsNephrology patientsOver 65 yrs oldOver 65 yrs oldYounger than 5 yrs oldYounger than 5 yrs oldPregnantsPregnantsContionous and unconciouss diet Contionous and unconciouss diet People who does not drink enough waterPeople who does not drink enough water

PREVENTION IN HOT SUMMER PREVENTION IN HOT SUMMER DAYSDAYS

Appropiate accessories like sun glasses, Appropiate accessories like sun glasses, umbrella, hat to protect from sun lightumbrella, hat to protect from sun light

Light dresses appropiate with climateLight dresses appropiate with climate

Drink lots of waterDrink lots of water

Regular and enough meal portionsRegular and enough meal portions

Not use unnecessary and non-prescribed drugsNot use unnecessary and non-prescribed drugs

Do not exposure to direct sun lightDo not exposure to direct sun light

Refresh air in closed areas regularlyRefresh air in closed areas regularly

FFrostbiterostbite

FFrostbiterostbite

Frostbite is the freezing of Frostbite is the freezing of a part of the body, most a part of the body, most often the often the nose, ears, nose, ears, cheeks, fingers or toescheeks, fingers or toes..

Because of extreme cold, Because of extreme cold, blood can’t circulate to blood can’t circulate to the affected area and the affected area and tissue harm occurs due to tissue harm occurs due to coagulation of the blood coagulation of the blood in the affected area.in the affected area.

FFrostbiterostbite

Alternate NamesAlternate Names : : Cold Exposure - Cold Exposure - ExtremitiesExtremities

FFrostbiterostbite

FIRST DEGREEFIRST DEGREE- Mildest form, with early intervention heals quicklyMildest form, with early intervention heals quickly- There is paleness of skin and sensation of coldThere is paleness of skin and sensation of cold- There is numbness and weaknessThere is numbness and weakness- Later on redness and tingling sensation Later on redness and tingling sensation

SECOND DEGREESECOND DEGREE - With increasing length of time the signs become more prominent With increasing length of time the signs become more prominent - Feeling of stretching on the affected areaFeeling of stretching on the affected area- Edema, swelling, pain and blistersEdema, swelling, pain and blisters- When healing blistres turn to black crustsWhen healing blistres turn to black crusts

THIRD DEGREETHIRD DEGREE- Irreversible damage of tissuesIrreversible damage of tissues- There is a black area with clear cut There is a black area with clear cut

margins form healthy skin margins form healthy skin

Frostbite: PreventionFrostbite: Prevention

Be aware of factors that can contribute to Be aware of factors that can contribute to frostbite, such as extreme cold, wet clothes, frostbite, such as extreme cold, wet clothes, high winds, and poor circulation. This can be high winds, and poor circulation. This can be caused by tight clothing or boots, cramped caused by tight clothing or boots, cramped positions, positions, fatigue, certain , certain medicationsmedications, , smoking, smoking, alcohol usealcohol use, or , or diseasesdiseases that affect that affect the the blood vesselsblood vessels, such as , such as diabetesdiabetes..

Frostbite: First AidFrostbite: First Aid

Shelter the victim from the cold and move Shelter the victim from the cold and move the victim to a warmer place. the victim to a warmer place. Keep the patient/victim calmKeep the patient/victim calmDo not move the patient/victimDo not move the patient/victimRemove any constricting jeweRemove any constricting jewelllleery and wet ry and wet clothing. clothing. Cover with dry dressings and give Cover with dry dressings and give some hot liquids. some hot liquids. Put dressings between Put dressings between frostbitten fingers or toes to keep them frostbitten fingers or toes to keep them separated.separated. Do not burst the blistersDo not burst the blisters

Frostbite: First AidFrostbite: First Aid

Do not rub the affected areaDo not rub the affected area

Keep the hands and feet in natural Keep the hands and feet in natural positionposition

After warming if there is still numbness, After warming if there is still numbness, wrap the affected areawrap the affected area

Elevate arms and legsElevate arms and legs

Call 112Call 112

Frostbite: Do NotFrostbite: Do Not

DO NOT thaw out a frostbitten area if it cannot DO NOT thaw out a frostbitten area if it cannot be kept thawed. Refreezing may make tissue be kept thawed. Refreezing may make tissue damage even worse. damage even worse. DO NOT use direct dry heat (such as a radiator, DO NOT use direct dry heat (such as a radiator, campfire, campfire, heating padheating pad, or hair dryer) to thaw the , or hair dryer) to thaw the frostbitten areas. Direct heat can frostbitten areas. Direct heat can burnburn the the tissues that are already damaged. tissues that are already damaged. DO NOT rub or DO NOT rub or massagemassage the affected area. the affected area. DO NOT disturb DO NOT disturb blistersblisters on frostbitten skin. on frostbitten skin. DO NOT smoke or drink alcoholic beverages DO NOT smoke or drink alcoholic beverages during recovery as both can interfere with blood during recovery as both can interfere with blood circulation. circulation.