Module 4 - Thermal, Electrical and Chemical Injuries
Assessment
1. Physical Examination
- Airway – assessment and support needed
- Breathing – effort, depth and breath sounds
- Circulation – assess for shock and tissue perfusion
- Remove all clothing and jewelry
2. Mechanism of Injury - Start with careful history of burn injury, including burn source (flame, hot liquid, gas or surface, caustic chemical, electricity or radiation), environment, duration of exposure, and time of injury.
3. Associated Injuries – Can include fractures, internal organ injury, pulmonary contusions or pneumothorax incurred as burns are traumatic injuries.
4. Patient Age – Young children (<10 yrs old) and elderly (>50 yrs old) are at higher risk of morbidity than adults.
5. State of Health – Explore the patient’s past medical history, noting pre-existing medical problems that may complicate outcome or burn treatment, including any allergies, medications, history of hypertension or diabetes, and ensure a complete review of systems.
6. Pre-hospital Treatment – Any ointments or dressings self-administered or administered by the emergency response team as well as any fluid consumption, as this is important for calculating fluid requirements in the first 24 hrs of injury.
7. Depth of Burn *
- Superficial (1st degree)
- Partial-thickness (2nd degree)
- Full-thickness (3rd degree)
8. Percentage of body-surface area (BSA) estimation* (Rule of Nines)
* Key considerations for determining inpatient vs. outpatient status
Author: SP Zinn