Page 402 - ATP-P 11th Ed

Burn Quick Reference Guide

Type of Injury
1. First Degree: superficial, involving only epidermal damage
a. erythematous and painful due to intact nerve endings
b. heal in 5 to 10 days; pain resolves within 3 days
c. no residual scarring
2. Second Degree: partial thickness, involving the epidermis and dermis
a. more superficial burns are moist and blister; deeper burns are white and dry, blanch
with pressure, and have reduced pain
b. heal in 10 to 14 days
c. can develop into third degree burns with infection, edema, inflammation and ischemia
d. treatment varies with degree of involvement – grafting is indicated for deep burns
3. Third Degree: full-thickness, most severe of burns
a. results in necrosis and avascular areas
b. tough, waxy, brownish leathery surface with eschar, numb to touch
c. grafting required
d. usually have permanent impairment
4. Fourth Degree: full-thickness as well as adjacent structures such as fat, fascia, muscle
or bone
a. reconstructive surgery is indicated
b. severe disfigurement is common
Body Surface Area (BSA)
1. Adult
a. “rule of nines”: each arm is 9% of BSA, leg is 18%, anterior trunk is 18%, posterior
trunk is 18%, head is 9%, and perineum is 1% (see chart)
2. Children
SECTION 5 b. children under 10 years old should be evaluated by the Lund-Browder burn chart
a. BSA varies with age (children have a larger percentage of body surface area which
exaggerates fluid losses)
(see chart)
c. quick method: the patient’s palm is 1% of the total body surface area
Severity
1. Minor:
a. partial thickness: <15% BSA in adults, <10% BSA in children
b. full thickness: <2% BSA

392 SECTION 5 BURN QUICK REFERENCE GUIDE