Burns

I am scared of burns. I don't know what to do but after seeing burns for a few times, I start to get some understandings of it. I tend to follow the following principles (hopefully most of the burns we see at GP clinic is just minor burns):

1.  Assess the whole person, follow the principle of ABC 

2.  Know when to refer, the burns unit is available 24/7 for you to get advice (please go to RCH website), refer 

• All full thickness burn
• Circumferential burns
• All burns to face, eyes, ears, hands, feet, genitalia, perineum or a major joint, even if less than 10 %
• Chemical burns
• Electrical burns
• Burns associated with significant fracture or other major injury 
• All inhalation or airway burns
• Burns in children under the age of 12 months
• It is out of your/your hospital's comfort zone 

3. Assess the TBSA of burns. In children, their palm size is around 1 % of their body surface area. In adults, you can use your palm to gauge

4. Categorize burns into the following 3 categories and treat accordingly:

• superficial: only epidermis is involved
• superfical partial thickeness: dermis is involved, forms blister, fixomull 
• superficial deep thickness: hist white slough, red mottled, sluggish capillary return
• Full thickness: dry, charred whitish, absent capillary return 

5. 

superficial burn --> can leave it open, in infants  use non adherent dressing

partial thickness burn --> mepilex Ag Tm with crepe bandage or acticoat 3/7

Full thickness burn --> refer 

Reference:

1. RCH burns guideline