Dry heat, moist heat, direct contact with hot surfaces, chemicals, electricity,
ionizing radiation, hot water, sun burn
skin layers
epidermis, dermis, subcutaneous layer
burn injury common complications
- fluid loss
- electrolyte imbalance
- dehydration
- shock (↓ blood volume, ↓ tissue perfusion)
- infection
burn: inflammatory response
- vasodilation
- ↑ capillary permeability
- edema
,- tissue damage
- release of cytokines & prostaglandins (pain, inflammation)
burn severity
type, depth/severity, total body surface area burned
- depth
- age
- cause
- presence of other injuries
- involvement of airway & respiratory
- Overall health
rule of nines
determines TBSA% burned
- anatomic regions of the body
- add all affected burn areas
,palmer method
size of the clients hand, including fingers, is 1% TBSA
parkland formula
4 mL x % burn (TBSA) x pt weight in kg = total fluids (mL) for 24 hours
- ½ of the total volume is given over the first 8 hrs
- remaining fluid given over next 16 hrs
what IV fluid is used for burns?
lactated ringers: contains electrolytes
- fluid resuscitation for dehydration, hypovolemia, blood loss
Weight 75 kg
Deep thickness burns to anterior and posterior torso, and anterior and
posterior of both arms
, 1. What is the TBSA?
2. What is the total volume of fluid this client requires?
3. How much fluid will be administered during the first 8 hours?
4. How many mL/hr will be administered during the first 8 hours?
5. How many mL/hr will be administered during the next 16 hours?
1. 54%
2. Total fluids = 4 mL × 54% × 75 kg = 16200 mL
3. 8100 mL (half of 16200 mL)
4. 8,100 ml / 8 = 1,012.5 mL/hr
5. 8,100 mL/ 16 = 506 mL/hr
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