¶ … Burns

Nowlin (2006) notes that nurses need to treat burn victims as trauma patients by treating the whole person before devoting exclusive attention to the burn itself. Although most burn wounds are minor, as many as half of the one million burn cases that occur in the United States each year must be referred to specialized burn treatment centers. In all cases, nurses should first conduct a primary intake survey including the ABCs: assessing airway, breathing and circulation. During the primary survey, nurses may notice patients who have difficulty breathing and who may require instant intubation. Nowlin (2006) claims that erring on the side of caution may prevent problems from arising later on in treatment, because smoke inhalation can cause swelling that makes intubation more difficult. In the case of major burn victims, nurses should administer an IV to make up for fluids loss.

During a second survey, the nurse can examine the burn, taking into account and recording its severity and extent of total body surface area (TBSA). Assessment procedures are different for children. The nurse should take care to leave in place any clothing that directly touches the wound, while attempting to expose the burn as completely as possible. Patients should be kept warm and if necessary, offered pain relief medication. Third-degree burns usually demand immediate transportation to a specialized burn center, in which case no creams should be administered. Minor burns, on the other hand, can be treated with lotion or, if blisters have formed, by washing with a mild antibacterial soap

Fluid resuscitation is usually part of the process of treating burn victims. A risk of hypovolemia may arise from major burns and nurses should take care to monitor the patient's fluid output (urine) as well as continuing to monitor breathing. In some cases, patients with chest burns struggle to breath and may require escharotomy. When patients with severe burns undergo surgery, doctors will provide skin grafts as soon as possible to prevent the body's natural formation of scar tissue, which contracts and leaves the patient with lifelong disfigurements or impediments to normal range of motion. By treating each case individually and with care for the entire patient, nurses can ensure quality of care for burn victims.

Reference

Nowlin, a. (2006). The delicate business of burn care. RN. 69(1) Jan. 2006.