Pediatric emergency medicine trisk 3217 3217

FIGURE 104.2 Skin burns are classified as superficial, partial thickness, or full
thickness. A: Superficial burns affect only the outer layer of epidermis. B: Partialthickness burns affect the lower layers of dermis. C: Full-thickness burns destroy the
entire layer of dermis. (From Lippincott Williams & Wilkins Comprehensive Dental
Assisting , 2012: Lippincott Williams & Wilkins/Jones & Bartlett Learning, Burlington,
MA. www.jblearning.com . Reprinted with permission.)

Management
First Aid. Early cooling is accomplished by running cold water over the
injured area. If performed in the first 60 minutes after injury, it stops
ongoing thermal damage and minimizes edema, reducing progression to
full-thickness injury. Applying ice directly to the wound is often painful,
and the extreme cold can worsen the injury. Parents should be instructed not
to put grease, butter, or any ointment on the burn because these substances
do not dissipate heat well and may contaminate the area. Intact blisters
should not be broken prior to medical evaluation. Burns should be covered
with a clean cloth or bandage.
Prehospital. Prehospital care providers should focus initially on airway,
breathing, and circulation, as they would for any other patient. Rapid
transport to a hospital setting is crucial. Oxygen should be administered.
The patient should be intubated if there are signs of upper airway
compromise or impending obstruction. If transport time is likely to be
prolonged, intravenous fluids should be started.