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Burn Injury Treatment

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Proper burn injury care is determined by a variety of factors, including the type, depth, location and severity of the burn, the age of the patient, pre-existing medical conditions and presence of inhalation injuries and/or other injuries associated with the accident.

Serious burns are one of the most painful personal injuries a person can suffer. Many patients require hospitalization, surgery, rehabilitation and counseling over a long period of time. Victims of burn injuries may be able to file a personal injury lawsuit against the person or parties responsible to recover compensation that can help defray the cost of care. It is important to contact a personal injury attorney as soon as possible to make sure your legal rights are protected, learn about burn injury settlements and to adhere to statutes of limitations. Those who have been accused of causing an accident that led to injuries should consider speaking to a defense lawyer such as lawyers to fight DWI arrest.

Emergency Burn Injury Care

Decisions made in the minutes and hours immediately following burn injuries can save the life and or improve the outcome of the patient. Emergency treatment is dependent on the burning agent (flames, chemicals or electricity) and the severity (minor versus moderate to severe) of the burn. The Mayo Clinic and the Burn Institute offer the following recommendations for emergency burn care.

Minor Burns. Minor burns — which generally means sunburns and thermal burns that are superficial (first degree) or partial thickness (second degree) depth and are smaller than the palm of the hand and do not affect substantial portions of the face, hands, feet or perineum — can usually be treated as follows:

  • Apply cool running water or cold compresses to thermal burns (burns from external heat sources such as flames and hot liquids) for a few minutes. Do not apply ice or ointments or pop any blisters.
  • Keep the burn clean and dry with loosely sterile coverings.
  • Manage pain with over-the-counter medication. If pain, blistering or signs of infection persist, contact a physician.

Moderate to Severe Burns. For moderate to severe burns, it is important to call 911 or seek medical attention right away. Moderate to severe burn injuries can include:

  • Burns larger than the size of the palm
  • Burns involving substantial portions of the eyes, ears, face, hands, feet or perineum
  • Burns that are grey, white, or leathery in appearance and/or painless, indicating a deep partial thickness or full thickness burn
  • Suspected smoke inhalation injuries
  • All chemical and electrical burns, as damage is not always immediately obvious

While waiting for help to arrive, the following steps are recommended:

  • Do not remove burnt clothing
  • Do not immerse large severe burns in cold water because it can cause shock
  • Begin rescue breathing if the burn victim is not breathing (if you are trained in rescue breathing)
  • Begin CPR if the burn victim has no detectable pulse and no signs of breathing (if you are trained in CPR)
  • Elevate the burned body part or parts
  • Cover the area of the burn with a cool, moist, sterile bandage; clean, moist cloth; or moist towels

Burning Agent. Special considerations related to the burning agent include:

  • If the victim's clothing is on fire, extinguish flames using "stop, drop and roll."
  • Due to the risk of shock or electrocution, those attending to electrical burn victims are advised not to touch the victim until the power source has been disconnected or the victim is otherwise free from the power source. Wait for help to arrive if there is any question as to the safety of the area surrounding the victim.
  • For chemical burns, flush the skin for at least 20 minutes (longer if pain persists or as directed by medical personnel). Chemical burns in the eyes should be flushed continuously until help arrives. Dry chemicals should be brushed off the skin before flushing. Remove clothing and jewelry that has been exposed to the chemicals. Call poison control if there is any possibility the substance is toxic.

Burn Transfer Criteria

Advances in burn care and increased admissions to specialized burn centers have improved outcomes in burn injury care. The American Burn Association recommends transfer to a burn center if any of the following criteria are met:

  • Chemical or electrical burns
  • Partial thickness burns covering more than 10 percent of the total body surface area (TBSA)
  • Burns covering substantial portions of the face, hands, feet, genitalia, perineum or major joints
  • Smoke inhalation injury
  • Third degree or full-thickness burns
  • Patients with certain pre-existing medical conditions
  • Children in the hospital for a burn injury without the appropriate facilities to care for them
  • Patients who will need social, emotional and/or rehabilitative interventions

Treatment for Major Burn Injuries

Patients with moderate to severe burns should be taken to a hospital or burn center. Upon admission, the team will evaluate the injury and address the patient's airway, breathing and circulation. Thereafter, burn injury care includes pain management, treatment for smoke inhalation, pre-existing medical conditions and other injuries associated with the accident, and additional treatments as follows:

Fluids. Fluid resuscitation is important to prevent and treat dehydration and shock, as well as to treat burns that cover a large area of the body. Fluids are given to help prevent kidney damage from a protein released in patients with muscle destruction.

Wound care. Infections, one of the most serious complications of burn injuries, are responsible for as many as 10,000 deaths per year in burn injury patients. Proper wound care is essential to help minimize the risk of life-threatening systemic infections. Burns must be carefully cleaned and debrided (problematic tissue removed), and covered with sterile dressings. Topical prophylaxis such as silver sulfadiazine cream or bacitracin, biobrane dressings and/or use of biologic agents such as pigskin or skin grafts all help guard against infection.

Surgery. There are several surgical procedures that may be performed to minimize burn injury complications.

  • Escharotomy is performed to remove thick, crusty surfaces that can develop in full thickness burns. These eschars can cut off blood supply to a limb or impair breathing.
  • Skin grafts involve replacing damaged skin with healthy human or synthetic tissue, preferably from another area of the patient's own body.
  • Dermabrasion and other plastic surgery procedures can help improve the appearance of scarring and other burn-related skin damage.

Rule of Nines

Accurate assessment of the percentage of total body surface area (TBSA) is an essential component of burn injury treatment. The "Rule of Nines" is the best known method for determining TBSA. The Rule of Nines attributes 9 percent of TBSA to the head and neck, and to each upper limb. Each lower limb, the anterior torso and the posterior torso represent 18 percent of TBSA each. The perineum is 1 percent. Calculations vary for children (for example, their heads account for a larger portion of TBSA).

Pressure. Scarring that grows beyond the initial wound is called hypertrophic scarring. Pressure and pressure garments can help minimize the appearance of hypertrophic scars.

Physical and occupational therapy. Physical and occupational therapy may be necessary if there is decreased mobility and function from scar contractures and other burn-related injuries.

Nutritional support. Adequate nutrition is an important part of the healing process. Since severe burns can as much as double the metabolic rate, patients need to compensate. If they are unable to meet their nutritional requirements with diet alone, supplementation can be given via feeding tube or intravenously.

Psychological support. Patients may need medication and or psychotherapy to help cope with anxiety, depression and post-traumatic stress disorder.

Compensation for Burn Injuries

Major burns may take years to heal and leave permanent scarring and disfigurement. No amount of money can undo this harm, but it can help ease the financial burden placed on the victim and his or her family. The potential award or settlement is dependent on the extent of medical and rehabilitation expenses and pain and suffering. Additional considerations include the likely impact the injuries will have on the victim's future lifestyle, earnings and physical abilities. A personal injury lawyer can protect your legal rights and help you recover any financial compensation you are entitled to.

*Source: The University of Alabama National Spinal Cord Injury Statistical Center




Did You Know?

The American Burn Association estimates 40,000 people are hospitalized for burn injury treatment each year.

Burn Centers

There are 125 specialized burn centers in the United States that average 200 admissions per year.

Source: American Burn Association