NREMT EMT 4: Patient Treatment and Transport - Burn Management, Rule of Nines, Cooling, Dressing, Preventing Hypothermia

What This Is: Burn Management

Burns are injuries to the skin and underlying tissues caused by heat, flames, or electricity. Imagine touching a hot stove or being in a fire – it hurts and can cause serious damage. Burn management is about treating burns to prevent infection, promote healing, and reduce pain.

Key Steps / Core Facts:

• Rule of Nines: A way to estimate the size of a burn. Imagine a body divided into nine sections (head, each arm, each leg, front and back torso). Each section is 9% of the body's surface area. (Use the "9s" to estimate burn size.)
• Cooling: Remove clothing and cool the burn with cool (not cold) water for 10-15 minutes. This helps reduce pain and prevents further damage.
• Dressing: Cover the burn with a non-stick dressing or a clean, dry cloth. Avoid using ice or ice water, as this can cause further damage.
• Preventing Hypothermia: Keep the person warm with blankets or a warm bath. Hypothermia can occur when the body loses heat too quickly.
• Burn Classification: Burns are classified as first (minor), second (moderate), or third (severe) degree. First-degree burns affect only the outer layer of skin, while third-degree burns damage deeper tissues.
• Pain Management: Use over-the-counter pain medications like acetaminophen or ibuprofen to manage pain. Do not use aspirin or other medications without consulting a doctor.
• Infection Prevention: Keep the burn clean and dry, and avoid breaking any blisters that form.
• Monitoring: Watch for signs of infection, such as redness, swelling, or increased pain.
• When to Seek Help: If the burn covers a large area, is deep, or is on the face, hands, or feet, seek medical attention immediately.
• Red Flags: If the person has difficulty breathing, is confused, or has a weak pulse, call 911 or your local emergency number.

What Laypeople Can Do:

• If someone has a burn, first check for danger (oncoming traffic, fire). Then cool the burn with cool water for 10-15 minutes.
• Keep the person warm with blankets or a warm bath.
• Avoid breaking any blisters that form.
• Do not use ice or ice water to cool the burn.
• Call 911 or your local emergency number if the burn is severe or covers a large area.

Common Mistakes:

• Mistake: Not cooling the burn quickly enough.
• Fix: Cool the burn with cool water for 10-15 minutes to reduce pain and prevent further damage.
• Mistake: Using ice or ice water to cool the burn.
• Fix: Ice can cause further damage and delay healing.
• Mistake: Not keeping the burn clean and dry.
• Fix: Keep the burn clean and dry to prevent infection.

Quick Practice Scenarios:

• A child touches a hot stove and has a burn on their hand. What should you do first?
• Answer: Cool the burn with cool water for 10-15 minutes.
• Reason: This will reduce pain and prevent further damage.
• A person has a severe burn on their chest and is having trouble breathing. What should you do first?
• Answer: Call 911 or your local emergency number.
• Reason: This person needs immediate medical attention.
• A person has a burn on their arm and is experiencing pain. What should you do first?
• Answer: Use over-the-counter pain medication like acetaminophen or ibuprofen.
• Reason: This will help manage pain and promote healing.

Last-Minute Exam Cram:

• Agonal breathing is NOT normal breathing – start CPR.
• The normal body temperature range is 97.7-99.5°F (36.5-37.5°C).
• The normal heart rate range is 60-100 beats per minute.
• The normal blood pressure range is 90-120/60-80 mmHg.
• The rule of nines is used to estimate burn size.
• First-degree burns affect only the outer layer of skin.
• Second-degree burns damage deeper tissues.
• Third-degree burns damage the deepest tissues.
• Burns can be classified as first, second, or third degree.
• Cooling burns with cool water for 10-15 minutes reduces pain and prevents further damage.
• Keeping burns clean and dry prevents infection.
• Using ice or ice water to cool burns can cause further damage.
• Over-the-counter pain medications like acetaminophen or ibuprofen can be used to manage pain.
• Severe burns require immediate medical attention.