Question

Differentiate between first degree, second degree, third degree, and fourth degree burns.

A 55 year old man sustains third degree burns on 65% of his body from a house fire. When the patient arrives to the ED, the patient’s temperature is 35.2 C (95.3F), his weight is 67kg. How should the treatment team prioritize this patient care? What resuscitation fluid is recommended? How much (in mL’s) resuscitation fluid would you administer to this patient?

Answer 1

Ans) First-degree burns are considered mild compared to other burns. ... Second-degree burns (partial thickness burns) affect the epidermis and the dermis (lower layer of skin). They cause pain, redness, swelling, and blistering. Third-degree burns (full thickness burns) go through the dermis and affect deeper tissues.

- The treatment of third-degree burns may require the process of skin grafting or the use of synthetic skin. Severe burns covering large parts of the body may need more intensive treatments such as intravenous (IV) antibiotics to prevent infection or IV fluids to replace fluids lost when skin was burned.

- The ideal burn resuscitation is the one that effectively restores plasma volume, with no adverse effects. Isotonic crystalloids, hypertonic solutions and colloids have been used for this purpose, but every solution has its advantages and disadvantages.

- The Parkland formula for the total fluid requirement in 24 hours is as follows: 4ml x TBSA (%) x body weight (kg); 50% given in first eight hours; 50% given in next 16 hours.

4 ml × 65% × 67 kg = 17420 ml

8710 ml to be infused in first 8 hours

8710 ml to be infused in next 16 hours.