November 30th, 2023 By: Alicia Linter, CCRN, MSN, ACNP-BC
Emergency Care of Burn Injuries
Today, Alicia Linter, a Burn Nurse Practitioner, came to my class and discussed the different levels and treatments of burn injuries. She discussed how she came into her job and taught us about the life of a burn nurse in a specialist burn center. The U.S.A. Hospital has one of the largest burn centers on the Northeastern coast and they are in the top five for patient care. Some of the most common burn injuries that she sees are from burning trash or diesel burns. Alicia Linter is able to perform surgeries the same way any doctor would, she has operated on hundreds of burn victims. She discussed a new kind of ointment that is being used in modern medicine, Nexobrid. This ointment will eat off the dead/burned skin in 3-4 hours instead of a 6-hour surgery. She also used Thermal Imaging to see the depth of the burns, the deepest part of the burn will be green on the image.
Skin Structure:
The skin is separated into three separate layers; the epidermis, the dermis, and the subcutaneous tissue. A nurse can determine the type and severity of a burn by which layer of skin it affects. A first-degree burn will normally only affect the epidermis. These types of burns will heal in 3-5 days and have very minimum pain levels. A second-degree burn will begin to seep into the dermis, this is where you would find blisters and deep tissue burns. The healing time for these burns is 10-21 days. A third-degree burn would be under the category of severe dermis burn. These burns will not heal on their own and may even need a skin graft. A fourth-degree burn is usually from an electrical burn. These burns will extend past the layer of skin and to the muscles or bones. With a fourth-degree burn, the patient may need to amputate the burned area.
Treatment Goals
The goal of a burn nurse is to treat the wound at hand, while also accommodating the patient.
Some major daily goals are:
- decrease pain
- prevent infection
- promote healing
- optimize functional/cosmetic outcomes
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